Saline vs Silicone? (photos)

Question

I had my first consultation today. I had thought I’d do saline implants. The surgeon I spoke with today strongly suggested doing silicone implants for me. He said shape and size would be easier to achieve. Any thoughts on this? I don’t mind if they’re slightly less squishy but I really care about getting the shape right. Can the same shape be achieved with saline implants? I like round, full breasts. He suggested a mastopexy w/ augmentation and lipo for my side boob/underarm.

Daniel Barrett, MD · Answer

Hi jcchuq,
  
I understand your concern. However, there is no evidence that directly links silicone implants to autoimmune diseases. 
  
The two main types of implants are silicone and saline. The shell of the implants can be either textured (which reduces capsular contracture) or smooth. A textured implant sometimes requires a larger incision. The shape of the implant can be either round or tear drop shaped (gummy bear). Both have their advantages and disadvantages. 
  
The different types of implant offer different pros and cons. For instance, the pros of silicone implants are that they look and feel more natural and ripple less.
  
On the other hand, the pros of saline implants are that they do not require as large of an incision as silicone, less expensive, they have less incidence of capsular contracture (scarring around the implant), one can tell immediately if there is a rupture, the size can be slightly adjusted, and they can be used for women less than 22 years of age.
  
Daniel Barrett, MD, MHA, MS
  
Certified, American Board of Plastic Surgery
  
Member, American Society of Plastic Surgery 
  
Member, American Society of Aesthetic Plastic Surgery

Emmanuel Mallol Cotes, MD · Answer

Thank you very much for this interesting question.
Saline or Silicon?...It is a question that never fails. recommend using - Cohesive Gel - Silicone Breast Implants with textured cover. They have proven to be quite safe by multiple studies of the highest scientific rigor around the world and aesthetically best as they give a firmer consistency, better projection and therefore a most natural appearance than Saline implants.
Respectfully,Dr. Emmanuel Mallol Cotes.-

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. You are a great candidate
for a breast augmentation.  I highly recommend silicone instead of saline implants.   The size, profile, and shape of the
implant is based on your desired breast size/shape, your chest wall
measurements, and soft tissue quality.  This decision should
be based on a detailed discussion with equal input from both you
and your surgeon.  Make sure you
specifically look at before and after pictures of real patients who have
had this surgery performed by your surgeon and evaluate their results.   The most important aspect is to find a
surgeon you are comfortable with. I recommend that you seek consultation with a
qualified board-certified plastic surgeon who can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D. FACS
Harvard-trained plastic surgeon

William Aiello, MD · Answer

Hi jcchua, Silicone versus Saline is a personal choice. When you consider breast enlargement, the best way to decide whether to have saline or silicone gel implants is to learn more about the different types of breast implants . For full disclosure you need to read the implant manufacturer’s brochure and the FDA patient information on breast implant safety, but for our patients we like to break down the basics. The top differences between these implant are 1) Price-Saline is cheaper 2) Feel-Silicone feel more like natural breast tissue and do not "slosh" about or show as much rippling on thin patients 3) What happens if the implant shell develops a tear. Saline-It deflates. Silicone-You may not know. These should be your concerns. Both implants come in all the same volumes (although Saline has greater variability, if over filled), projections and shapes. Either implant can achieve a round, full breast. Good luck to you!

Joshua A. Halpern, MD, PA · Answer

I enjoy using both. I have had a number of patients who have had either saline or silicone breast enlargement before they got married or had children. A number of their husbands still do not know their wives have implants. Currently the majority of women who choose to have a breast enlargement choose silicone gel breast implants. The thought is that the implants feel more natural. Patients who are nervous about having silicone implants, I recommend going with saline. I’ve been informed by Johnson and Johnson that my long term leakage rates are 200 times better than the national average for silicone gel implants. I utilize the bloodless breast enlargement technique, which I invented. (See the video on our page). Patients typically have no bruising. Recovery is quicker versus traditional techniques. It’s not uncommon for surgeons that I operate on to be operating on their own patients five days after surgery. One advantage of using saline implants are for cases of breast asymmetry. One is able to get better symmetry with saline implants. I hope you find this information useful. Please watch the enclosed video.

Tom J. Pousti, MD · Answer

Thank you for your question and photos.
In my practice, the type (saline versus silicone gel) of breast implant utilized is individualized mainly depending on the patient's starting anatomy and goals.  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. In other words, if a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result.
In regards to discussing breast size and shape, communication with your surgeon is critical in achieving the results you wish. I find that this is best done with the use of pictures as opposed to trying to predeterming specific implant size or profile.
Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant size/profile selection) is:
1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. ***Ask to see lots of examples of his/her work.
2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. 
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, I have found that the use of words such as “natural” or "round, full" or "C or D cup" etc means different things to different people and therefore prove unhelpful.
Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.
3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers.
I hope this helps. Best wishes for an outcome that you will be very pleased with.

David Nicholas Csikai, MD · Answer

If you really like the rounder shape and firm then saline may be wha you need, The only thing is that you can usually feel a saline implant more than a gel with wrinling and rippling. sometimes there is visible wrinkling. discuss this with your surgeon.

David A. Lickstein, MD · Answer

Most patients prefer the feel of silicone.  It is worth noting, though, that a wide array of sizes and profiles are available in saline or silicone.

Kenneth R. Francis, MD, FACS · Answer

Dear jcchuq,Hello again!  I will stand by my answer yesterday and say that you should have a breast lift with your breast augmentation.  Controlling shape better with silicone implants versus saline implants is mythical in my opinion and if it is fullness and roundness that you desire, a saline implant can just as easily, and more likely, provide that.  Be careful with wish pics because the woman in your wish pic certainly did not start out where you are starting from.  When choosing wish pics try to view patients that have before photos that are similar to your own before appearance.  Good luck!

Marcel Daniels, MD · Answer

Based on your pictures, you should get a nice result with implants only. Seek out experienced breast surgeons in your area, especially ones with Allergan Inspira implant experience. The Inspira "softtouch" is a favorite of mine and my patients! Hope this helps, good luck!

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