Should I get saline or silicone?

Question

I have delayed my surgery several times as I’m not sure which option would be best. Would silicone increase the risk of Breaat implant illness??? Which is more natural???

Brian K. Reedy, MD · Answer

Thanks for your question
Most patients prefer the silicone, gummy bear implants. They feel soft and natural. Reach out to your surgeon to discuss the best option for you. Best wishes!

Semih Yildiz, MD, FEPOBRAS · Answer

Silicone gel implants usually feel more natural than saline, especially in patients with thinner breast tissue, because the gel is softer and tends to ripple less. Saline implants can still give a good result, but they are more likely to feel firmer, show rippling, or deflate suddenly if the shell fails.

Breast implant illness symptoms have been reported by some patients with both silicone and saline implants, and current evidence does not clearly prove that silicone gel alone creates a higher risk than saline. The outer shell of both types is silicone, so choosing saline does not completely remove that concern. If BII is a major fear for you, it is worth discussing whether implants are the right choice at all, or whether a smaller implant, fat transfer, or no surgery would feel more comfortable. For the most natural feel, most surgeons and patients generally prefer modern cohesive silicone gel implants when the patient accepts the maintenance and monitoring that come with implants.

Ali Riza Öreroglu, MD · Answer

Breast implant selection varies based on patients' anatomical structure, aesthetic preferences, and overall health. I find it crucial to conduct a detailed consultation and assessment process for the surgical procedure and the choice of implant type. Saline implants may have limitations in providing a natural look; therefore, I typically recommend Ergonomix type 2 implants. Plans are tailored based on patients' health conditions, and necessary tests are conducted preoperatively. Every surgery carries risks, but I take necessary precautions to minimize them. Saline implants, containing a saline solution, can be easily absorbed in case of leakage but may lack a natural appearance. Silicone implants, especially in Ergonomix type 2, have a low probability of capsule formation. I prefer Ergonomix 2 implants when it comes to natural result.

John L. Burns Jr., MD · Answer

Silicone implants have a more natural feel with less rippling.  Saline is fine and has an advantage in that if it leaks you know for sure and don't have to worry about silent rupture.

Bora Ok, MD · Answer

Hi from Istanbul! I prefer silicone implants for my patients since they tend to offer a more natural feel and stability. However, it's crucial to opt for high-quality implants and an experienced plastic surgeon to ensure the best results. Best of luck on your journey!

Leila Kasrai, MD, FRCSC · Answer

Both saline and silicone implants are made with a silicone shell. The implant shells are then filled with either silicone or saline. Both can achieve natural looking results. The risk of developing an illness after surgery is considered rare. Therefore, you would have to determine which would be more suitable for you.

Daniel Barrett, MD · Answer

Dear Laura Scott1309,
the two main types of implants are silicone and saline. The shell of the implants can be either textured (which reduces capsular contracture) or smooth. A textured implant sometimes requires a larger incision. The shape of the implant can be either round or tear drop shaped (gummy bear). Both have their advantages and disadvantages.
The different types of implant offer different pros and cons. For instance, the pros of silicone implants are that they look and feel more natural and ripple less.
On the other hand, the pros of saline implants are that they do not require as large of an incision as silicone, less expensive, they have less incidence of capsular contracture (scarring around the implant), one can tell immediately if there is a rupture, the size can be slightly adjusted, and they can be used for women less than 22 years of age.There have been numerous studies on the safety and efficacy of silicone breast implants. The FDA has approved them to be safe and breast augmentation is the most common cosmetic surgical procedure performed in the United States every year. Implants are much different than they used to be with rigorous testing and cohesive gel. I can't tell you how happy my breast augmentation patients have been with their implants.
I would recommend a consult with a plastic surgeon to go over all of your concerns. Saline implants are also a perfectly good option if you are still concerned and are less expensive.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Jeffrey M. Darrow, MD · Answer

The positives of saline implants: 1) they cost less than silicone implants, 2) the implants can be filled asymmetrically if you have small volume differences of your breasts, 3) if you develop a leak you will know as the saline is absorb by your body and you will see a gradual deflation.
The negatives of saline implants: 1) there is more folding of the implant shell, which in thin people can result in palpable or visible rippling of the skin of the breast, 2) saline implants don’t feel as natural as silicone implants.
I am not aware that the rate of Breast Implant Related Illness is greater in one implant over the other.  
I recommend that you obtain the FDA consent form regarding breast implants, read it in its entirety, and then contact the website of the American Society Of Plastic Surgeons for additional resources on breast implants. These will likely help you answer many of your questions, in addition to a detailed discussion and consultation with your plastic surgeon. Best wishes.

Ted Eisenberg, DO, FACOS, FAACS · Answer

Through outcome surveys and ultrasound evaluation, Swanson, in his 6/2020 PRS publication, objectively found that the visible and palpable rippling rates of silicone gel and saline implants were similar. His study was the first scientific study comparing the two implants. With saline, if it deflates, you know without the need for special x-rays or testing. Usually they require smaller incisions because they are placed empty in the pocket then inflated. They are often about a $1000 dollars less than silicone. These are just a few of the advantages. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Farbod Esmailian, MD · Answer

You have to be comfortable with your choice. Both implants can have a natural look, as it depends on the surgeon and how the procedure is addressed as well as implant sizing and the fill. Currently, approximately 85% of the procedure that are done in the country are performed with some type of silicone implant. When I say type, I am referring to the different cohesive or gummy levels of gel that are available on the market. Silicone implants have decreased implant rippling and a more natural (like breast tissue) feel.

Most important factor in your surgery should be the surgeon you choose, rather than the implant. Make certain your surgeon is board certified and has a great deal of experience in breast implant surgery.

Hope that helps.

Most important factor in your surgery should be the surgeon you choose, rather than the implant.  Make certain your surgeon is board certified and has a great deal of experience in breast implant surgery.

Hope that helps.

Should I get saline or silicone?

Answers (17)

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