What size implants should I get? Also silicone or saline? (Photos)

I went in for consultation last week and he said I should have mastoplexy with my breast augmentation... just want to know opinions

Doctor Answers 11

Saline or Silicon

If presented with the options including all of the facts, most people choose silicone implants these days.  They have a more natural look and feel and great longevity.  Concerning the size, you just need to meet with a board certified plastic surgeon and discuss your goals.  He/She will be able to guide you based your breast measurements and desires.  Good luck!


Austin Plastic Surgeon
5.0 out of 5 stars 78 reviews

Breast implant considerations

Thank you for your question.  Most women in my practice consider silicone to feel more "natural".  Saline is still a viable option depending on your preference.  Breast implant selection is an important process and requires good communication between you and your surgeon. Typically, breast measurements are initially obtained to provide an initial guide to implants appropriate for your chest. It's then advised that you try different sizers in a normal bra with a tight t-shirt on to get an idea of what your breasts would look like. It's important to focus on the look that you want and not overly focus on a specific cup size or implant size.  If you're looking for a natural result, implants alone would likely be fine.  For a more perky appearance, a limited lift might be added.  Be sure to consult with an experienced board certified plastic surgeon. Good luck!

Zachary Farris, MD, FACS
Dallas Plastic Surgeon
5.0 out of 5 stars 16 reviews

Saline vs. Silicone

Both saline and silicone implants are FDA approved for cosmetic breast augmentation in the United States. Clinical trials demonstrate similar infection, failure and re-operation rates. Neither type of implant causes breast cancer. Despite lawsuits, and internet horror stories, medical studies do not link silicone implants to autoimmune disease like lupus, scleroderma or rheumatoid arthritis.

The major difference between saline and silicone implants is how the implants look and feel. In general silicone implants are softer, lighter and will feel more "natural." Saline implants are firmer, rounder and gives a more augmented or fake look. These can be positives or negatives depending upon your goals. The main downside to saline is increased scalloping and rippling, meaning a higher likelihood of seeing (visibility) or feeling (palpability) the implant in thin patients. The only two things that control implant visibility and palpability are the device itself and the amount, and quality, of tissue above the implant hiding it. Therefore, the type of implant selected plays a large role in your result in terms of both look and feel. The vast majority of my patients select silicone implants.

Interestingly, when we refer to silicone or saline, we are talking about the inner fill material. Both saline and silicone implants have the same silicone shell, so the body is exposed to the exact same material for the majority of woman who never experience a failure. Only if the shell was to fail would the breast pocket and capsule be exposed to the fill material. Saline is absorbed and urinated out, silicone gel remains inert, and except in extraordinary cases, stays within the breast pocket.

One factor that should not be considered when considering the difference between saline and silicone breast implants is price. A few hundred dollars is a small difference upfront, for a device you may have for decades. Additionally, both implants carry a lifetime warranty against device failure, but the silicone implant includes a 10-year warranty to help pay some of the surgery fees (up to $3500) should the device fail. To put it simply, both have a lifetime “parts” warranty and silicone includes a 10 year “labor” warranty while that “labor” portion of the warranty is an additional $200 for saline, thereby negating most of the price savings.

What size implants should I get? Also silicone or saline? Mastopexy?

Thanks for your photo and questions.  Though I often recommend mastopexy for patients with ptosis, I would not consider this option for you since your breast aesthetic is excellent.  With an appropriately sized implant I think you are very likely to achieve an excellent result as long as you and your surgeon avoid the choice of too large an implant during the surgical procedure.  I prefer to use round cohesive smooth silicone gel implants for my patients and select the final implant dimensions and volume during the procedure when i can see the actual contour and size of the result with a test implant in place.  Best wishes and enjoy your results.  

Jon A Perlman MD FACS 

Certified, American Board of Plastic Surgery 

Extreme Makeover Surgeon ABC TV

Best of Los Angeles Award 2015, 2016 

Beverly Hills, Ca

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 30 reviews

What size implants should I get? Also silicone or saline?

Based on the photos, I think that you will have a very nice cosmetic result without a mastopexy (breast lift). The size for you is based on your desired post-op appearance and your breast dimensions. The implants should not be wider than your breasts. Most women choose silicone implants because of a more natural feel and a decreased risk of rippling or wrinkling. Good luck!

What size implants should I get?

Thank you for sharing your question and photographs.  Depending on your desired appearance I think you can have a very nice result with an augmentation alone and do not require a breast lift.  Silicone implants are currently used 3:1 relative to saline but the best style, size, and shape implant depends on your specific goal outcome, which can only be determined through an in-person examination.  Hope this helps.  

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 43 reviews

Saline vs silicone, some advices:

Thank you very much for this interesting question.
In my practice i recommend using - Cohesive Gel - Silicón Breast Implants with textured cover.
They are quite safe and aesthetically best as they give a firmer consistency, better projection and most natural appearance than Saline implants.
Kind regards,
Dr. Emmanuel Mallol Cotes.-

Emmanuel Mallol Cotes, MD
Dominican Republic Plastic Surgeon
4.7 out of 5 stars 179 reviews

Breast Augmentation - Size Selection

Thank you for your question. "Tissue based planning" relies on your chest and breast measurements and is the safest way to ensure good long term results. Your surgeon should determine what size and projection are necessary to give you your desired result based on your body's measurements. The best way to assess and give true advice would be an in-person exam. Please see a board-certified plastic surgeon that specializes in aesthetic breast surgery. Hope this helps and good luck with your surgery.

Breast Implants/Breast Augmentation/Anatomic Gummy Bear Implants/ Silicone Implants/Breast Implant Revision Surgery

I appreciate your question.

The size of implant best for you  is dictated by your chest wall measurements.  Once we determine that we can choose the profile based on what you want or need to achieve.  If you are seeking a natural look, then the diameter of the implant should be equal to or, more ideally, smaller than the width of your breast. The breast width is a measurement of how wide your breast is at the base, which should be measured at the level of the nipple. Choosing an implant that is smaller in diameter than your breast width will avoid the "side breast" fullness that is often associated with a more artificial appearance.  Other than that, you should choose the implant based on volume, not on the dimensions of the implant. You should choose a board certified plastic surgeon that you trust to help guide you in this decision.  

Silicone will give you a fullness at the top (upper pole fullness).

Silicone implants come pre-filled with a silicone gel and are the softest implant available. They feel more natural, which makes them a good option for women with less natural breast tissue; but they require a larger incision. It may be more difficult to realize if this type of implant has ruptured, so it is important to monitor them with annual follow-up visits. Additionally, because this implant contains a more liquid silicone (less cross-linked), if this implant should rupture, it will leak only into the scar capsule formed around the implant but may cause some discomfort or implant distortion.

Anatomic gummy bear implants might be a good choice to give you volume.

These highly-sought-after, anatomic implants offer a look that more closely resembles the natural silhouette of a breast, and, therefore, are a very attractive option for individuals seeking a natural-looking, aesthetic primary breast augmentation. Additionally, these implants are an especially excellent option for patients undergoing restorative or corrective breast surgery because they provide more stability, shape, and reduced incidence of capsular contracture. Compared to other types of silicone gel implants, the silicone in the cohesive gel implant is more cross-linked; therefore, should the implant shell “rupture,” it maintains its shape and silicone does not leak.

During your breast augmentation consultation, you should feel the different types of implants available, and try on various implant sizers in front of a mirror to help you to get an idea of how you will look following the surgery. You should also bring pictures of the look you would like to achieve, as well as a favorite top to wear when trying on implant sizers.

The best way to assess and give true advice would be an in-person exam.

Please see a board-certified plastic surgeon that specializes in aesthetic and restorative breast surgery.

Best of luck!

Dr. Schwartz

Board Certified Plastic Surgeon

#RealSelf100Surgeon

#RealSelfCORESurgeon



What size implants should I get? Also silicone or saline?

Implant size should be based on a measurement of the base width of your breasts which are surgeon should have measured.  In your photo the nipple appears to be above the fold beneath her breast and if this is so a dual plane breast augmentation  alone without a left may be possible.  I suggest a second consultation with an experienced board certified plastic surgeon. For more information please read below:

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.