Comparing Breast Implant Options: Silicone vs. Saline

Choosing the right breast implant is one of the most important decisions you'll make during your breast augmentation journey. Understanding the differences between implant types helps you have informed conversations with your surgeon and make the best choice for your body and goals.

Types of Breast Implants

Saline Implants

Saline implants consist of a silicone shell filled with sterile saltwater solution.

How They Work

The implant shell is inserted empty and filled to the desired volume after placement. This allows for smaller incisions and adjustable sizing.

Feel and Appearance

Saline implants tend to feel firmer than natural breast tissue. They may be more visible or palpable, especially in thin patients with little natural breast tissue.

Safety Considerations

If a saline implant ruptures, the body safely absorbs the saltwater. Ruptures are immediately noticeable as the breast deflates, making detection straightforward.

FDA Approval

Saline implants are FDA-approved for augmentation in patients 18 and older.

Silicone Gel Implants

Silicone implants are pre-filled with silicone gel that mimics the feel of natural breast tissue.

How They Work

These implants come pre-filled and require a slightly larger incision for insertion than saline implants.

Feel and Appearance

Most patients and surgeons agree that silicone implants feel more like natural breast tissue. They're less likely to show rippling, especially in thinner patients.

Safety Considerations

Modern silicone implants are extremely safe. If a rupture occurs, the gel typically stays within the implant shell or surrounding capsule. Regular MRI screenings are recommended to detect "silent ruptures."

FDA Approval

Silicone implants are FDA-approved for augmentation in patients 22 and older.

Cohesive Gel ("Gummy Bear") Implants

These are a type of silicone implant with a thicker, more cohesive gel filling.

How They Work

The gel maintains its shape even if the shell is cut or broken—similar to cutting a gummy bear candy in half.

Feel and Appearance

Form-stable implants hold their shape well, providing consistent results over time. They may feel slightly firmer than traditional silicone but offer excellent projection.

Benefits

• Less rippling or wrinkling
• Maintains shape over time
• Lower rupture and complication rates
• Natural appearance

Comparing Key Factors

Natural Feel

Winner: Silicone

Silicone gel most closely mimics the feel of natural breast tissue. This is especially important for patients with thin skin or minimal natural breast tissue.

Incision Size

Winner: Saline

Because saline implants are filled after insertion, they require smaller incisions. However, the difference is typically minimal with modern surgical techniques.

Rupture Detection

Winner: Saline

Saline ruptures are immediately obvious as the breast deflates. Silicone ruptures may go unnoticed without imaging, though they're not typically dangerous.

Adjustability

Winner: Saline

Saline allows for minor volume adjustments during surgery. Silicone comes in fixed sizes, though experienced surgeons achieve excellent precision.

Rippling Risk

Winner: Silicone

Saline implants are more prone to visible rippling, especially in thin patients. Silicone's gel consistency reduces this risk.

Cost

Winner: Saline

Saline implants typically cost less than silicone; however, the difference is usually modest compared to the overall procedure cost.

Beyond the Fill: Other Implant Choices

Shape: Round vs. Anatomical

Round Implants

• Same shape in all directions
• Looks the same even if implant rotates
• Creates more upper pole fullness
• Most commonly used

Anatomical (Teardrop) Implants

• Shaped like a natural breast (fuller at bottom)
• Must stay in position to look natural
• May provide more natural results for some patients
• Requires textured surface to prevent rotation

Profile (Projection)

The profile determines how much the implant projects from your chest:

• Low Profile: Wider base, less projection; natural appearance
• Moderate Profile: Balance of width and projection; most versatile
• High Profile: Narrower base, more projection; good for narrow chests
• Extra High Profile: Maximum projection; dramatic enhancement

Surface Texture

Smooth

• Moves freely within the pocket
• Lower risk of capsular contracture in submuscular placement
• Most commonly used in the US

Textured

• Adheres to surrounding tissue
• Required for anatomical implants
• Less common due to association with rare complications

Making Your Decision

Consider Your Body Type

• Thin patients with little breast tissue often do better with silicone
• Patients with more natural tissue have more flexibility in their choice
• Your chest width influences ideal implant dimensions

Consider Your Goals

• Natural look and feel: Consider silicone
• Concerned about undetected ruptures: Consider saline
• Maximum projection: Consider high-profile options
• Subtle enhancement: Consider low or moderate profile

Consider Your Lifestyle

• Active lifestyle: Both types are durable and safe for physical activity
• Contact sports: Neither type is contraindicated, but discuss with your surgeon
• Mammography needs: Both allow for effective breast cancer screening

Consider Long-Term Factors

• Implants typically last 10-20 years but aren't lifetime devices
• Future surgeries may be needed for replacement or complications
• Your preferences may change over time

The Consultation Is Key

The best way to choose the right implant is through a thorough consultation with a board-certified plastic surgeon. During your consultation:

• Try different sizers to visualize results
• Discuss your aesthetic goals in detail
• Review before-and-after photos
• Ask about the surgeon's preferences and experience with different implant types

Your surgeon can recommend the implant type, size, and profile that will best achieve your goals while complementing your unique anatomy.

Final Thoughts

There's no universally "best" implant—only the best implant for you. Both saline and silicone implants are safe, effective options with excellent long-term outcomes. The key is working with an experienced surgeon who takes the time to understand your goals and helps you make an informed decision.