Breast Implant 101: Saline vs. Silicone

Saline Breast Implants vs. Silicone Breast Implants

Breast ImplantsIn the 1990s, silicone implants were taken off the market due to concerns there was a link between silicone implants and auto-immune disease. After years of studies, more than any other medical device has ever gone through, there was no link established between silicone implants and an increased risk of any systemic disease. In 2006, silicone breast implants were approved by the FDA and are now the most widely used implant for breast enhancement surgery.

Although, more woman choose silicone over saline, that doesn’t mean they are the best choice for everyone. There are differences between silicone and saline implants each with its own advantages and disadvantages depending on the situation. Women should consult with a board-certified plastic surgeon who specializes in cosmetic breast surgery to determine which option is best suited for her body and desired goals.

Saline Breast Implants

“Feel”
Saline implants are firmer than silicone implants, which means they are not as natural feeling as that of real breast tissue. There is also the chance of being able to feel the outer edge or fill valve of the implant, especially when there is very little breast tissue and/or the implant is placed above muscle.

“Look”
While is some cases, the look may be just the same as silicone, there are instances where saline does yield a more dramatic look. If you were to hold a saline implant from the top with two fingers, it would not change shape with gravity, while the silicone in silicone implants would move towards the bottom. So, when saline is implanted into the breast it provides a more structured appearance, while silicone can appear more natural.

There is also a slightly greater chance of visible rippling or wrinkling with saline implants, which could be seen if there is very little breast tissue and/or the implant is placed above muscle. For this reason, silicone implants are recommended for women who lack breast tissue.

“Incision”
Saline implants are empty when inserted into the breast, which means a smaller incision is needed. For women wanting large or excessive breast implants, saline may be a better option due to the reduced incision size and smaller scar. For women wanting a a peri-areolar or belly button incision, saline implants are much easier to insert.

“Size”
Like silicone, saline implants come in a variety of sizes, however each size comes in a range. For example, one size might be 420cc – 450cc. This means the implant shell can filled within this volume range. Since saline implants are filled once they have been placed inside the breast, this allows the surgeon to make adjustments to the volume to compensate for any asymmetries between the two breasts.

“Rupture”
The most common complication with saline breast implants is a rupture. If an implant ruptures, deflation usually occurs quite quickly. Whether it is a quick or gradual loss of volume, patients are comforted knowing that it is just salt water entering into the body, which will be harmlessly absorbed by the body. While this is obviously not desirable from an aesthetic point of view, it doesn’t need to be fixed urgently, however plastic surgeons agree it should be removed sooner rather than later as a safety precaution.

Silicone Breast Implants

“Feel”

Silicone implants are the most popular implant of choice, because most closely emulate natural breast tissue. They are softer to the touch.

“Look”
Silicone implants are filled with a silicone gel material that is very pliable and creates a more natural look than saline. There is less chance of visible rippling or wrinkling compared to saline. Silicone is a better option for women with very little breast tissue and/or those wanting over-the-muscle placement. It is also a better choice for women needing post-mastectomy breast reconstruction.

“Incision”
Since silicone implants come pre-filled a larger incision is necessary to insert them into the breast. The most common incision site for silicone implants, especially larger sizes, is in the inframammary fold (breast crease). Placement in this location allows for a longer well-hidden horizontal incision.

“Size”
There are a large variety of sizes available. Implants come in a set size (ex: 339cc, 457cc). They do not come in a range like saline does. The volume is set and cannot be altered during surgery. If there is significant asymmetry between the breasts, a different size implant can be placed in each breast to compensate for the differences.

“Rupture”
Although rare with silicone implants, if it should rupture, it will not deflate like saline implants. You will most likely have no idea your implant has a defect. This is called a silent rupture. There are a couple of possibilities that can occur with a silicone rupture, the gel stays inside the breast capsule or it migrates to other parts of the body. The FDA recommends women with silicone breast implants have an MRI screening for silent rupture 3 years after surgery and every 2 years after that. More information about silicone implants can be found on the FDA’s website.

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