Saline or Silicone???OMG I can't decide.

I've read about silicone leaking and that completely scares me.

Doctor Answers 23

Saline vs. Silicone

I think there are some very good answers here and the pros and cons of silicone and saline have been well presented.

When one of my patients is making this decision, the information I provide always includes a comment about capsular contracture.

I do believe that gel implants have a more natural feel, especially in patients who do not have a lot of their own breast tissue.

But the difference between the feel of a gel vs. a saline implant is very small compared to the difference between any implant with capsular contracture and one without. What I'm saying is that a gel implant with contracture, will feel much harder and less natural that a saline implant without contracture.

I do like and utilize both implants but in terms of softness, the major factor is actually avoiding capsular contracture. I always take into consideration the differences between the implants when discussing options, but I know that avoiding hard capsules with either one is the key to a soft result.

Just another piece of the puzzle for you to consider. 

Good luck!

Rocky Mount Plastic Surgeon
5.0 out of 5 stars 5 reviews

Dr Kayser

Thank you for your question. Both implants have pros and cons. Both implants are FDA-approved and are good devices to achieve enhancement of a woman's breast size.

It is important to understand that both implants are man-made devices and that they are not intended to be lifelong devices. As such, it is also important that a patient can expect that, at some point in their lifetime, they will have to have them removed or replaced. This can occur from either a breakdown of the shell which can result in a leak or from the irregularities caused by abnormal scar that surrounds the implant. This is called a capsule and is a normal development to any foreign object that is placed in the body.With saline implants, the feel will be less natural, being more watery like a balloon. Saline implants also have the problem of being more visible with regard to rippling. However, because saline implants are filled with salt water, if they leak, the patient will know immediately as the body will simply absorb the fluid that is contained within the implant. This can be very reassuring to patients who may have any anxiety about whether or not the implant does leak.Silicone implants tend to have a more natural feel and tend to reveal less palpable or visible irregularities. However, should a silicone gel implant developed a break in the shell, this can go undetected for months or years. Current recommendations are that patients are seen on a yearly basis by their plastic surgeon and that they have periodic MRIs -which are out-of-pocket expenses. Ultimately, the question is not so much about whether or not the implant will leak but, whether or not it hurts you if it does; there is significant data that show that women with silicone implants have no higher risk of developing any of the problems that have been then women with saline implants. Finally, saline implants are less expensive and to some patients, this can be a financial consideration in making their decision. I would certainly discuss all these options with your plastic surgeon. I hope this helps and have a wonderful day. Dr. Kayser - Detroit

Melek Kayser, MD
Detroit Plastic Surgeon
4.9 out of 5 stars 37 reviews

Saline implants vs silicone gel implants

Dear "can't decide",
 I have been in practice for over 28 years and did breasts augmentation surgeries on thousands of patients . I used  almost exclusively, smooth, round. moderate profile saline implants. Many of my patients are mothers and daughters and it is highly unlikely that mothers would have referred me their daughters if they would have been unhappy with my surgery...
 I use saline implants for the following reasons:
 1. Cost about $1000 less than silicone implants.
2. Saline implants can be inserted through  a small sub areola incision , which is scar friendly , while large silicone implants have to be inserted through long incision in the sub mammary fold, which is scar unfriendly.
3. The sub areola incision, allows for the creation of a very predictable and very nice cleavage under direct vision and feel, while the sub mammary incision is too far from the cleavage area for ease of dissection and control of bleeders, which is the reason for the surgeons' concern  of dissection close to the midline. This concern doe not exist with the sub areola approach.
 4. When the infra mammary fold (IMF) has to be lowered (to make more room for  large implants), the dissection through the sub areola incision is more precise and more consistent than the IMF incision which is too close for comfort.
 5. When saline implants leak (not very common) , it is very easy to replace them, while removing the silicone gel is more complex.
 6. Silicone implants are , statistically, associated  with higher rate of capsule contracture than saline implants
 7. It is a myth that silicone implants feel more natural than saline implants. I have replaced many silicone implants with saline implants due to different complications , to the delight of my patients. Moreover, quite a few of my patients had the breasts augmentation surgery before they got married and the husband does not know that they have breasts implants...
  8. Finally. It is wiser to choose the surgeon, rather than the implant, because not all result are the same. Experience, skills and aesthetic eye are critical for good and satisfying outcome.
  So, do your due diligence and choose wisely.
 Always, consult with experienced board certified plastic surgeons who operate in accredited surgery center for your safety. Most importantly, check the before and after pictures in the photo gallery, to make sure that they are numerous , consistent and attractive with nice cleavage, perky, symmetrical and natural looking.
               Best of luck,
                                  Dr Widder

Shlomo Widder, MD
McLean Plastic Surgeon
4.8 out of 5 stars 124 reviews

Saline or silicone--big question

I counsel my patients there are two main difference. Saline is cheaper but is more firm and has more visibility under the skin. And please remember that saline implants are a silicone shell filled with salt water. Silicone implants are a bit more expensive, but they have less rippling and feel very natural. Silicone has made tremendous strides and the risk of rupture is much lower than it used to be. The newer silicone is more like jello or marshmellow and is not liquid. Hope this helps shed some light on your dilemma.

Kendall Roehl, MD, FACS
Webster Plastic Surgeon
5.0 out of 5 stars 10 reviews

Silicone or saline

The main issues with saline are mold contamination which occurs with trauma to the implant or in areas where mold is common in the environment and the patient is exposed to high levels.  I treat hundreds of patients with sick building syndrome due to mold in or around their implants.  One fourth of the population cannot get rid of mold biotoxins and develop fibromyalgia and neurological problems when they are exposed to even small amounts of mold.

The issue with silicone implants is leakage in patients who have detoxification defects such as MTHFR and become chemically toxic when the implants leak.  About one third on the population has these detoxification defects.  Some patients with certain genetic types such as HLA B27 and HLA DR53 have autoimmune problems right away with any silicone exposure.  

As our practice treats patients with defective implants, we are aware of these problems, but other plastic surgeons are not aware of this even though these issues are reported in the medical literature (except for MTHFR which is a more recent discovery).

Susan Kolb, MD
Atlanta Plastic Surgeon
4.2 out of 5 stars 28 reviews

Saline vs Silicone Implants

With both implant types there are choices when it comes to size, shape, and profile. The criteria best to suit you will be discussed in full detail at your breast augmentation consultation.

A #SalineImplant is made with a #silicone outer shell that is filled with saline water during the surgery. It is filled with sterile saline (salt-water). Since saline is like normal body fluid, it is safe and easily absorbed if the implants were to leakThe #implant shell is ordered in a specified size which can be filled to a minimum or maximum fill amount. This allows the plastic surgeon some flexibility with sizing during surgery. Often times a woman has breasts which vary slightly in size. If one breast is slightly smaller than the other, each implant can be filled to a different amount to create better symmetry. Saline tends to be a little less natural feeling than silicone, but it can also create a more dramatic upper breast appearance, which some women prefer. A new saline breast implant option called Ideal Implant™ was recently FDA approved and was created for women who are not comfortable having silicone implants in their body, but desire a more natural feeling implant than the traditional saline implant on the market. The unique structure of the Ideal Implant allows for a similar look and feel as silicone with the safety of saline.

A #SiliconeImplant is made with a silicone outer shell and filled with a gummy-bear-like consistency silicone. More women tend to choose silicone breast implants due to the natural feel and appearance. Silicone implants are now made of a cohesive gel which are anti-leak even when cut. Look and feel like natural breasts due to the cohesive silicone gel material. New generation silicone gel implants are far superior than those used in the past with a proven track record of safety. Silicone implants have gone through more testing than any other medical device and are the preferred choice for over the muscle implant placement.
However, the FDA recommends women have periodic MRI testing to ensure their silicone implants are free from any defects.

Jed H. Horowitz, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 109 reviews



The new generation of Silicone cohesive gel implants are much stronger, durable and have a non-liquid filling similar to a gummy bear. Because of this, many of the previous concerns about rupture and leakage have been alleviated. I recommend that you book an in person consultation with a board certified Plastic Surgeon so that you can discuss your goals, your concerns, and the pros and cons of both.

All the best

Jerome Edelstein, MD
Toronto Plastic Surgeon
5.0 out of 5 stars 176 reviews

Saline vs. Silicone Gel: which one is better?

Great question!

The age-old debate over the advantages and disadvantages of silicone gel implants has raised questions over the safety of silicone itself as well as the reasons why women would chose it.  Thankfully, science has proven that silicone IS safe long-term and experience has shown that the results are far more natural from the standpoint not only of look and feel but also movement.  

Worldwide, more Plastic Surgeons are using silicone implants and this same trend is now being seen in the United States.  In may PS practices, surgeons are using exclusively silicone implants with very positive feedback from their patients.  In contrast to devices used 20 or 30 years ago, today's implants are designed better, last longer, and have a much more natural feel to them.  Saline...well, it just looks and feels like a water balloon for the most part.  

I hope this information was helpful. Please let me know if you have any other questions!

Gregory A. Buford, MD, FACS
Denver Plastic Surgeon
4.9 out of 5 stars 42 reviews

Saline or Silicone??? OMG I can't decide.

Thank you for your question. Silicone and Saline are both great implants, there are some differences between them that you may want to discuss with a board certified plastic surgeon. Reading about the implant online may provide you with information that is not accurate. 


Martin Jugenburg, MD
Toronto Plastic Surgeon
4.9 out of 5 stars 457 reviews

Breast Augmentation

Thank you for the question. The silicone vs saline implant discussion is something I focus on when meeting with my patients during the consultation. Silicone are FDA approved and well studied. The advantages are a soft natural result and an excellent safety profile. The saline are filled with salt water are are safe as well but a little less natural. Each decision should be made after a full discussion with your board certified plastic surgeon.

Frank J. Ferraro, MD
Paramus Plastic Surgeon
5.0 out of 5 stars 48 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.