Are the risks of a ruptured gel implant serious enough to choose a saline implant instead?

I am 5' 5" 123 pounds. I have been to two consultations. Doctor A said get saline moderate plus 225 cc. Doctor B says because of my slenderness a ripple effect may occur with saline and says get gel. I only want gel because i want a natural feel. Gel is scary since it can rupture and go undetected and only last about 10 years under warranty. I do not want saline because i do not want rippling, and i want a more natural feel especially because i do not have much breast tissue to begin with.

Doctor Answers 8

Are the risks of a ruptured gel implant serious enough to choose a saline implant instead?

There are several different issues that you brought up that warrant further discussion. First, silicone gel implants do tend to feel more natural and have less palpability than saline implants, especially in thinner women with minimal breast tissue. The second issue you brought up is silicone gel implant rupturing and detecting that rupture and the implant warranty. Here is what I tell my patients:
Silicone implants are safe and have not been linked to breast cancer or any other diseases.
The leak rate for silicone implants is slightly lower than the leak rate for saline implants.
When a silicone implant leaks, there is no volume change to the breast. In some women, the silicone will be inert and just stay in the implant pocket and not cause a problem. In other women, the leaking silicone may cause a condition called capsular contracture which causes the breast to become more firm. Sometimes this is the first sign that the implant has leaked. This can be corrected with surgery, but again will not cause any other health issues.
The warranty you describe does not relate to how long the implants might last. It only relates to the length of time the  company will pay for the cost of replacement surgery if the implant leaks, usually within 10 years. All silicone implants sold in the USA are warrantied for replacement(meaning the company will give you another pair of implants at no charge) for as long as you have them.

Risks of gel implants

are negligible at this time as a summary of studies reviewed in 2000 by the Institute of Medicine concluded that there is no evidence that gel implants cause systemic diseases and that was 14 years ago and nothing new has shown up since.  Some doctors just are biased towards saline and they will insist that is all you should have, regardless of the science that is out there.  All implants have warranties that help pay for surgery up to 10 years then the warranty is limited to replacement of the implant.  I would use gel implants in my own family if they wished to have them.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 32 reviews

Breast aug

Thank you for the question.

I would suggest for you to speak to your PS, your implants were registered and there' warranties that can help you get help.

Dr. Campos

Jaime Campos Leon, MD
Mexico Plastic Surgeon
4.4 out of 5 stars 243 reviews

Risks of a ruptured silicone gel implant

The risks of a ruptured gel implant are not serious enough for it to be the only reason to choose a saline implant. Consider any other reasons why you might prefer a saline implant and weigh them up against the ripple effect. Modern silicone gel implants are safe and in the rare event of a rupture, removal and replacement can still be performed as a planned procedure, ie not an emergency. A ruptured saline implant would also require a planned procedure to replace it. Most manufacturers now provide a lifetime warranty for silicone gel implants, but bear in mind this often covers just the cost of the replacement implants. The other costs of surgery will still need to be borne by you. 

Roy Ng, FRCS(Plast)
London Plastic Surgeon
4.8 out of 5 stars 11 reviews

Saline or silicone gel?

Both the saline and silicone implants have the same type of outer rubbery silicone shell. The inner fill is different: sterile saline solution in the saline Implant and silicone gel in the silicone Implant. There are advantages and disadvantages of each type of implant. Both are utilized by surgeons across the country with satisfactory results. They are both safe and approved for usage by the FDA. Currently there are more silicone gel implants used in the U.S. While either implant can produce excellent cosmetic results in the appropriate patient, most patients prefer the feel of the silicone gel implant.

The best way to determine what the best implant is for you is to discuss the advantages and disadvantages of the various types of implants along with your concerns and personal preferences at a consultation with a plastic surgeon who should be certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAP).

Robert Singer, MD FACS

La Jolla, California

Robert Singer, MD
La Jolla Plastic Surgeon
4.6 out of 5 stars 19 reviews

Saline vs silicone breast augmentation

While it is difficult to give you precise advice without at least pictures, in general if you have minimal breast tissue the feel of the silicone breast augmentation is a lot more natural and better than saline augmentation. The new form stable breast implants are less likely to rupture and even if ruptured do not travel to lymph nodes per se. In terms of warranty, now the new silicone Sientra breast implants have a lifetime warranty.

Kevin Tehrani, MD, FACS
New York Plastic Surgeon
4.8 out of 5 stars 88 reviews

Silicone v saline

This is a tough decision for most women but if you do not have enough soft tissue coverage, then you are at greater risk for rippling. It is inaccurate that silicone gel implants have to be replaced at the 10 year mark.  Silicone does feel more natural but is more expensive.  Ask your plastic surgeons about the warranties but know that manufacturer's largesse can change over time,

Saline vs gel

Based solely upon your height and weight I would be recommending a silicone gel implant to give an optimal result.My main concern with saline in a relatively slender patient like yourself is the potential for visible rippling. While this can still happen with gel it is much more unlikely and you get a more natural feeling implant as well. You are correct the gel warranty is only for 10 years but this does not mean the gel implant will rupture in that time frame - I have patients I put gel implants in at the start of my career 25 years ago who have no concerns with their implants. Follow your Plastic Surgeons recommendations re MRI and/or mammograms  post-op and you should have no concerns with a long term undetected rupture.   

Paul Buhrer, MD
Annapolis Plastic Surgeon
4.9 out of 5 stars 12 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.