What Type of Implants Would Give Me a More Natural Look? Saline or Silicone? Under the Muscle?

Which one is better? I want to look as natural as possible! Under the muscle or over? Saline or silicone?

Doctor Answers 12

Which Type of Implants Would Give a More Natural Look

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Both cohesive gel (silicone) and saline implants have pros and cons for producing a natural look and feel.  It really comes down to your body type when choosing an implant that is right for you.  A consultation with an experienced surgeon is the best way to get advice for implant type. Be sure to choose a surgeon that is board certified and whom you feel comfortable with.  At my clinic, patients have the opportunity to try sizers on and even use computer imaging to help decide which size and type of implant is best for them.

Submuscular Silicone

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Silicone under the muscle generally looks more natural and feels more natural. I always telll my patients that sub muscular implants have an advantage in that there is a lower capsular contracture rate, lower risk of nerve injury and less rippling and palpability.

Leonard W. Gray, MD, FACS
San Francisco Plastic Surgeon
4.5 out of 5 stars 48 reviews

Saline vs Silicone?

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In terms of the look of the implants I think that both Saline and Silicone look very similar when placed under the muscle.  If you have a lot of loose skin you can put Silicone over the muscle but for the most part I put the implant under the muscle for the best results.  The feel of the implants however do differ and the Silicone implant will feel more natural than the Saline. 

Robert N. Young, MD, FACS
San Antonio Plastic Surgeon
4.6 out of 5 stars 73 reviews

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For the most part either implant will create the same natural look.

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The saline and gel implants come in basically the same dimensions  and you can achieve therefore the same natural look with either one. Depending on your anatomy either implant can be placed above or below the muscle and still achieve again a natural result. It  requires an in person consultation to determine whether the implant should be placed above or below the muscle. In fact, in some individuals either approach can work.

David A. Ross, MD (retired)
Chicago Plastic Surgeon

Implants and a natural look

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Look and feal of a breast augmentation are two different things.  Given you have a fair amount of breast tissue, the LOOK is essentially equivelant.  The FEEL can vary tremendously.  In general the FEEL is far superior with silicone implants.  However , saline implants do not feel fake.

Always go under the muscle for the most natural look.

Talmage Raine MD FACS


Talmage J. Raine, MD, FACS
Chicago Plastic Surgeon

Saline or silicone?

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Usually, silicone gel implants under the muscle will look and feel more natural. Remember that size of the implant, projection, and skin sufficiency all bear on this too, and the best choice will be made based on examination and discussion with your surgeon.

Natural Look. Silicone-gel filled vs. saline-filled

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In general and below the pectoralis muscle where implants generally need to be, a properly sized and positioned saline-filled implant will look just like a silicone-gel filled implant. Part of "natural" is the feel; if you can feel the implant. Saline-filled implants even done perfectly will not feel as natural where the muscle doesn't cover it. Gel-filled implants only real advantage is that they feel more natural than saline regardless of where you put them or how much tissue coverage is over them. 

To specifically answer your questions: (1) Under the pectoralis muscle and (2) depends on whether "natural" means "look" or "feel" as well as how much tissue coverage you have over the side and lower pole of the breast where the muscle doesn't cover. 

Other factors relating to naturalness include properly sized implants, properly positioned implants, proper release of the pectoralis muscle lower/lateral edge, and proper filling (if saline-filled). 

Scott L. Replogle, MD
Boulder Plastic Surgeon

Most Natural Breast implants

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While either saline or silicone breast implants can give a great result, in my experience, silicone implants placed under the muscle, tend to give a softer more natural appearance.

Natural look with breast implants

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There are so many factors which go into a most natural look after augmentation. The ideal result we feel is with an implant that will shape the breast, yet move and flow with the natural breast so that they feel as one. The best implant is one that cannot be easily detected. Depending on the breast size and density, the skin envelope, and the ultimate goal or 'look' after breast augmentation, there is no best implant. The gel is not always better for some, and submuscular is not always the answer. We suggest a consultation with a surgeon with an open mind who will listen, and see how your goal fits with what your breast will allow. We have excellent results with all techniques, and you will find after a consultation what is right for you.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews


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Silicone gel implants will always provide a more natural result.  The only exception to this would be in someone who has moderate amount on breast tissue like a C or D cup and only wants to increase one cup size.  In this situation the implant acts more like an enhancer and a saline implant will give you a fairly natural result.

Todd B. Koch, MD
Buffalo Plastic Surgeon
4.6 out of 5 stars 37 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.