Recommendation on saline or silicone

I'm 5'1" and around 98lbs. After Breastfeeding 2 kids my once b cup breasts are deflated and uneven. I've had 2 consults. One stated the difference in size 25 ml and I would be a decent canidate for silicone implants. The other said it was 25-50ml. I worried that if I go with silicone the odds of me becoming more evened out will diminish due to being prefilled and if I go with saline, I'll have more noticeable rippling due to my thin stature. How much breast tissue is enough to minimize rippling

Doctor Answers 12

Saline vs. silicone implants for breast asymmetry

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Ultimately, you have to choose the implants that you feel comfortable with.  What this means is that both saline and silicone implants have their pros and cons.  Both implants are FDA approved and are considered safe; saline implants will typically have a firmer feel than silicone.  However, rippling can occur in thin individuals with either implant.  

If breast asymmetry is a concern, then asymmetric silicone implants can be used.  Also, keep in mind that every woman will have minor degrees of asymmetry between her breasts without surgery.  Surgery won't completely eliminate these asymmetries no matter how hard we try.  The bottom line is that I would recommend that you do what makes you comfortable.  Good luck!

Oklahoma City Plastic Surgeon
5.0 out of 5 stars 21 reviews

Breast aug

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Thank you for the question.

To best help you, a physical examination or picture evaluation is required in order to determine which procedures and techniques would be best for your case.

Dr. Campos

Jaime Campos Leon, MD
Mexico Plastic Surgeon
4.4 out of 5 stars 257 reviews

Gel or saline?

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Go with what works best for you and your needs.  If you truly have a marked difference in size, consider asymmetric implants by one size (gel) to help diminish the difference.  Otherwise saline implants will be filled asymmetrically to help even things out.  But if the difference is minimal, don't worry about trying to make things perfect as the difference you appreciate now will diminish when the volume of the implant is added to them.  Gel implants have more positives but the bottom line is implants are simply designed to increase the breast volume.

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

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First of all, the saline implant does not have the consistency and form of the silicone one.

A gel cohesive implant gives better shape and more natural appearance.

The most important factor to avoid rippling is the location of the implant, as more tissue covering the implant less noticeable it will be. 

I would recommend the gel cohesive silicone implant under the muscle plane  for minimizing chances of rippling.

Is important  for you to know that saline implants  have  highest rate of reintervention than silicone ones.

Adolfo Sesto, MD
Dominican Republic Plastic Surgeon
4.9 out of 5 stars 55 reviews

Saline or silicone?

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Both the saline and silicone implants have the same type of outer rubbery silicone shell. The inner fill is different: sterile saline solution in the saline Implant and silicone gel in the silicone Implant. There are advantages and disadvantages of each type of implant. Both are utilized by surgeons across the country with satisfactory results. They are both safe and approved for usage by the FDA. Currently there are more silicone gel implants used in the U.S. While either implant can produce excellent cosmetic results in the appropriate patient, most patients prefer the feel of the silicone gel implant.

Keep in mind that following the advice from a surgeon on this or any other website who proposes to tell you exactly what to do without examining you, physically feeling the tissue, assessing your desired outcome, taking a full medical history, and discussing the pros and cons of each operative procedure would not be in your best interest. I would suggest you ask your  plastic surgeon who should be certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with. You should discuss your concerns with that surgeon in person.

Robert Singer, MD FACS

La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 22 reviews

Recommendation on saline or silicone

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The type of implant used may  determine the final outcome of breast augmentation surgery, 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.     I hope this, and the attached link, helps.

Silicone breast implants a better choice than saline for thin person with minimal breast tissue

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Thank you for your question.  I concur with other surgeons that silicon is a better choice for you.  Rippling is much more with saline breast implants and especially in a small thin person like you is very distressing if it occurs and cannot be corrected.

Hopefully your implants can be placed beneath your chest muscle which gives you further coverage.

A small 25 cc asymmetry in my experience does not require different sized implants.  A photograph would help.  Please follow your plastic surgeons advice as to whether different sized implants are needed.  In my experience 25-50 cc difference represents about a tablespoon half and is not a great volume difference.

Saline vs silicone

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I would think gel would be a better option given your small stature. As far as your asymmetry, your surgeon can use sizers to minimize this issue. The rippling, given your size, is a bigger problem for you than the minimal asymmetry that will result from a few cc's that the salines would offer.

Saline or Silicone

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I would strongly advise you to go with silicone.  Although there is the likelihood that you will continue to be slightly assymetric, most women are.  I think that slight assymetry is easier to deal with than palpability or rippling of the implants which you may get with saline.  
Discuss this with your surgeon during the consultation.

Implant type

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From your description I would think you would be better off with silicone gel implants because of the decreased risk of rippling and the softer feel.  Different sized implants can be used if necessary to make the breasts closer to the same size.

Gary Hall,MD

Gary Hall, MD (retired)
Kansas City Plastic Surgeon

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.