Can't Decide Between Silcone and Saline?

I am scheduled to have breast augmentation on Thursday, June, 6, and I am still undecided on saline or silicone. I am not concerned that the silicone will make me sick if it ruptures--I am more concerned about the surgery to replace a ruptured silicone implant. I do not have a lot of breast tissue. I am 5'5 and 128 lbs. I am currently an A cup. The idea of rippling breasts is not appealing to me, as I have spent enough years of my life being embarrassed of my breasts.

Doctor Answers 13

Silicone or saline? Silicone.

Modern silicone implants don't rupture as frequently as the old ones did. Mentor quote a rupture rate of 0.4% per year cumulative for their CPG contoured implants. So at 10 years, a 4% chance of implant rupture. At 20 years the rate is higher than 8% but nevertheless a further operation is not guaranteed, only likely in your lifetime. Allergan quote 1% per year for their 410 matrix implants. Silicone has a lower rupture rate than saline these days and many saline implants rupture by 10 years. You will need another operation as you will lop sided with a flat breast. Saline implants can gradually deflate over time too leading to rippling and the aggressive round shape can cause more subcutaneous erosion of breast material especially if above the muscle. Modern gel is quite thick and if caught reasonably early is easy enough to clean up, unlike the old gel that would infiltrate and cause granulomas. My personal choice in your situation would be a contoured silicone implant underneath your muscle.

Canberra Plastic Surgeon
5.0 out of 5 stars 6 reviews

Silicone or Saline Implants??

It looks like I missed your surgery which I'm sure was a success! Congrats!  As for silicone or saline implants, you can have a nice result with either implant.  They are both FDA approved and I wouldn't worry about getting sick from a rupture as the silicone implants are made with a highly cohesive gel.  It sounds like you don't have a lot of your own breast tissue, so if I saw you, I would most likely recommend the silicone gel implants but it's a very personal decision with the biggest difference mainly being the cost and feel of the implant.  Congrats again on your surgery! ac

Angela Champion, MD
Newport Beach Plastic Surgeon
5.0 out of 5 stars 5 reviews

Saline vs. Silicone Breast Implants

First, because your surgery date has passed, let me say that I hope your procedure was free of complications and that you are thrilled with your result, whatever you chose. I would still like to weigh in on your question for the benefit of other readers. Choosing between silicone and saline is a common concern, because patients can get beautiful results with either. I agree that a ruptured silicone implant will not make you sick. The surgery to remove and replace a ruptured cohesive gel silicone implant should not be any more uncomfortable than replacing a saline implant. In fact, as a saline implant deflates, the implant pocket collapses down. It ends up being a little more surgically invasive to replace a deflated saline implant than silicone. If you didn’t have too much breast tissue at 5’5” and 128 pounds, I would have recommended silicone implants, for less rippling and a softer result. Whatever your decision, good luck with your recovery!

James N. Romanelli, MD, FACS
Long Island Plastic Surgeon
4.6 out of 5 stars 23 reviews

Saline-filled vs. silicone gel-filled breast implants

I give the patient the choice of saline or gel breast implants but here's how I present it to them beforehand. 

There should be no difference in the look of the result if the implant is properly sized, positioned and filled (saline). The only major advantage of the silicone gel-filled breast implant over the saline-filled one is the feel -- if you can feel it (which I rate for the individual patient). 

The major advantage of the saline-filled breast implant is that it is filled with clearly harmless IV saline and it tells you if it's failed -- no test or worries. The major disadvantage of the silicone gel-filled breast implant is that although it holds up well and there's no evidence of a threat to health if it fails, there's currently no simple test to determine if the gel implant is intact or as failed and needs to be replaced. 

The minor advantages of the saline-filled implant are incision size (2 cm compared to 3.5 - 4 cm in the inframammary crease), cost (less than half), and ability to adjust volume from one side to the other (within 10%). 

Scott L. Replogle, MD
Boulder Plastic Surgeon
4.0 out of 5 stars 1 review

June 6th surgery

Hope it went well and with whatever you selected, appreciate the improvements it brings to your contours.  Hope its a great experience and delivers the outcome you expected.  There is nothing natural about implants so both have their downsides...

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

Saline or Silicone Breast Implants?

 I would suggest that you do your due diligence carefully in regards to the pros and cons of saline versus silicone breast implants and make  your decisions based on objective data ( as opposed to emotion) as much as possible.

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.

Based on your description of body type and concerns, it sounds like you may be best off with silicone gel breast implants.

 Best wishes with your upcoming procedure.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,499 reviews

Saline or Silicone Breast Implants

Hi and thanks for your question

It depends on your personal choice. Silicone implants feel natural and they dont ripple like saline implants. Then there is a history of silicone implants causing problems that was investigated thoroughly only after which the FDA has approved its use. If this concerns you about silicone implants then go saline. Although silicone implants have been approved in the US recently, the rest of the world have been using it for quite some time

Hope this helps

Naveen Somia, MBBS, PhD, FRACS
Sydney Plastic Surgeon
5.0 out of 5 stars 74 reviews


If you don't have much of your own breast tissue i.e. A cup or smaller, I recommend Gel implants. It will give a more natural result.  The risk of palpability and rippling is markedly less than saline.

Todd B. Koch, MD
Buffalo Plastic Surgeon
4.6 out of 5 stars 36 reviews

Silicone vs saline

Choice is dependent on your own comfort zone.  Silicone implants give better results and cost more.

Saline implants cost less but results are no as good.  However if you are kind of person who will keep worrying about silicone, you should get saline implants.  Peace of mind is important too.

Such decisions are personal and only you can make them for yourself

Vasdev Rai, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 23 reviews

Can't Decide Between Silcone and Saline?

I doubt any surgeons will favor saline implants for you. In a patient with a lot of breast tissue, and a small implant, the advantage may be minimal. But where the bulk of the final volume is implant, the silicone implants feel more natural, and are much less likely to have bothersome ripples. 

All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 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.