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Breast Implants: Silicone, Saline Scorecard

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If you decide to have breast augmentation surgery, you’ll be making many decisions along the way. One important choice you’ll have is whether to select silicone or saline implants. This can be a tough call as there are advantages and disadvantages either way.

Here’s a scorecard that may help you decide:


To be honest, the look of your implants post-surgery depends more on the right fit in terms of size and profile and your surgeon’s skill in placing them properly than the implant material. That said, saline implants are known to cause rippling under the skin for some patients, especially women who have little natural breast tissue. Many cosmetic surgeons will not make a definitive statement on this point, but when they do, most vote for silicone.

Advantage: silicone


Silicone gel breast implants are almost universally regarded to have the most natural feel by plastic surgeons and patients alike. They earned the nickname “gummy bear” implants because of the firm-but-pliable feel of the material. Saline implants consist of a tough silicone shell filled with salt water.

Advantage: silicone


Silicone implants come pre-filled and pre-sized and must be inserted in their final form. Saline implants are inserted empty and then filled, meaning the scar can be slightly smaller.

Advantage: saline


There’s no question that saline solution is harmless for the body. It has many medical uses, including intravenously for dehydration and as an irrigation fluid for eyes and nose, for cleaning wounds and so on.

For those old enough to remember, silicone may still carry some stigma from the very earliest silicone-filled implants that were ultimately banned from the market. These older implant generations contained a much more liquid form of silicone that did escape the implant shell and sometimes the breast pocket when ruptured. Whether the liquid silicone actually caused the health problems some women claimed has never been proven.

The current generation of silicone implants contains a semi-solid form of silicone, like the famed gummy bear. They are some of the most studied of all medical devices and the FDA declared them safe in 2006. Silicone also has many medical uses inside the body, including in artificial joints, drug delivery systems, heart devices and facial implants.

Advantage: even


This new generation of cohesive silicone gel implants has not been available long enough for extended studies, but early data suggest that the implants have improved durability. In any case, when the shell of a cohesive silicone gel implant breaks, as some will inevitably do, it’s very possible the patient will not notice. Like a gummy bear, the inside is not likely to leak out. The FDA recommends women with silicone implants have regular MRI screenings for this reason, but few women actually do. If you choose silicone implants and suspect a rupture, you should see your doctor. Most physicians would recommend replacement if your suspicions are confirmed.

If you should elect saline implants, you’ll know right away if one deflates. The saline solution will be absorbed into your body, and implant replacement will definitely be needed.

Advantage: even


Saline implants cost less than silicone gel implants, about $1000 less. The cost of silicone implants may come down over time, but for now the score is clearly:

Advantage: saline

Maybe after all this you’re no more certain than you were before. No worries. That’s why plastic surgeons offer consultations. Sign up for at least three. You’ll have the chance to touch and hold different kinds of implants, and you should have the opportunity to ask as many questions as you like. Most women come away excited at the chance to have the figure they’ve always wanted, whether enhanced with silicone or saline implants.

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EmpowHER Guest

Another thing that would be good to note are the age restrictions. I believe you have to be over 18 to get saline and over 22 to get silicone. Some additional things people looking to get breast implants should consider are placement, incision technique, and texture. This article sums those up well: http://www.advancedplasticsurgeryinstitute.com/plastic-surgery/breast-augmentation.cfm

Good article! Nice to see someone lay out the pros and cons so well.

November 26, 2013 - 3:48pm
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