Silicone vs. Saline: Learn more about each breast implant type

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Jill Daniels, Freelance Medical Writer

Jill Daniels is a freelance health writer based in New York City. She spent several years writing for WebMD, including their Weight Loss Clinic and Fertility Center programs. Jill has also written/reported for publications including InStyle, People and Women's Own. She received a degree in journalism for Northwestern University's Medill School of Journalism.


May 07 2008

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For many years, women who wanted breast augmentation basically had one choice when it came to implants: saline. Now that silicone breast implants are back on the market and readily available, the question arises: Which implants should you choose: saline or silicone?

Deciding between the two types of breast implants is not easy as there are a variety of pros and cons to each type. It's important to understand your own needs and desires when it comes to breast augmentation. In other words, what is it that you are looking to achieve?

Breast Implant Basics
Both saline and silicone implants have outer shells made of a solid silicone rubber. The difference lies in what is used to fill the shell. Saline implants contain a sterile saltwater solution and silicone implants are filled with a gelatinous silicone gel.

Many of the side effects associated with breast implant surgery are the same for saline implants and silicone implants. Both carry the risk of pain, decreased nipple or breast sensation, infection and capsular contracture (when scar tissue hardens around the breast). Both saline implants and silicone implants carry a risk of rupturing as the rubbery outer shell can form tears, and they both may need to be replaced at some point – they are not lifetime devices.

That said, if you're trying to decide which type of implant is best for you, it's helpful to know some specific pros and cons of each.

Saline Implants – The Pros

  • Saline implants can be filled after insertion in the body, thus requiring only a small incision.
  • Saline implants contain small valves that doctors use to fill the implant when it's in the body, so it's possible to alter the size to meet a woman's physical needs or aesthetic desires "on the spot". This also makes it easier to correct existing breast asymmetry.
  • With one type of saline implant, adjustments can be made in the size for several weeks after surgery. These have a small port that the surgeon can inject saline into. After a few weeks, this port is removed and the implants stay the same size after that.
  • If a saline implant ruptures, the saline (salt water) is absorbed easily in the body.
  • If a saline implant ruptures, the implant deflates, quickly calling attention to the problem.

Saline Implants – The Cons

  • Saline isn't compressible like silicone, which has a thicker consistency that closely mimics human fat, a major component of female breast tissue. Consequently, many people think that saline implants look more fake or augmented than silicone implants do. Saline implants have also  been criticized for feeling hard or unnatural.
  • Saline implants are more likely to ripple, which may actually show through the skin, particularly in small-breasted women who have little breast tissue to cover  the implant.

Silicone Implants – The Pros

  • Many people believe that silicone breast implants are softer and offer a more natural look and feel than saline breast implants.
  • Silicone implants may look better on very thin women and women who have small breasts because not as much breast tissue is needed to cover the implants effectively.
  • Because the consistency of silicone is much thicker than saline, it tends to ripple less.
    Silicone Implants – The Cons
  • The size of the implant has to be chosen prior to insertion because it cannot be changed once it's in the body without another operation. The fact that it is prefilled also means a longer incision for insertion may be necessary.
  • If the outer shell breaks and the silicone leak migrates, it may require a more extensive procedure than basic replacement surgery to clean all of the silicone out of the body.
  • If a silicone implant ruptures, it's typically "silent" and can be difficult to detect because the silicone gel can leak into the surrounding area without any telltale signs. The rupture can be confirmed by ultrasound, CT, or magnetic resonance imaging (MRI). The FDA advises that women with silicone implants should get an MRI every few years to check for problems.

Other Facts You Should Know

  • Saline implants are approved for women age 18 and older for cosmetic use, and for women of all ages for medical or reconstructive use. Silicone implants, on the other hand, are approved for women age 22 and older for cosmetic use, and, like saline, for women of all ages for medical and reconstructive purposes.
  • While price may or may not be a factor to you, you should know that silicone implants cost about a thousand dollars more than saline implants. And the recommended MRI screenings that go along with silicone implants can add up, too.
  • In countries where there was never a safety controversy, and both silicone and saline implants have been available for years, the majority of women choose to have silicone breast implants.

Surgical techniques are always changing and breast implants are continuously being refined. There are new options, such as cohesive gel implants, also known as gummy bear implants, on the horizon. Before you commit to anything, talk to you doctor and ask all the questions you may have. Your plastic surgeon should be able to provide you with the latest information you need to make an educated decision.