5 Questions You Have About Silicone Breast Implants Answered by a Board Certified Plastic Surgeon

Since I joined Berks Plastic Surgery in 1998, I’ve performed literally thousands of breast augmentations. One of the first and most important choices my patients make (after choosing an experienced, board certified plastic surgeon, of course) is whether to get saline or silicone breast implants. If you’re considering breast augmentation, you’ll make this choice too.

Having basic information about your options is key to making a confident decision. As one of the few plastic surgeons in the Reading area who performs a high volume of silicone breast augmentations, I’ve answered some of my patients’ silicone breast implant FAQs below.

1. Are silicone or saline implants better?

It’s very hard to make a blanket statement about which is “better” in a blog post: for some patients, saline may be the better option, while for others, silicone is better. That said, our plastic surgeons believe the benefits of silicone surpass those of saline, and the vast majority of our Reading breast augmentation patients choose silicone—and they’re glad they did. A few reasons why:

• Silicone implants feel softer and more natural. Saline implants usually feel firmer, especially for women with less natural breast tissue to cover the implant. This is because most surgeons overfill them a little to prevent a “sloshing” sound and/or reduce rippling.
• Silicone implants typically look more natural. While patients with more ample natural tissue to cover the implant edges can get a very natural look with saline, women with thinner tissues will usually fare better with silicone.
• Rippling or wrinkling is rarely an issue with silicone. The saltwater in saline implants can move around and cause visible edges and rippling in patients with thinner tissues.
• Silicone is generally lighter compared to saline in the same size implant.
• Silicone comes in a wide range of sizes, shapes, and profiles, allowing for a customized fit and symmetry.
• Both silicone and saline implants have an excellent safety record. And either way, your implants will have a silicone shell. Thus, given the above benefits, most patients prefer silicone.

2. What’s the difference between silicone and gummy bear implants?

This common question is kind of a trick question: gummy bear implants are silicone implants!

The gel in standard silicone implants (often called simply “silicone”) is softer and provides the most natural feel of any breast implant option, yet it is still very thick and will stick to itself—it’s more the consistency of Jell-O than jelly. Because this softer silicone fill can move slightly within the shell, silicone gel implants are always round to ensure you retain a uniform breast appearance. Plus, they use a smooth shell, which is believed to be the safest.

In contrast, the silicone in gummy bear implants is “form stable.” It will hold its shape in any position, even if cut in half. This firmer silicone is close to the consistency of gummy candy (hence the cute name), and is ideal for anatomically shaped breast implants. However, gummy bear implants result in a firmer breast with little aesthetic advantage, and they require a textured shell, which is associated with higher complication rates. Our plastic surgeons can achieve an equally natural look—and a more natural feel—with silicone gel without these drawbacks, so we don’t even bother with gummy bear implants at Berks Plastic Surgery.

3. Which implants last longer: silicone or saline?

Both saline and silicone implants are designed to last many years; however, no breast implant is considered a “lifetime device.” At some point, most women will need to have their breast implants replaced, regardless of implant type.

The risk for rupture remains very low for the first decade, and then starts to increase every year—this is why you’ll often hear that implants should be replaced every 10 years. Actually, there’s no need to replace silicone implants unless you are having a problem or would like to exchange them for aesthetic reasons, even if it’s been 10 years.  

That said, it’s good idea to visit your plastic surgeon every few years to make sure everything is still going well, and there are a few benefits of replacing your breast implants every decade or so. First, you will “reset the clock” on your implants and thus have a better chance of avoiding a rupture in the first place. Also, breast implant technology is always improving, so updating your implants every so often lets you take advantage of the latest and greatest options.

4. Will I have to get MRI screenings with silicone implants?

The FDA currently recommends that patients with silicone implants get regular MRI screenings: 3 years after breast augmentation surgery and every 2 years thereafter. Why? Saline will noticeably deflate if the shell ruptures, but the highly cohesive silicone used in today’s silicone gel implants usually holds its shape even when ruptured. An MRI is one of the only ways to accurately detect a shell rupture for a silicone implant.

Although it’s extremely rare for silicone to rarely move out of the breast capsule (the natural scar tissue that seals the implant off from the rest of the body)—or even implant shell in the case of gummy bear implants—it’s best to replace a ruptured implant.

5. How much do silicone breast implants cost?

If there’s any slight downside to silicone implants, it’s that they cost a few hundred dollars more than saline. For example, at Berks Plastic Surgery breast augmentation with silicone costs start at $7,475 versus $7,000 for saline. However, taking into account the more natural look and feel, and the fact that breast implants are meant to last many years, the additional cost is minor in the grand scheme of things.

Have more questions about silicone breast implants? Ask us at a consultation.

I hope you’ve got a better idea about the pros and cons of silicone breast implants after reading these FAQs, but you’d be a rare patient if you didn’t have a few of your own questions. If so, I invite you to contact our office and schedule a personal consultation with me, Dr. Brian Reedy, or my colleague, Dr. Scott Lindsay. Whether you live near Reading or you’ll be traveling to see us, you will receive our undivided attention to make sure you get the answers you need to make a confident decision about breast augmentation and your implant options.