I'm a 48 y/o woman, 5'3 150lbs...hoping to lose another 25lbs. Silicone or Saline Implants?

I'm a 48 y/o woman, 5'3 150lbs...hoping to lose another 25lbs. I am scheduled for a mommy make-over and am still indecisive about whether to go with Silicone or Saline and considering 450-500cc implants. I am aware of the pros and cons for each, however, I'm wondering which one's would give my breasts the best results. My doctor is going under the muscle for the procedure. Any advice/opinions will be greatly appreciated.

Doctor Answers 7

Choosing The Right Implant?

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Thank you for your question!  I suggest you see a board certified plastic surgeon who preforms these routinly.  Best of luck!Dr Dhaval Patel
Double Board CertifiedPlastic SurgeonChicagoHoffman EstatesOak Brook

Gel vs. Saline filled implant

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An overfilled saline filled implant in a thin patient is not a good idea. The implant can look to round and it increases the risk of rippling along the edges of the implant.  If you are thin and your breast is going to be more implant than you then you will always do better with a gel filled implant.  Atlanta Plastic Surgeon, Dr. Z

Silicone or Saline

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Your photos show that you don't have a lot of breast tissue. So for that reason I would recommend silicone gel. I would also recommend that you consider a lift. But there are a lot of issues regarding both selection of implants and lift procedures. Continue to discuss with your surgeon.

Silicone vs. Saline: Silicone Wins Every Time!

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Last week, I had a patient who I did a breast augmentation on 12 years ago call me in tears because her right breast deflated while she was at a party.  Saline implants have an expiration date.  The trouble is we don't know when that expiration date is.  The valve is usually the problem, and there are no valves on silicone implants.  Today's silicone implants are a semi solid or soft solid substance, therefore total deflation is impossible.  Silicone implants are softer, look more natural, and have less chance of rippling. 

Some of your responders have suggested that silicone implants are more expensive.  Actually, when you take a long term perspective, if you need to do a redo because of deflation, silicone becomes cheaper by far. 

Saline/silicone - you will be happy with either, but do you need a lift?

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Saline versus silicone?  Keep in mind you will be happy with either and when the implant is under the muscle and you have some of your own breast tissue (you do), the difference in feel characteristics is small.  Usually I use saline implants in this situation simply because there is negligible advantage in using silicone gel and it is more expensive.

The more important question is whether you need a lift.  You have significant asymmetry and your nipple level is particularly low on the left side.  An augmentation does not correct this degree of sagging and does nothing to improve nipple symmetry.  If you have a simultaneous lift, it should be a vertical lift, which offers better shape and less scarring.  If you just want the volume and don't care too much about nipple position or symmetry, just have the implants.  If you wish to look at some photos of lifts+ implants, I have a link to this section of my website, so you can get an idea of the results.

Breast implant choice for mommy makeover

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Silicone implants tend to have a more natural feel than saline, however they have a higher cost. Looking at your photos, you may also require a periareolar lift at the time of you breast augmentation to give you the best shape possible. 500 cc is a large implant, discuss this further with your plastic surgeon prior to surgery.

Best wishes,


Best Implant Choice

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Based on the photo you provided, I recommend silicone gel implants placed under the muscle. Silicone gel implants will help achieve a more natural feel and look.  It's difficult to say but you may need a breast lift as well and if you are continuing to lose weight, I would HIGHLY recommend that you lose the weight first and then go in for consultations because the procedure may change depending on how your breasts change with the weight loss. Clear communication with your plastic surgeon is important in achieving the desired goals of the patient.  I like to communicate with patients with “goal” pictures.  During surgery, I use temporary sizers to determine the size/profile that will give the patient the look she is looking for. Trying to predict the size of the implant preoperatively is not ideal.  I think it is too much responsibility for the patient to choose the size of the implant.  Ideally, the surgeon would make that determination once he/she is in the operating room with sizers in and examining the patient in the upright and supine position.  There are many variables that come into play when choosing the correct implant size (how much breast tissue the patient currently has, the shape of the chest wall (concave vs. convex), etc..  

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.