The Difference Between Saline and Silicone Breast Implants

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When it comes to choosing the right breast implants for your body, there are many decisions to be made: size, shape, placement, profile, type of filler and type of incision. It sounds totally overwhelming, but a good board-certified plastic surgeon will help guide you and make sure you feel confident with every single choice. One of the biggest decisions is the type of filler you prefer, whether that's silicone or saline. Here are the key differences between the two.

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Saline Implants
Traditional saline implants are available for women over the age of 18—or any age for reconstruction—and rely on saline (sterile saltwater) to provide fullness. A silicone shell is inserted into the body during surgery and then filled to the desired volume by a plastic surgeon via a small incision that results in a small scar. According to the American Society of Plastic Surgeons (ASPS), some saline implants have the advantage of being adjusted post-op via a remote injection port—this is commonly done in some types of breast reconstruction procedures to fine-tune the final implant volume over the course of several months, and then the implant port is removed.

One of the biggest cons with saline implants is that they tend to not look and feel as natural as silicone implants and may cause a rippling effect under the skin, especially in thin patients or those with thin skin. This type of implant can also leak, and although not ideal, the saline gets absorbed by the body and is not deemed dangerous.

Pasadena, CA plastic surgeon Lily Lee, MD doesn't offer traditional saline implants at her practice anymore because she thinks the Ideal Implant is a better option. "If clients want saline, I offer the Ideal Implant. Why drive a Toyota if you can drive a Lexus? The Ideal Implant is a chambered, structured saline-based implant that comes closer in feel to the silicone implant. Nonetheless, everyone is different. Some of my clients think there is a world of difference in how the Ideal feels compared to the silicone implants, and some are unable to tell the difference. The ratio of how much breast tissue a client has compared to how large their implant is makes a difference as well. Someone with a lot of breast tissue and a fairly small implant will be less likely to feel the difference." 

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Silicone Implants
Pre-filled silicone implants are made of a thick, cohesive gel that helps prevent the silicone from migrating. Most surgeons agree that silicone implants feel more like natural breasts. "There is a big difference between the two types when it comes to the feel of the implant," says Irvine, CA plastic surgeon Andrew Smith, MD. "Generally silicone implants are softer than saline ones, and we now have new varieties of cohesive implants—known as 'gummy bear'—that allow us to customize the experience to an even greater detail." 

Silicone implants require longer incisions (2 to 2.5 inches) to be made than saline, but "there's less associated rippling," says Dr. Smith. Another question you should ask your doctor when deciding which filler type is right for you: What happens if it leaks? "If a silicone implant ruptures or leaks, it will be silent, meaning you will not know without an MRI," says Dr. Lee. "With a saline-based implant, leaks are detected within days because the implant will be noticeably deflated." And according to the FDA, women must be 22 years of age or older to be offered silicone implants for breast augmentation, but they can be any age for breast reconstruction.

Additional risks associated with breast implants have been a hot topic in recent news and should be discussed in-depth with your surgeon before entering the OR. Click here for everything you need to know and stay tuned to NewBeauty for updates.