Saline Breast Implants Less Likely to Harden?

I've had Silicone breast implants for 35 years without replacements. The only problem I've had is hardening. I am having them replaced because I now have a rupture. I've gotten 2 opinions: one says Saline, while the other says gel. The main concern for me is long term health. Is Saline a lot less likely to harden (capsular contraction)? Is it better to get Saline implants because they are easier to change in the future when I get lots older? I'm 5'5", 135 lbs. and 61 years old.

Doctor Answers 3

Hardening of silicone vs saline breast implants

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We initially thought that saline implants were less likely to harden than silicone.

Then we had data suggesting that the silicone harden less.

Then we had some European data indicating that silicone do harden more.

Get the picture? It is not obviously in favor of one implant or the other.

A subtle point to make is that, it is not generally the implants that harden but the scar tissue around them.

Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Are saline implants better to avoid longterm problems?

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You are asking some great questions. It is hard to say which implant for you will have a lower capsular contracture rate. However, you hit on the key issue. A saline implant is definitely easier to remove if it leaks compared to a silicone. That being said, saline impants have higher leak rates in the short term, 4-10 years, than silicone. If your tissues are very thin, you might not be happy with the aesthetic appearance of saline implants. There are so many variables that it can be difficult to decide. Given your age and your justified concern about the difficulty of future surgery if the implants need to be changed, I would lean towards saline for you. There are many good breast surgeons in Atlanta. I personally know the surgeons at Atlanta Plastic Surgery and Paces Plastic Surgery. Some additional second opinions might be helpful.

Tracy Pfeifer, MD
Manhattan Plastic Surgeon
4.8 out of 5 stars 29 reviews


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Incidence of capsular contracture is a bit lower with saline implants. Newer gel implants are much improved over the 35 year old ones you have. Another consideration is location of the implants, above or below the muscle. Many plastic surgeons will change hardened implants above the muscle to under the muscle.

Edmond A. Zingaro, MD
San Francisco Plastic Surgeon

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