Silicone vs. Saline: Which Breast Implants are Right for You?

Paper or plastic? Tea or coffee? Chocolate or vanilla? We are often faced with either/or questions in life and, when it comes to discussions about breast implants, I doubt there’s a more frequently asked question than “silicone or saline?”

Just like with the others (except maybe with chocolate vs. vanilla…definitely chocolate☺), not everyone can agree upon an answer to the question “are saline or silicone implants better?” Both types of implants have an excellent safety record, come in a variety of sizes, and, in the hands of an experienced, board certified plastic surgeon, can achieve a beautiful, natural looking breast augmentation.

The more pertinent question, then, would be “which breast implants should I choose?” We touched on the benefits of silicone breast implants in a previous blog post, but today I’d like to take a closer look at when saline might be a good option and when silicone is likely to achieve the better result.

Saline implants may be right for you if:

• You have a good amount of natural breast tissue. Saline implants are more likely to show rippling. While overfilling the implant can help minimize rippling, the trade-off is a firmer breast feel. The more natural tissue you have to cover the implant, the less likely rippling will be an issue, even when the implant is filled to specification.
• You are under 22 years old. Saline implants are FDA approved for patients 18 and up; silicone implants are FDA approved for patients 22 and up. Why this is has more to do with the regulatory history of breast implants than safety. It is legal to get silicone if you are under 22, and plenty of women make this choice. However, breast implant manufacturers often will not honor a warranty for silicone implants if you have them placed before you are 22—so if this concerns you, saline may be the best option.
• You don’t like the idea of getting MRIs to monitor your breast implants. The FDA recommends that women with silicone implants get routine MRI scans every 2 to 3 years to monitor for possible ruptures (it is completely up to the patient to honor this recommendation). This recommendation does not apply to saline, as a rupture becomes evident when the implant deflates and the saline is absorbed by the body.
• You want the least expensive implant option. On average, saline implants cost a few hundred dollars less than silicone.
• You prefer an transaxillary incision type. Because saline implants are filled after placement, they can work with this insertion site. However, it should be noted that this incision type may have added risks compared with inframammary (breast crease) incisions, and fewer surgeons recommend it for that reason. In my 20 years of experience performing breast augmentation, I too have come to strongly favor the inframammary incision. This incision allows me optimal access to create the breast pocket and place the implant in exactly the right place for the best possible results. Plus, once healed, inframammary incisions are hidden—even when you are not wearing clothes—in the natural crease under your breast.

You’ll probably prefer silicone implants if:

• You want a totally natural look. While a skilled plastic surgeon can achieve a fairly natural look with saline implants, the “natural give” consistency of silicone gel implants help them look even more natural inside the breast.
• You also want a totally natural feeling breast. There is no denying that silicone gel implants feel more like natural breast tissue. The latest generation of highly cohesive silicone gel implants closely mimic the feel of a real breast, while saline implants can be quite firm, especially if overfilled to avoid rippling. Silicone implants are also lighter than saline implants of the same size.
• You have very little natural breast tissue. Unsurprisingly, many breast augmentation patients fall into this category. Because silicone implants have a much more viscous filling than saline (which is just saltwater), rippling and wrinkling is much less of an issue with silicone, so even patients with minimal or thin breast tissue can enjoy a natural look. That said, it’s worth noting that even our patients with more ample tissue prefer the natural appearance and softness of silicone.
• You are interested in shaped implants. While shaped saline does exist, you have many more options for size, profile and shape in form-stable silicone implants—which come with the other advantages of silicone implants.

Most women today choose silicone for their breast augmentation

National plastic surgery statistics estimate that approximately 70% of women choose silicone implants; that percentage is even higher here at Berks Plastic Surgery: 98% of Dr. Reedy’s breast augmentation patients in 2017 chose silicone! While we always give our patients the choice and encourage them to weigh the pros and cons of both implant types, most favor the soft, natural feel and natural look of silicone. More importantly, the vast majority of these patients are very happy with their choice, and feel silicone is well worth the moderately higher upfront cost.

Now offering new Motiva® breast implants!

Berks Plastic Surgery is one the first practices to offer the latest advancement in breast implant technology: Motiva® silicone breast implants. Motiva implants are FDA-approved and offer a more natural look and feel, as well as better safety monitoring. Learn more »

Considering breast augmentation in Reading? Let’s talk.

If you are thinking about enhancing your breasts, the most important choice you’ll make is who will perform your surgery. At Berks Plastic Surgery, our board certified plastic surgeons have been performing breast augmentation with saline and silicone breast implants in Reading since 1992, with thousands of happy patients who love their look. If you are looking to explore all of your breast enhancement options, a consultation with one of our plastic surgeons is a great place to start. Call 610-320-02