Is There a Sizing Difference when Switching Saline to Silicone?

Question

I currently have saline 325s filled to 350.  I have to redo my donut lift due to scarring issues and since I've lost size due to weight loss I wanted to get bigger implants while switching to silicone.  My doctor recommends no less than 450 and no more than 500.  I told him that i would probably go with the 500s but having second thoughts now.  How big will the difference be going from 350 saline to 500 silicone?  Thanks for any help.

Otto Joseph Placik, MD · Answer

Technically there is no difference in the volume. However, in practice patients tend to feel as if the silicones are smaller and I will generally go up somewhere between 5-10%

Gregory Sexton, MD · Answer

I agree with the other reviews.

	If I have a patient changing implants to a larger size, I think one needs to go up at least 100cc to see a difference, and 150-200cc for a larger difference, depending on height, weight etc.

Tom J. Pousti, MD · Answer

Yes, there is a difference with how silicone gel implants sit on your chest wall (projection) compared to saline implants. Silicone gel "mold" better to your chest cavity and therefore look "smaller" than the comparable saline implant. 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.

Steven Wallach, MD · Answer

When changing from saline to silicone, size for size volume they are the same. Going from 350-500 will probably add a cup size of volume.

Peter A. Aldea, MD · Answer

Removing old breast implants (especially the capsule you alluded to as "scarring issues") enlarges the pocket for subsequent breast implants making the same volume implants smaller.  With time, there is loss of volume of breast tissue meaning that larger implants would be required to compensate for it.
On the other hand, the larger and the heavier the implants, the more they stretch the breast leading to loss of tissue and sagging. Therefore using ever larger implants rapidly cause breast sagging and irreversible breast tissue changes.
The solution? Use temporary sizers during surgery which would give you the clearest idea of which EXACT implants would give the best appearance without necessarily just placing a pair of large implants in and requiring another procedure in 1-2 years.

Peter E. Johnson, MD · Answer

Each gram of silicone gel is about the same as 1 cc  of saline,which is equivalent to 1cc of the silicone as well. Therefore a 350 cc saline implant can be the same as a 350 cc gel implant, or a 350 gm implant as determined by the manufacturer. I have heard rumors that the gel will appear smaller and vis versa though it is hard to substantiate in practice. When changing an implant to 'go larger'  as a rule of thumb it will take about 150 cc to make a visible difference, so I agree that the 500 cc implant is a good choice, over say 450 cc.
Best of luck,
peterejohnsonmd

George J. Beraka, MD (retired) · Answer

Hi.
1)  For your revision breast augmentation and breast lift, you would want to go a little bigger, and I think 400 cc breast implants would be reasonable.  Your surgeon can put in sterile disposable sizers during surgery to see which size actually looks best.
2)  500 cc's is too big for almost every woman.  Very large implants age very badly.

John Whitt, MD (retired) · Answer

There is no significant difference between the sizes of saline and silicone implants of the same volume. This means that a 325cc saline implant is the same volume as a 325cc silicone implant. The difference lies in the fact that saline implants have a volume range but silicone implants are a definite volume which cannot be altered.

Bruce K. Barach, MD (retired) · Answer

500 cc implants in conjunction with a redo mastopexy might be asking for trouble. the skin envelope has already been too loose twice...the weight of implants that big might well be expected to stretch it out again. even though your eyes might like the larger size breast, your breast tissues might not be able to sustain that larger look.

Richard P. Rand, MD, FACS (retired) · Answer

Your question cannot be answered without examining you because the surgeon would need to measure you and assess your tissues to give you a true answer. However, in general, you need to go up 100 cc's or more to notice enough size difference to be worth it.

Is There a Sizing Difference when Switching Saline to Silicone?

Answers (11)

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