I Have Read Many Different Views on Saline Vs. Silicone. What Gives Saline the "Harder" Feel? (photo)

Trying to determine which would be better for a 32B who breast fed and now has deflated, sagging boobs that engorged to a size 36C. I like the idea of saline in a sense that you can expand it while in the breast ( I feel like that would make the look more accurate ). Yet, I'm a very petite person with a small chest and would prefer to have a natural look and "feel". Suggestions are highly appreciated :)

Doctor Answers 10

Saline or silicone gel

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Saline implants have to be filled enough to prevent rippling and this can make them feel firmer than silicone gel implants.  The difference is not that much actually.  The bigger you go in size the more difference there is though.  Saline implants can be very natural and I am still using them about half the time.  I especially like the fact that you can put them in a much smaller incision.  Just make sure you visit with a Board Certified Plastic Surgeon and have all you questions ready. 



Gary Hall,MD

Kansas City Plastic Surgeon

Saline vs. Silicone For My Breast Augmentation

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I, like many other plastic surgeons, once the pocket is created inter-operatively will put in a saline sizer to determine exactly what size silicone implant would be best for the patient.  I place all my implants in through the armpit underneath the muscle.  Then I put a saline sizer inside, inflate it to the pre-operative planned size, do this bilaterally, then sit the patient up to be sure the two sides are as symmetrical as they can be.  I then replace them with silicone implants.  I get permission pre-operatively from my patients to make slight variations in their desired fill volume to allow me to assist them in getting the outcome they requested.  

Silicone gives a much more natural look and feel.  As to why saline gives a harder feel, I think the answer to this has to do with the physical properties of water vs. silicone, especially with respect to flow rates.  Also, most plastic surgeons tend to overfill saline implants so as to get less rippling, but this also leads to harder breasts.   

Saline or Silicone and what is the best implants for you

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I use a technique known as Dimensional Breast Augmentation. This involves taking a variety of measurements of your pre-surgery body, such as your height, breast width, weight, etc. Then, we discuss your goals and with this information, a suitable implant size is selected. Find out if your surgeon does this for you.

Having said this however, you would probably benefit from an implant that can give you a bit more projection. This can help give your breasts a perkier contour.

Silicone has a more natural feel simply because of the cohesive "gummy bear" like texture of the filling. Saline is firmer because essentially they are made of bags full of liquid.

Silicone versus Saline...

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each has their benefits and risks.  I have a comparison chart on my website but in summary, gel (or silicone) implants are softer, more natural, ripple less, and you are never faced with a spontaneous deflation where you awaken with one breast essentially flat.  Gel implants are softer because they compress more easily.  Put a gel and saline implant on a table and just push down on them equally and you will appreciate  the difference.

As for size, I do not use sizers as it seems to introduce an extra step that I have found is not needed.  But then I let patients size with external sizers in unpadded brassieres and a size is picked before surgery.  I've seen too  many instances where patients were unhappy when the doctor picked the size for them during surgery.  You should be able to know what size will create the look your desire.  Good luck!

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

Silicone vs. saline

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The most natural look and feel would be attained with a silicone implant.  Saline implants may feel firmer because they are a bag of water, similar to that of a balloon.  Silicone implants may feel softer because the gel is softer and feels more like your natural breast tissue.  In a petite person such as yourself, you may want to consider smaller implant sizes to be more proportionate with your frame.  


What gives Saline the Harder Feel as compared to Silicone Breast Implants

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I am in agreement with the statement that Saline Implants feel firmer that Silicone Implants because they must be overfilled in an attempt to avoid the rippling effect they can produce.  This overfill is perceived has a unnatural feel of the breast with the saline as compared to the silicone implant.  However, the feel of the saline implant has not been the most signicant concern of my patient's.  My patient's hate the rippling that can actually be seen on the side and bottom of the saline augmented breast.  My recommendations when chosing an implant are:

  1. If you are extremely thin with a cup size of B or less (which most augmentation patient's are), then you should probably consider silicone over saline
  2. If you are B cup or larger with more soft tissue laterally, then saline may be appropriate
  3. If you don't mind having the noticable rippling on the side of your augmentated breast then saline is acceptable.
  4. If you primary concern is to have a natural feeling breast then I recommend Silicone

Joseph Rucker, MD, FACS
Eau Claire Plastic Surgeon
4.7 out of 5 stars 21 reviews

Silicon implants generally feel more like a real breast

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Hi there-

Especially in thin patients, there is going to be a noticeable and significant difference in the appearance and feel of silicone implants and saline implants, regardless of placement position (although this difference will be magnified if placed on top of your muscle).

While I would have to get to know you a lot better to be able to give you more firm advice, I would say that in general, because silicone implants now come in increments of 25cc (and this is a very small jump in size from one implant to another), there is a MUCH smaller chance that you are unhappy because the silicone implants did not allow perfect sizing than of you being unhappy because the saline implants felt unnatural, showed visible wrinkling, and just weren't as pretty as you hoped.

Having said all of that, there is no doubt in my mind that of all the details that go into a well-done breast enhancement procedure, the one that is going to most significantly affect your safety, your outcome, and the experience you have, is going to be the surgeon you choose. Choose the best surgeon you can, and the other details will fall into place.

I Have Read Many Different Views on Saline Vs. Silicone. What Gives Saline the "Harder" Feel?

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Your questions/statements place you in a dual position. You want very accurate sizing but a natural look and feel. Salines are like water balloons they are filled and fell FIRMER than the silicones. While the silicones are softer more natural in look and feel. You need many in person consults in your city with boarded PSs. Ask yo feel and touch the samples of implants. 

Is silicone really softer after breast augmentation

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If a saline breast implant is filled correctly it will have a soft and 'huggable' texture and can blend will with the breast. The silicone gel is more viscous and has a 'flow' more like the natural breast and might have a better feel to some (not highly cohesive implants). The sofness is determined more often by the capsule and capsular contracture will make any implant firm and round.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 43 reviews

Silicone feels softer because it does not have to be filled as much

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Both silicone and saline would feel the same if the same volume was placed in the same implant shell.  Saline feels firmer because for any given implant shell it must be filled more than silicone implants do.  The reason for this is that a saline implant that is under-filled will likely form a sharp fold in the implant shell and eventually develop a leak.  Silicone implants on the other hand tend to maintain a smoother shell contour even when they contain less volume for the same implant shell surface as compared to saline.  I would recommend silicone as they feel and look more natural especially in thin individuals.


All the best,

Dr Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
4.9 out of 5 stars 171 reviews

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.