Was Dead Set on Silicone Implants, Now my Head is Spinning! What Do You Recommend? (photo)

I had originally requested saline implants (reason: smaller scar). After much research & discussion with my husband & Dr at the 2nd appt I switched to silicone (reason: more natural look/FEEL). Well, at my pre-op today, my Dr. said I may get the results I desire better with saline... he hadn't mentioned this at the other appts. I'd like an athletic, perky, natural, not heavy look with upper pole fullness. I'll post my "like" page & my own breasts for comparison. Can silicone give these results? My implants will be sub muscular and placed through the areola.

Doctor Answers 12

Saline or Silicone Implants - Which is Best?

Thank you for your question. With respect to saline versus silicone implants, there is no question that silicone implants give a more natural result with less of the associated cosmetic issues such as implant visibility and rippling. You can easily achieve the look you are going for with silicone implants and I don't see the need to change to saline. I can speak to this definitely since some of the results you "like" are mine where we used silicone implants placed beneath the muscle to achieve this outcome. Since you are in the San Diego area we can give you more information if you desire. 

Best of luck,

Vincent Marin, MD, FACS

San Diego Plastic Surgeon


San Diego Plastic Surgeon
5.0 out of 5 stars 46 reviews

Saline or Silicone Breast Implants?

Thank you for the question and pictures.

Given the amount of breast tissue you are starting with,  I think you will end up with a very nice results whether you use saline or silicone breast implants. Given your concern  for as “natural feel as possible", silicone breast implants may be your best bet. With proper technique and implant selection your desired look should be achievable with either type of implant.

Although it sounds like you are well informed regarding the pros and cons of saline versus silicone breast implants I have listed some of these below:

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. Each patient differs in the amount of breast tissue that they have.  If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants.  If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result.

On the other hand, saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference.  Patients may need an MRI to diagnose a silicone gel rupture.   Saline implants are also less expensive than the silicone gel implants.
Other differences involve how the breast implants are filled. Saline implants are filled after they’re implanted, so saline implants require a smaller incision than prefilled silicone breast implants.

Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,487 reviews

Choosing between saline and gel implants

The look that you are seeking may be achieved with either saline or gel. Since you have indicated in the post that you are also seeking a natural feel, then you would be better off with gel implants. One major advantage that you have with saline implants is a shorter scar since salines are filled after implantation. If you are confused with your surgeon's recommendations, you may wish to consult in person with 2 - 3 additional experienced and expert board certified plastic surgeons to clarify your options.

Kris M. Reddy, MD, FACS
West Palm Beach Plastic Surgeon
4.4 out of 5 stars 41 reviews

Different shape with saline vs silicone?

Each implant manufacture has multiple shapes and sizes in saline and silicone. these shapes are catorgorized by slight different terminology by the different companies but basically can be referred to a low profile, moderate profile, high profile,ultra high profile and shaped implants. In addition there are smooth and textured implants. Using the wide array of sizes and styles the ultimate shape of your breast can be optimized. The main difference between saline and silicone implants is the materiel that fills the implant ,salt water versus silicone gel. The gel is more dense and has a feel more similar to breast tissue particularly in larger implants. At small sizes the difference is reduced.

Jay M. Pensler, MD
Chicago Plastic Surgeon
4.6 out of 5 stars 14 reviews

Silicone or saline implants

You present an interesting situation that I have seen several times. Although it is true that silicone gel gives a more natural look and feel, the pictures that you show as a "desired result", are best achieved with saline implants. That is because they give a more rounded look.

You should also know that when we were putting in only saline implants the patients were quite happy and they are not rushing back to get them out and gel put in. And the saline implants are less expensive and have a smaller incision. You also have enough breast tissue to act as padding that can make even saline implants feel more natural.

John P. Stratis, MD
Harrisburg Plastic Surgeon
4.5 out of 5 stars 34 reviews

Silicone Implants Generally Give Superior Results

Silicone implants, in my opinion will always give a better result than saline implants.  I think that will be the situation in your case as well.  I do not think that you are more likely to obtain a "fake look" with silicone rather than saline implants.  Perhaps a second opinion would help since you are now confused..

John Whitt, MD (retired)
Louisville Plastic Surgeon
5.0 out of 5 stars 2 reviews

Saline vs Gel

If the implants are sub-muscular you probably couldn't tell the difference between gel & saline. Plus your areolae aren't big enough to get the size you need thru the incision. AND saline are adjustable after they are placed but gel aren't. And you aren't burning any bridges...you could change to gel later if you wish (thru an infraa-mammmary incision). The clincher is that gel costs $1000 more than saline. Dr Foster

Lawrence Foster, MD (retired)
Sacramento Plastic Surgeon
3.3 out of 5 stars 15 reviews

Implant choices

You can probably get a nice result with either saline or silicone, it really is a personal choice.  If you have concerns speak with your surgeon.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Which Breast Implant?

Considering the look you want and the significant amount of breast tissue you are starting with, the implant size is not going to be very big and either implant will get you that look. As to scars, it should not be a concern because with small gel implants the scar for either implant is less than 2 inches.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 27 reviews

Silicone implants

You will find many different opinions but I do not believe there is any difference in the "look" between silicone gel and saline.  The main difference is the feel and risk of rippling.  I think you will have a nice result with either implant.  The silicone gel will be softer however and usually will require a longer incision.


Gary Hall,MD

Gary Hall, MD (retired)
Kansas City Plastic Surgeon
4.5 out of 5 stars 32 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.