Which would make my breasts look/feel more natural - silicone or saline (or any other?)? Is it possible with my breasts? (Photo)

At 20 years old, 5'3, 116lbs I have never really measured my breasts (or lack of) due to embarrassment but am considering going up to a large B/small C cup. I am wondering if it is possible to make them look natural and if it is, which would be the best method?

Doctor Answers 23

Saline or silicone for natural breats

Sometimes when patients are very thin, it might be recommended that they consider silicone implants for breast augmentation.  Thin patients with small breasts have very little tissue to cover the implants so a smaller silicone implant may look more natural.  In general, I think the shaped silicone implants, like Sientra, can look very natural on a smaller breasted woman.  These are  th generation silicone implants and may have a lower leak rate.  Always make sure to see a board certified plastic surgeon.  Good luck.

Portland Plastic Surgeon
4.9 out of 5 stars 50 reviews

Reasonable Expectations Required

You seem like a good candidate for augmentation.  Saline or silicone implants could be used.  Each has their good and bad points.  In my practice I only use saline filled implants because there no question about their safety.  There is no expiration date on saline implants and as they get older they do have a risk of leaking.  If that happens your body absorbs the saline and you have to get it replaced.  Not fun, but not really a big deal.

If a silicone implant leaks, as it gets older, most of the time you will not know it leaked.  You will have a failed device in your chest and exposure directly to the silicone gel.  Even with cohesive gel implants.  This is why the FDA recommends continued MRI scans of your implants forever!  How many years apart between MRI scans is open for debate.  So, you have to ask your plastic surgeon what are his/her recommendation for follow-up MRI scans?  And ask yourself if you are prepared to pay $1,000 to $1,500 in the future for routine surveillance or anytime you think there has been a change in the look or feel of your implants?

I have a page on my website dedicated to leaking silicone implants.

Both types of implants are along term commitment of follow-up and care.

Good luck

Gordon Telepun, MD

Gordon M. Telepun, MD
Decatur Plastic Surgeon
5.0 out of 5 stars 15 reviews

Most natural looking breast augmentation

Thank you for your question and photos  With the minimal amount of soft tissue that you have, saline implants would most likely demonstrate visible rippling and a very unnatural contour.  In my opinion for most patients with petite anatomy/smaller breasts, most likely either silicone shaped/anatomic implants or fat transfer breast augmentation would give you the best result.  The most important question is what type of "look" you want to achieve from your augmentation/enhancement. This can only be determined with a comprehensive exam and consultation, but I can offer my opinion based on your photos, description of your anatomy and your wishes.

I have found that for many of my patients that have a body type similar to you, and that want a very natural look, that anatomic (or shaped) silicone implants are the best choice. This type of implant will give you a very natural upper breast slope with a perky and full lower breast shape that usually cannot be achieved with round implants in patients with your body type. Shaped implants do not create a noticeable bulge/fullness at the upper breast the round implants will, and look very natural.

Fat transfer augmentation is also a great choice if you only want to go up 1-1.5 cup sizes and have a very natural result. I have found that even very fit women have enough fatty tissue for a small augmentation if their abdomen, flanks, back, and entire thighs are utilized to harvest the cells for fat transfer. This may be a great choice for you as it is also a great method for correcting asymmetry. This is a very involved procedure with many steps that should be discussed at length with your surgeon before opting for this treatment method.

You should seek consultation with several board certified plastic surgeons in your area to find someone that you are comfortable with after a comprehensive exam and discussing your treatment options. Please see the link below for example breast augmentation before and after photos.  Best wishes!

Daniel Brown, MD, FACS
La Jolla Plastic Surgeon
5.0 out of 5 stars 22 reviews

Silicone v Saline

Good afternoon!

Silicone will give you the softest, most natural result possible! I would place your implants under the pec muscle, through either a nipple or crease incision.

Donald R. Revis Jr, MD
Fort Lauderdale Plastic Surgeon
4.5 out of 5 stars 118 reviews

Which Would Make My Implants Feel More Natural

Silicone and Saline implants are both excellent implants and are FDA approved in the United States. It depends on the amount of breast tissue you have and the size you would like to be as both implants look
good when done for the right indication. If you have minimal to no breast tissue I usually recommend silicone implants as they have less chance of visible rippling. This should be done in the hands of a Board Certified Plastic Surgeon.

Rod J. Rohrich, MD
Dallas Plastic Surgeon
4.9 out of 5 stars 61 reviews

Which would make my breasts look/feel more natural

I think that small/moderate implants above the muscle would look and feel natural.  Since you are small framed, I feel this is a reasonable plan to pursure.

Fred Suess, MD (retired)
San Francisco Plastic Surgeon
4.5 out of 5 stars 8 reviews


You have breasts that will be mostly implant after augmentation. Your areola are wide and you will do well will saline or silicone implants. The choice is yours and a very personal one. The silicone implants are preferable because they will feel softer and more natural especially for you

Norman Bakshandeh, MD, FACS
New York Plastic Surgeon
4.9 out of 5 stars 14 reviews

Silicone vs Saline Implant

Both Silicone and Saline give you nice results visually. The feel of silicone implants, however, is significantly superior. Judging by your photographs I would recommend anatomic silicone implants, which would give you a more natural shape and projection. In the first photograph there is some asymmetry between the two breasts but this may be due to your posture. There should not be a problem in getting good, natural looking results. All the best.

Ajaya Kashyap, MD
India Plastic Surgeon
4.9 out of 5 stars 163 reviews

Silicone vs Saline Implants - What is Ideal?

Silicone feels more natural and behaves more like your breast tissue than saline. For example it does not tend to bounce as much when you are running (less "water hammer effect).
The only exception to this is the IDEAL implant which is planned to  be released in 2015. 

Silicone implants have distinct advantages over saline implants in terms of performance: they wrinkle less and conform to a more natural breast shape, and also have a softer feel that is more breast-like. However, silicone implants have gained a reputation for being less safe than saline implants. Despite the fact that there is no known toxicity of silicone gel breast implants, the possibility of a “silent rupture,” undetectable except by MRI, has been enough to make many women opt for saline implants or wait for a better product to come along. The time will be here most likely within a year or so with the advent of the Ideal Implant, the name given to a new design saline hybrid implant. It has the natural feel of silicone and safety of saline.
Saline implants, though providing peace of mind by being perceived as safer than silicone, often do not create a result that seems as natural. Wrinkling, scalloping, a globular shape, and water balloon-like feel, and increased risk of capsular contracture have been the trade-off for peace of mind with breast implants. The Ideal Implant solves many if not all of these concerns.
The Ideal Implant has bothThe Ideal Implant is one of the major technological advances to come along in the past few decades in implant manufacture. Using a novel design with internal baffles, the saline implant is manufactured to achieve a similar feel and performance comparable to a silicone implant. Approximately 95% of both patients and their surgeons expressed satisfaction at the current two-year data point by the FDA. The Ideal Breast Implant is soon to be released in the US market, hopefully with in the year.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
4.9 out of 5 stars 154 reviews

Breast implant saline vs silicone

As a general rule silicone will always give you a softer feel then sailine. Where this makes less of a difference is if the implant size that you're choosing is small relative to your breast size.  For example if you are a C-cup and wanting to go to a D-cup, it may not matter as much if you use saline or silicone. If however you are an A-cup and going to a D-cup, silicone is probably a better option.

Young R. Cho, MD, PhD
Houston Plastic Surgeon
4.8 out of 5 stars 36 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.