Can I use Saline and get acceptable results? (photo)

I have very little breast tissue. I am planning to use 270cc mod Profile Saline implants. I want to achieve: 1) fullness (c cup); 2) upper pole natural slop; 3) lower pole fullness; 4) breasts not as far apart as they are now (move to the midline); 5) no visible rippling; 6) implant not palpable/ feel natural. Do you think i have enough tissue to use Saline and achieve my goals? I am afraid of silicon: 1) microscopic gel bleeding 2) difficult to detect rupture; and 3) long term safety unknown.

Doctor Answers 11

Saline Implants vs Silicone

Based on your photo I feel you can achieve a very nice result with saline prostheses. During the 14 years when silicone was unavailable for use in the United States, the vast majority of patients achieved their desired outcome. It is important to place the implant under the pectoral muscle and overfill the implant by at least 10%. This diminishes the chance of palpation and visible rippling. If properly positioned both saline and silicone will achieve a natural result with a gentle slope and lower pole fullness.

Today's cohesive gel (silicone) implants have minimal gel bleed unlike their predecessors from the 70's and leakage is readily detectable with an MRI. The prospective studies prior to their re-release showed no demonstrable safety risks with silicone implants, but certainly no one can say for certain what may happen decades from now. Which ever implant you choose I think you will achieve an excellent result in experienced hands. Best, Dr. DeLuca

n.b. Case linked below is to a patient with a bust similar to your own before augmentation w/ saline implants.

Albany Plastic Surgeon
4.9 out of 5 stars 183 reviews

Saline-filled breast implants and acceptable results

You have fairly average, normal breast tissue and should have enough tissue to blend in a saline-filled, round implant in the sub-pectoral position. This could change with time but if the implant is filled properly you shouldn't have visible rippling.

A moderate profile saline-filled implant that is matched to the internal width of your breast should make you look about 1 1/2 cup sizes larger than you are now which should be in the C cup range.

A moderate profile, round implant matched to the internal width of your breast and positioned properly below the pectoralis muscle should give you a very natural upper pole slope.

Your lower pole should also fill out naturally to look about 1 1/2 cup sizes larger over all.

Your goal of your breasts being closer together is not realistic. An implant is just pillow volume behind your breast and does not move the breasts closer together. The gap between them has a deeper cleavage but the distance between them remains very close to the same. If the surgeon tries to make your breasts look closer together with an implant that is too wide for the base of your breast, it will either not fit where it belongs, will result in a disconnect of the medial border of the pectoralis muscle, or show rippling on the medial side of the breast, all of which are unnatural and a cause for the need for a revision.

Saline-filled implants feel inherently "ripply". If they are filled properly (rated fill to no more than 10% overfill) they shouldn't have standing or visible ripples. The FEEL of the implant is masked by the amount of tissue over the implant in the lower pole of the breast where the muscle doesn't cover. You appear to have enough tissue to avoid visible ripples if the implant is filled properly.

On the fear of silicone gel-filled implants: their only advantage is their inherent feel of tissue. The problem of microscopic gel bleeding has been largely solved with modern gel-filled implants but there is still no simple, inexpensive test to verify their integrity. There does not appear to be any long term health effects of silicone gel-filled implants whether intact or not but it is hard to prove. Saline-filled implants still have a silicone rubber shell but they are filled with IV fluid and they make it obvious if they fail and need to be replaced. Their drawback is that they don't feel as natural as silicone gel-filled implants but they can have the same appearance as gels in your situation.

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

Choosing between silicone and saline breast implants

Both saline or silicone breast implants are suitable. However, silicone could better serve your desires in terms of feel and visible rippling.

Raffy Karamanoukian MD FACS

Los Angeles

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
4.8 out of 5 stars 94 reviews

Saline implants

I believe you will have a beautiful, natural result with saline. Even when the implant is placed behind the muscle, a small portion will not be covered laterally and inferiorly. This is where you may feel some subtle rippling over time. Best wishes!

Holly Casey Wall, MD, FACS
Shreveport Plastic Surgeon
4.9 out of 5 stars 31 reviews

Breast Implant Options

Both implants are safe. Silicone feels more natural and tends to have less visible rippling, all things being equal. That being said, you should have a great result with saline implants that will feel natural as you are choosing a smaller volume and you have a adequate amount of native breast tissue. Rippling tends to be more of a concern if one is choosing large implants and has relatively little breast tissue.

William J. Hedden, MD
Birmingham Plastic Surgeon
4.8 out of 5 stars 321 reviews

Saline implants: acceptable results?

Based on your picture, and the moderate size of implant you are planning, I believe that absolutely you could get a nice result with saline. It is essential that the implant be submuscular, and in order to minimize rippling, I also believe it should be below the serratus fascia laterally, and a dual plane approach gives a more natural appearing tear drop result.

Many patients share your concerns about the disadvantages of silicone gel implants. Approximately 80% of my patients choose saline implants, and with the appropriate surgical technique and appropriate size implant relative to patients breast tissue, patient satisfaction is very high.

One observation that is rarely made..the silicone gel bleed that occurs over time with any silicone gel implant results in a higher capsular contracture rate over time with silicone versus saline. This is another advantage of saline implants followed over a long period of time.

Thomas A. Mustoe, MD, FACS
Chicago Plastic Surgeon
4.8 out of 5 stars 96 reviews

Breast Augmentation, Dr. Adibfar, Plastic Surgeon Toronto


You should be able to achieve good results with both types of implants although a tear drop shaped gel implant would give you a more natural looking final result (upper pole with natural slope and adequate lower pole fullness).

Either way I would recommend a "dual plane" (partially under muscle) position in order to minimize the chance of any visual or palpable ripples (especially of the saline implant) in the upper pole.

In general Saline implants have more palpable or visible ripples especially if you lose weight or breast tissue as you age.

The positioning of the implants is really dependent on the current position of your nipples and breasts although with implants you would achieve more of a cleavage.

A thorough evaluation and consultation would allow us to give you more scientific answers about all of your questions and concerns.

Best wishes.

Ali Adibfar, MD, DDS
Toronto Plastic Surgeon
4.8 out of 5 stars 79 reviews

Saline vs. Silicone Breast Implants

You should expect good results with either implant type, but rippling will be more noticeable (especially by feel) with saline implants. Also note that the implants will be centered on your breasts, but by making your breasts wider may create the illusion of your breasts appearing closer in the mid-line.

Michael Kreidstein, MD
Toronto Plastic Surgeon
4.6 out of 5 stars 32 reviews

Saline is a perfectly acceptable choice

Hi Rainsunshine,

Saline is a perfectly acceptable choice and you look like you have good coverage for the implant. Silicone can ripple and can be felt in patients who are very thin and have very little fat over their implants.

An in-person consultation with a plastic surgeon is best to answer your specific questions as each person is different, has different fat distribution/thickness etc. That being said, in my experience, looking at your submitted picture, I cannot see why a saline implant would not give you a beautiful result.

In our practice we are about 50% saline and have yet to have a patient come back unhappy and wanting an exchange for a silicone breast implant. When the implant type is selected carefully to fit a patient's body and expectation, results are beautiful.

Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 469 reviews

Silicone do not saline breast implants are best to avoid the visible rippling

Thank you for your question. Both silicone and saline implants can give you a nice breast augmentation result, however if your major concern is rippling,, saline implants are more likely than silicone gel implants to cause rippling.

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.