Does a 225 cc saline implant look the same size as a 225 cc silicone implant?

Question

Does a 225 cc saline implant look the same size as a 225 cc silicone implant? Assuming if the volume is the same, the weight is fairly similar, but why don't they "look" the same? Heard you need more ccs in a silicone implant to get the same size in a saline implant. Confused.

Shahram Salemy, MD, FACS · Answer

This is a great question and the short answer is that for similar profiles and volumes, the 2 implants will probably look pretty close postop, but the feel can be very different, in particular on very thin women.  In my experience very thin patients with tight skin who want a larger saline implant are more likely to have a "fake" or rounded appearance to their breasts with more palpable rippling. Compare that to a women who may have a bit more breast tissue to begin, who wants a more modest augmentation and prefers silicone implants-- these patients tend to get very natural results.  So while the type of implant is important, so are a number of other factors including size, pocket (subglandular versus submuscular) and the patient's body habitus and goals.  This is why it's so critical to discuss your goals in detail with your surgeon so that you can get the best results possible!Great question and good luck!

Larry S. Nichter, MD, MS, FACS · Answer

For the most part they are the same size if similar volumes are used. If reality, the 225 cc's for silicone is the total volume whereas for saline it is the saline fill volume but does not take into account the silicone shell (which is very little volume). Saline implants can be filled to slightly more than listed and can be adjusted whereas silicone implants are factory sealed.

Martin Jugenburg, MD · Answer

Although saline and silicone implants are slightly different, the difference is minimal and difficult to appreciate once inside your body.  The difference in the look is up to the surgeon.  A silicone implant come pre filled and is always the same (for a given implant).  Saline implants are filled by the surgeon at the time of the surgery, and the surgeon can use his artistic eye to determine how to fill the implant (how much volume to put into a particular saline implant bag).  a 200cc saline implant filled to 225 will look different than a 180cc implant filled to 225.  (more overfilling = rounder look)

Shim Ching, MD · Answer

Saline and silicone look pretty much the same.  If a saline implant is "overfilled", meaning the a smaller implant is filled to a higher capacity, the implant can look and feel different.  But assuming the shell is the same and the same amount of saline or gel is in the implant, the implants are the same size.

Diana Breister-Ghosh, MD · Answer

Since
the implant material is different in each implant, the two implants do look
different.  It is my experience that the
silicone looks smaller than the saline. 
For example, if I am removing a

300
cc saline implant and the patient wants to be the same size, and wants to
replace it with silicone, I tend to go up to approximately a 325 or maybe even
a 350 because the silicone is softer and therefore, does not project as much as
the saline implant.

George John Alexander, MD, FACS · Answer

This
is a great question.  The best way to
think about it is that 225cc of saline or silicone is the same amount, so the
size will be the same.  Where the
confusion may lie, is that a saline implant can be filled more at the time of
surgery, whereas a silicone implant comes pre-filled from the manufacturer and
the size cannot be changed during surgery. Your board certified plastic surgeon should be able to explain this at
the time of consultation and may even have samples in the office for you to
see.  Hope this helps clear up the
confusion!

Khashayar Mohebali, MD, FACS · Answer

Your questions is very valid. There is a slight difference between how the implants look and feel for the same volume. In general, the saline implants have a slightly larger look to them for the same volume.  They tend to have a bit more projection and less conforming to you body than silicone giving them the image of being larger.  Hope that helps.

Tom J. Pousti, MD · Answer

The use of the same volume saline versus silicone gel breast implants may achieve a  modestly different outcome.    In my experience, silicone gel breast implants tend to conform to the chest wall;  the resulting appears slightly more “natural”,  and may appear smaller. On the other hand, saline breast implants tend to provide slightly more projection;  they may achieve a look that is less “natural”, and may appear larger. Of course, much of the outcome achieved with breast augmentation surgery will depend on how much breast and soft tissue coverage the patient possesses naturally. I hope this, and the attached link (dedicated to breast augmentation surgery concerns) helps.

Brian Windle, MD (retired) · Answer

Your question is not uncommon.  Another way to put it is, “What is the
difference between a saline implant and a silicone implant?”

If the implants are listed as the same size, in term of
voume or cc’s, then a 225 cc saline (salt water) implant has the same size
shell or outer layer as a 225 cc silicone implant.  The silicone implant is prefilled with 225 cc
of silicone gel.  These implants come
like that and cannot be changed.  The
saline implants, however, come empty or full of air.  At the time of surgery, the air is removed
and saline is added.  The amount of
saline that is added depends on a number of factors.  The manufacturer recommends that 225 cc of
saline be added to a 225 cc saline implant but they can be under filled or over
filled by abo 30 to 60 cc depending again on the situation.

Most surgeons will overfill a saline implant in an effort to
avoid ripples and folds in the implants and to try to give the implant more projection
since water does not provide much if any shape by itself.  These problems and the fact that saline
implants are prone to leaking, resulting in a “flat tire” are the reason most
patients and surgeons have shifted away from saline implants to silicone filled
implants.  In fact, most implants that
are used today worldwide are the fifth generation cohesive gel or gummy bear implants.  This is because they have been shown to have
a lower complication rate, have a more natural feel and look, and have a much
lower long term reoperation rate.   I have added a link to a page that has a lot of information about the new implants for you.

I hope that helps.

Best regards.

Brooke R. Seckel, MD, FACS (retired) · Answer

the main difference in appearance of a saline breast implant is the presence of ripples around the shell.  In some cases these ripples can show through the skin.  However if you have adequate breast tissue or sub-muscular coverage in the ripples do not show and the final result between a saline implant and silicone implant can be the same.  They will however feel very different as a silicone feels more like breast tissue of the saline feels like a bag of water.

Does a 225 cc saline implant look the same size as a 225 cc silicone implant?

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