Breast Implants for Someone with Health Concerns?

I'm considering having Breast augmentation, but I'm not sure if I should go with Saline or Silicone. My plastic surgeon recommends silicone, but after reading so many articles on implants, I'm worried that Silicone may not be safe. At the same time, I also read that Saline impants tend to leak or rupture more often than Silicone. Is this true? My main concern is my health. So which implant is recommended for someone with my concerns, and as much as possible won't give me an unnatural feeling?

Doctor Answers 12

Both are safe

In terms of safety, there is no evidence that silicone implants are unsafe compared to saline. You may or may not know this, but the shell of a saline implant is made of silicone. Both can give a natural result, but in my experience silicone has a more natural feel and shape in most patients. There are some studies that suggest saline implants rupture a bit more than the new generation cohesive gel implants, but these studies are limited and are not long term (10 years or more) yet. Finally, remember that with silicone implants, the biggest trade off in my opinion is that you don't know if they have ruptured (salines deflate when they rupture so it is obvious). The FDA recommends, but does not require, patients with silicone implants to have an MRI of their breasts every 2-3 years to see if there is a silent rupture. If there is, you should have them replaced, but again, there is no data that even if they are ruptured your life or health will be harmed.

I hope that helps, and the Mentor or Allergan website can offer you more info as well.

Good luck!

Dr. S

Seattle Plastic Surgeon
4.9 out of 5 stars 149 reviews

Go with your gut instinct

Here are the facts as I understand them:

Both implants are considered "safe" by the FDA

Both implants will give you a nice looking augmentattion and will look just about the same.

The gel will "feel" slightly more natural especially if you are thin and have little breast tissue.

You will be able to palpate some wrinkles and ripples in the outer or lower aspect of the saline especially when you lean forward.

In my practice, about 90% of the patients go with the gel because "feel" is a high priority and 10% with the saline because they feel "safer" instinctively with it. Neither is associated with causing health problems.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Informed choice of breast implants

This is a question that comes up very often, and there is not one right answer for every patient. There are advantages and disadvantages of each type of implant. But it is important that you make your choice for the right reasons.

Your body habitus also plays a role, as the more natural breast tissue that you currently have, then the less important "feel" of the implant becomes. The safety of both silicone and saline is well documented.

Also, I would not make a decision based on rupture rates, as I do not feel there is a large long term difference between the two.

During your consult, you should have been given much information on both. If not, go back for a 2nd visit, or go on another consult.

Good luck!

Dean Fardo, MD
Atlanta Plastic Surgeon
4.6 out of 5 stars 13 reviews

Silicone implants are safe

Silicone implants were removed from the US market between 1992 and 2007 because of testing required by the FDA, after a series of lawsuits in the early 90s ,sparked a"silicone scare" perpetrated by plaintiffs attorneys and consumer groups as well as TV personalities like Connie Chung. Studies done at Johns Hopkins, the Mayo Clinic, and UCLA have since proven that there is no link between silicone implants and serious medical problems that were purported. In Europe and Latin America, the silicone implants were never taken off the market.

The latest generation of silicone gel implants has a much better molecular construction which makes them more cohesive. I probably use silicone implants 60% of the time on my augmentation patients and 100% of the time on patients were having implants placed above the muscle. In 25 years of private practice I have never had a patient develop any serious medical problems related to silicone implants, and I perform over 125 augmentations each year.

Joseph M. Perlman, MD
Houston Plastic Surgeon
4.3 out of 5 stars 20 reviews

All Implants are Safe

It is astounding that there is still misinformation out there about the safety of implants. Straight up-all implants made in the U.S. are 100% safe! There is no difference in disease occurrence between women with and those without breast implants. Both implants are made of a silicone elastomer and filled with either silicone gel or saline. The silicone gels are more cohesive and therefore if they rupture the silicone doesn't go anywhere. Besides your body will create a capsule around the implant which keeps the silicone in.

The silicone will feel more "real." So enjoy the fact that hundreds of thousands of women have been studied and the implants are and have always been safe

Christopher L. Hess, MD
Fairfax Plastic Surgeon
4.4 out of 5 stars 33 reviews

Make yourself at ease when getting breast implants

Silicone and saline implants are both FDA-approved (I assume you are over the age of 22, which is a somewhat arbitrary threshold for which the FDA approved the use of silicone for cosmetic purposes). Both will give you good results when used properly by a board-certified plastic surgeon. Be sure to find out whether your surgeon was fully trained in a PLASTIC surgery residency. Membership in ASPS and/or ASAPS are other good indicators of competence.

I recommend that patients who have lingering concerns about silicone's safety, in spite of the large body of study data that confirms their safety profile, go with saline. This way, you can enjoy your result and sleep well at night, as will your surgeon, who will feel that you selected the option most agreeable to you. I would not try to talk a patient into getting silicone if she has safety concerns (however unfounded).

Your surgeon should be able to supply you with a brochure from the implant company that contains the results of the research studies on silicone implants, with data about leak rates and complications. The leak rate is about the same; the implications are somewhat different. A leaking saline implant will deflate like a water balloon and generally need to be replaced.

A silicone implant may leak but that gel bleed is likely to be contained by the body's capsule and may be clinically undetectable until the patient happens to get a mammogram or MRI for other reasons and the radiologist incidentally picks up the finding. In such an event, most plastic surgeons will err on the side of caution and recommend replacement. While unlikely to cause major illness, silicone leakage may lead to lumps, pain, and scarring around the gel material.

Hope this helps!

Tim Sayed, MD, MBA, FACS
Newport Beach Plastic Surgeon
4.9 out of 5 stars 17 reviews

If you are worried about silicone, use saline implants.

Hi!   The results with saline implants are just fine.  In Manhattan, we do breast augmentation both with silicone implants and with saline implants. 

Silicone implants are safe. But don't put something in your body that's going to make you worry.

George J. Beraka, MD (retired)
Manhattan Plastic Surgeon
4.8 out of 5 stars 9 reviews

Go for saline, you will have more peace of mind

Rupture rate is not much different between saline and gel. It is the detection of rupture that is different. Ruptured saline implant will lead to complete deflation; ruptured gel implant will stay contained within the capsule.

Gel implant will give you a more natural result but I think you should go for saline. Any time there is concern over silicone implant, safety, etc. I advice my patients to use saline. Best of luck!

Hisham Seify, MD, PhD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 19 reviews

What health concerns?

Health is a wide topic. What health concerns are you worried about? Silicone gel implants, when they work, feel more natural than saline implants but this depends on the relative size of the implants to your natural breast. You don't always need silicone gel implants to feel natural.Each implant type has its own relative risk and side effects. You should review these carefully with a board-certified plasticu surgeon to see which one fits your individual situation. Neither implant causes cancer or autoimmune disease.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 11 reviews

Age old question

The data is in from our FDA as of 17 Nov 2006 that they feel, after 14 years of clinical investigation, that silicone implants are safe. Having said this, they are not for everybody. Although I use silicone implants in 80+% of my breast patients, there are some who for what ever reason, don't feel comfortable with silicone. I look at my job as a plastic surgeon and patient educator to make sure you know what your options are, the risks/benefits/alternatives available, and then to perform a safe surgery for you. Discuss your concerns with your board-certified plastic surgeon so with his/her guidance you can come to a decision you feel comfortable with. I wish you well.

Dr Edwards

Michael C. Edwards, MD, FACS
Las Vegas Plastic Surgeon
5.0 out of 5 stars 35 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.