Received a Lot of Pressure from Dr.'s Assistant to Purchase Silicone, Was this Just for Upselling?

I haven't even gone in for my consultation yet, lets start there. I have two friends who are similar to my size and build who both got saline implants from this same doctor in '07 & '10. The Dr. went in around the nipple and they look fabulous! They both say they have the same sensitivity. The surgeon's assistant, who I spoke to, told me that 99% go silicone because of a better warranty...I had a LOT of pressure to choose the $1500 more expensive silicone than saline - is this about upselling?

Doctor Answers 8

Silicone implants have superior final appearance when compared to saline implants

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Silicone implants have a more natural feel and not subjected to rippling as saline implants.  In women who are a size A or B, rippling is often visible and I certainly recommend them in those cases.  The only reason people choose saline implants is they cannot afford the additional cost of silicone implants in my practice.

Best of Luck,

Gary Horndeski, M.D.

Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Upselling silicone?

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Implant selection is a very personal decision.  The implant is in your body and you have to be comfortable with it.  Time should be taken with you to discuss the pros and cons of each implant, as well as your anatomy and your goals for surgery before deciding on an implant.  The warranty difference is only a very small part of that.  I would recommend meeting with a few Board Certified Plastic Surgeons and contemplating the information given to you before making a final decision.  Good luck.

Mennen T. Gallas, MD
Katy Plastic Surgeon

Saline or silicone

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Silicone implants do cost the surgeon more money, about 800 to 1000 dollars more a pair.  They do not have a better warranty, so that is a non issue. You can get excellent results with either saline or silicone, but some doctors have a personal preference for one versus the other.  I prefer saline in most women because they tend to be more trouble free in the long term.  Get consultations with a few different surgeons until you find a doctor and approach that you feel comfortable with.

Ronald J. Edelson, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 29 reviews

Are silicone breast implants better than saline.

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Is the office staff recommendation of silicone gel implants over saline even before my consultation about up selling?  Maybe. You can upgrade your saline implant warranty for $100.00 to same level as gel warranty, in our experience. 

Steve Laverson, MD
San Diego Plastic Surgeon
4.9 out of 5 stars 50 reviews

Saline or Silicone Breast Implants?

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Thank you for the question.

I think it is somewhat unusual for a specific breast implant  type to have been recommended to you before consultation. Most plastic surgeons will make recommendations after examination and discussion of your goals.

The type of implant used may  determine the final outcome, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. Each patient differs in the amount of breast tissue that they have.  If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants.  If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result.

On the other hand, saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference.  Patients may need an MRI to diagnose a silicone gel rupture.   Saline implants are also less expensive than the silicone gel implants.
 Other differences involve how the breast implants are filled. Saline implants are filled after they’re implanted, so saline implants require a smaller incision than prefilled silicone breast implants.

If you have concerns about “up selling” and/or any other questions about this specific practice,  it won't hurt to seek additional consultations also.

I hope this helps.

Silicone vs saline

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This is a commonly asked question, in my practice I generally do recommend silicone over saline and no, it is not about upselling. Silicone, third generation silicone is in my opinion a better product. It weighs less, ruptures less, feels better, looks better, patients integrate it as their own much more quickly and patients in my practice who have had both hands down say silicone is their preference. The warranty is better on silicone because it has less problems. Another bonus of silicone is it doesn't age the breast as quickly as saline does. I have done beautiful augmentations with both products, but silicone is the better choice of the two. 


Good luck with your decision and your surgery.

Thomas B. Lintner, MD, FACS
Atlanta Plastic Surgeon

Upselling to silicone for breast augmentation

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Your instincts might be right in that the office is attempting to upsell you into something that you may not want. In our experience the warranty is the same, saline or gel. Still, warranty is at the bottom of the list when choosing the best implant for you. Looks like a red flag.

Best of luck, Peter Johnson, MD

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Silicone over saline

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It may just be recent experience with patient satisfaction or preference for silicone that is driving that discussion.  I will say that over 90% of the implants that I use now are silicone.  During the consultation, I discuss the pros and cons of the implants with the patient.  Thin patients with very little of their own breast tissue are often served best by silicone due to a maore natural appearance and feel.  But, they are more expensive.  I am finding that patients have a preference for the silicone.  Your surgeon may be noting the same.  Most surgeons are not making any more money for the implant choice.  The silicone implants simply cost more.  At your consult, discuss the pros and cons of the implant choices with your surgeon.  It can help you make the best decision for you.

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.