I am trying to decide between saline and silicone. I'd prefer the less expensive (saline), but want them to look natural (Photo)

Can I get natural results with saline?

Doctor Answers 9

Saline or Silicone?

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If you prefer the most "natural" feeling, and in some situations, the most natural looking implant result, then a new generation highly cohesive silicone gel implant would be the way to go. Sure, saline implants are less expensive, but over time you will be at increased risk for developing a palpable implant, visible rippling, and implant malpositon. So in the long run a new generation silicone gel implant could also be a real cost savings.

Your photos also suggest that you are likely in need of a breast lift as well as an implant, particularly on what appears to be your left side. Understandably most patients wish to avoid the additional scars and cost associated with a lift. For that reason some surgeons will tell the patient that they can "get away" with a larger implant that is positioned lower or on top of the muscle to "lift" the breast. This would be a poor choice. Implants do not lift your breast, and attempting to do so only results in a large implant that sits low on your chest wall, lacks fullness in the upper breast, and is very predisposed to migrate further south over time. Unless this is the kind of result that you had in mind it is usually best avoided.

Breast implant choices

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The most notable difference between saline and silicone implants is the feel of them.  The saline implants tend to feel more like a bag of water whereas the silicone, more like body fat or breast tissue thus making them more desirable. Judging from your pictures I might also recommend a lift.  The use of the Vectra imaging system could help you visualize your outcome preoperatively to help in your decision making.  Good luck!

Nothing natural about implants

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and you are starting out with marked asymmetry.  If you want to adjust for this asymmetry, saline implants are nice as they can be custom filled from the baseline volume.  But they are more palpable so you have to be accepting of that.  And when they burst, they do so without hours and it could impact an upcoming vacation if it happened the morning of your departure.  Gel implants are softer and cost more.  But you'll never have to deal with a untimely deflation with them and you can choose between the highly cohesive or the 'gummy bear' styles, each with their own pros and cons. 

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 33 reviews

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

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I appreciate your question.

The best way to determine implant size is based on chest wall measurements that fit your body. Once we determine that we can choose the profile based on what you want or need to achieve.

Implants under the muscle, there is less risk of capsular contracture. Anatomic implants tend to give a more natural shape with more nipple projection.

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
Director-Beverly Hills Breast and Body Institute

Saline vs Silicone

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In my opinion, it is critical to seek out the highest quality results when considering elective surgery.  You only get one body, so be careful about trying to cut costs, because you might cut quality at the same time.  The implants you will receive will likely be in you for over a decade, so when you consider the cost of saline versus silicone spread out over that time, the cost difference is fairly negligible. On the other hand, silicone implants will look and feel more natural, and will "wear-and-tear" on your tissues less because it is a softer and more compressible implant that moves better with your body.  It looks like you will need a breast lift, so anything that helps preserve the longevity of your results is important.  You will probably get a very reasonable result with saline, but you will get an even better result with silicone!

Robert Cohen, MD
Santa Monica Plastic Surgeon
5.0 out of 5 stars 58 reviews

I am trying to decide between saline and silicone.

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  • Good questions. You will find that the answers to these questions are best obtained during the consultation process.
  • Generally speaking, much of the final look and feel achieved after breast augmentation surgery depends on several factors:
  • 1. The initial shape, size (volume of breast tissue), symmetry of the patient's breasts. In general, the better the preoperative breast appearance the more likely the breast augmentation “look” will be optimal.
  • 2. The experience/skill level of the surgeon is important in determining the final outcome. For example, the accurate and gentle dissection of the breast implant pockets are critical in producing long-term well-placed breast implants. Careful measurements (dimensional planning) and careful selection of breast implant size/profile are part of the surgeon's responsibilities.
  • I personally think that these 2 factors are more important than any others, including type (saline or silicone) or model (low/moderate/high profile) of implant.
  • 3. The type of implant used may determine the final outcome, especially if the patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. In other words, if a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result.
  • 4. The size and model of breast implant used may make a significant difference in the final outcome. Therefore, it is very important to communicate your size goals with your surgeon. In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. I have found that the use of words such as “natural” or “C or D cup” etc.
  • Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup size may also be inaccurate.
  • I hope this, and the attached link (dedicated to breast augmentation concerns), helps. Best wishes.

I am trying to decide between saline and silicone. I'd prefer the less expensive (saline), but want them to look natural

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If you chose saline they should be placed under the muscle to hide rippling. You may need a combination breast lift and implant to have implants under muscle. If you choose implants on top of muscle avoid saline and choose silicone. Please read below:

I am trying to decide between saline and silicone.

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Saline and silicone implants are both good products and can give you a nice look. Saline has a high chance of rippling that you can feel and sometimes see. If you see it, you would normally notice it on the sides of the breast. Saline is salt water and has a little bit of a water balloon feel in most patients. In my practice 95% of patients choose silicone because it feels more like fat, that is more natural. But it is good to have choices and you should choose what suits you the best. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 29 reviews

You can get a natural look with saline breast implants

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You can absolutely achieve the same natural look with saline breast implants. All the women in the link below had saline implants, and you can see for yourself. The main difference is that in patients with very thin skin and low body fat, you would feel the silicone just a little bit less on the side and under the breast. You should also know the only way you can tell if a silicone implant is ruptured is by an MRI X-ray, which health insurance may or may not cover. Currently the implant manufacturers and the government are recommending that these X-rays be performed 3 years after surgery and then every two years thereafter. Saline is a good option. For more information on this and similar topics, I recommend a plastic surgery Q&A book like "The Scoop On Breasts: A Plastic Surgeon Busts the Myths." Best of luck to you.

Ted Eisenberg, DO, FACOS
Philadelphia Plastic Surgeon
4.9 out of 5 stars 85 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.