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Saline vs Silicone Breast Implants

Saline Vs Silicone Breast Implants

Several times each day I am asked the question, “Saline vs Silicone Breast Implants?”  I explain that I cannot say which is “better” because it is impossible to define “better.”  Also, breast implant in NYC selection is a very personal decision.  

I do tell my patients that silicone implants tend to look more natural and feel more natural.  They then must decide if bigger or smaller breast implants and if this constitutes “better” in their mind.

Saline and Silicone Breast Implant Video


Two basic choices for breast implants: Saline vs Silicone implants

Breast implants saline vs silicone picturesThere are two basic choices for breast implants: Silicone and Saline Implants. Each has advantages and disadvantages which I will discuss so that you can be more knowledgeable in your pursuit of breast augmentation. Both implants are composed of a solid silicone outer shell and it is the “filling” that makes each different. Saline implants are filled with saline salt water.

Silicone implants are filled with a cohesive silicone gel. If you cut a silicone gel implant in half, the gel will not ooze out – think of the consistency of the inside of a gummy bear. This is a tremendous improvement over the earlier generations of silicone implants that were composed of liquid silicone oil that would run out freely from a ruptured implant.

Saline breast implants are packaged unfilled

Saline implants are packaged unfilled. This means that the empty implant is placed in the breast and the surgeon fills the implant with saline fluid to the desired volume through a small fill tube. There are several advantages to this.

Because the empty implant can be rolled up like a cigar, it can be placed through an incision smaller than the incision required for a silicone implant. Another advantage of saline implants is that the surgeon has some latitude in the amount of volume that can be added.

The implants can generally hold a 30cc range of fluid. This means that a 300cc implant can be filled to anywhere between 300cc and 330cc.  This allows for intra-operative adjustment of volume to help achieve symmetry of the breasts. This has a specific advantage when performing breast augmentation on women with pre-existing breast asymmetries.

We can sit the patient up in the operating room and can look at the breasts and fine tune the volumes – maybe add a little to the right or take a little from the left.

Silicone gel implants come pre-filled

Silicone gel implants come pre-filled. This means that the volume is pre-determined and cannot be adjusted in the operating room, therefore the pre-operative examination and implant size selection is paramount. In addition, the pre-filled silicone gel implants require a longer incision to inert. This longer incision means a longer scar.

It also means that some incisions location choices may not be an option. For example, it may be impossible to place large silicone gel implants through a peri-areolar (around the nipple) incision in women with very small areolas.

In terms of the look and feel of the implant, no one will dispute that silicone gel implants look and feel more natural and a few of the top celebrities have chosen silicone implants. They are soft and feel very similar to natural breast tissue. Saline implants tend to be firmer and may show visible rippling around the edges.

There can also be visible folds, especially during movement or bending over. Placing the implants under the muscle can reduce some of this, but a saline implant will never look or feel as natural as a silicone gel implant.

Advantages of Saline Breast Implants

Saline breast implants contain a silastic shell – which is actually solid silicone. The saline implants may be placed through a tiny incision positioned into the surgical pocket deflated or pulled in a narrow cylinder. During a surgery your breast enhancement surgeon injects your implant in an inflating fluid with saline or salicylic acid if needed. When the saline leaks, your body absorbs them quickly.

When Your Breast Implant Rupture & Deflate

Studies show that the rupture or leak rate of both implants is the same. However, the ability to detect a leak is quite different between the two implant types. When a saline implant leaks, it is obvious. Your breast will be deflated in a few days or weeks depending on the size of the leak. When a silicone gel implant breaks, the gel will not leak out.

This means the breast will not change size. Rather, it will change very slightly in shape. These changes can be subtle and an MRI is needed to detect a silicone gel implant rupture. Studies do not show any connection between systemic sickness and a silicone implant rupture.

Silicone gel will not get into the blood and travel throughout the body and cause cancer, Lupus, arthritis, or any other illness. As stated earlier, implant selection is a very personal decision.

As a physician, I provide the details of each implant type, giving enough information so that my patient can make an informed decision for herself.  In my practice, approximately 80% of women select a silicone breast implant.  They find the implant softer, more natural, and without the common “rippling” that can be seen in saline implants.  Also, many patients who previously has saline implants placed, have returned to have the implants exchanged to silicone.

As you can see, there are advantages and disadvantages to each type of breast implant.

How have breast implants improved or changed over the years?

Implants made of silicon gel have had several generations of development and continue technological advancement in various ways. Originally created in a bid to replace silicone fill, silicone filled implants began becoming popular in the early 1990 – early 2000 period. Recent advancements in silicone implant technology have brought significant improvements. We have also installed 7 and 8 generations of silicone sex implants. The new silicone implants are slightly stronger and have more cross linking of silicone molecules which increases the rigidity of breast implants.

Questions and Answers about Saline and Silicone Implants

Breast implants silicone vs salineIs it better to get saline or silicone implants?

Although the benefits of saline implants may seem appealing, silicone gel implants are generally preferred by both plastic surgeons and patients for breast augmentation due to the drawbacks of saline implants.

As previously mentioned, one of the disadvantages of saline implant ruptures is immediately noticeable, which can be beneficial for early detection. However, most patients perceive this aspect as a downside overall.

What is the healthiest breast implant?

Both saline and silicone breast implants are deemed safe, with ongoing research to assess their safety and effectiveness. Ongoing studies aim to provide further insights into the safety and performance of both types of implants.

What are the negatives of saline implants?

One drawback of saline implants is that they can be more visible under the skin, leading to rippling, and some individuals may experience the sensation of water sloshing inside the implant.

Why choose saline implants?

Saline implants offer the potential for smaller incisions during surgery. The surgeon inserts the shell into the breast first and then fills it with saline, requiring less space for the compact shell compared to the entire pre-filled implant. Consequently, patients benefit from smaller scars due to the reduced incision size.

What is an adjustable breast implant?

Adjustable breast implants offer patients the unique ability to modify their breast size post-surgery, allowing for precise adjustments that align with their proportions and desired outcomes. These specialized implants are equipped with a small injection port or valve, which connects to the implant through a small tube. This feature enables patients to increase or decrease the implant’s volume as needed, providing a personalized approach to achieving their aesthetic goals.

Learn about Saline and Silicone Implants

To learn more about your options like Saline breast implants vs Silicone Gel Breast Implants for breast augmentation, visit a board certified plastic surgeon.

Contact us to schedule your appointment with Dr. Matthew Schulman, by calling 212-289-1851.

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