Saline vs. Silicone Implants for Breast Augmentation
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Breast implants are not all the same. Instead, they come in two forms: saline and silicone.
Patients use these implants to enhance the size of their breasts or restore their shape after an accident or surgery.
But what are the differences between the different types of implants? The main difference is the filling. Saline implants contain salt water while silicone versions contain a type of silicone gel. Silicone implants also feel more life-like than their saline counterparts, though they come at a premium.
What Are Saline Implants?
Saline implants are breast implants filled with salt water. Surgeons either put them into the breast tissue empty and then fill them up to achieve the desired volume or insert them pre-filled.
The outer shell of a saline implant is silicone, a smooth, flexible, hypoallergenic material used in many medical procedures. It is strong, reducing the risk of rupture post-operation.
Saline implant shells come in various sizes and textures. Some studies suggest that textured surfaces may be superior to smooth ones because they reduce capsular contracture or the tendency of the body to form scar tissue around any kind of implant.
What Are Silicone Implants?
Silicone breast implants have a silicone shell and gel filling. Because of this, their texture is different from saline alternatives.
Most silicone implants use a polysiloxane shell, using poly-diphenyl siloxane or polydimethylsiloxane. The gel filling is a lightly cross-linked silicone elastomer impregnated with silicone fluids to help it swell.
Manufacturers make the outer shell to be as strong as possible but also natural-feeling to reduce rupture risk. Shells come in multiple sizes and textures.
Comparing Saline Vs Silicone Implants
Saline and silicone implants have similarities and differences. The following table spells them out in detail.
Saline vs Silicone Implants
What Are The Advantages Of Saline Breast Implants?
The benefits of saline implants are substantial and include:
Easy adjustment. Surgeons typically fill saline implants after inserting them. Therefore, they are easier to adjust. Medical professionals can increase or decrease their size according to the patient’s needs.
Smaller incisions. Inserting the implant’s plastic shell into the chest requires only a small opening. Surgeons then fill the implant once it’s in position.
Firmer feel. Patients looking for a firmer feel often prefer gel-based implants.
More affordable. Saline implants are more affordable. Therefore, they can help lower the overall cost of breast augmentation.
Silent ruptures are unlikely. Saline ruptures usually result in a complete deflation of the implant. The body then safely reabsorbs any saltwater they contain. Therefore, patients can immediately see if they have a problem and get medical assistance.
Available to younger individuals. The FDA approves saline implants in people from age 18. Therefore, younger patients can access the treatment earlier.
Rounder look. Saline implants offer a rounder look than other options. Some patients may prefer this aesthetic.
Underarm insertion available. Lastly, saline breast implants are compatible with discreet underarm incisions. This procedure reduces the risk of breast scarring.
What Are The Advantages Of Silicone Implants?
Silicone implants are the latest technology and a fierce competitor of saline. Here are some of the advantages they offer:
Natural texture. Many people believe silicone implants feel more like natural breast tissue. The silicone gel they contain conforms to the touch similarly.
Natural appearance. Silicone implants also deliver a more natural appearance. They follow the body’s natural contours because the gel allows manufacturers to customize their shape. Their shape is less dependent on the internal pressure of the fluid they contain.
Lower risk of rippling. Rippling occurs when the implant changes shape and causes the skin at the surface to appear dimpled. Silicone breast implants are less likely to ripple.
Lighter feel. Silicone gel weighs less than saltwater. Therefore, some users may find these implants more comfortable long term than alternatives.
Less movement. Silicone gel implants conform to the internal shape of the body. Therefore, they are less likely to move around over time. Less conforming implants are at a higher risk of migrating to a new position.
Reduced risk of capsular contracture. Silicone implants appear to reduce the risk of capsular contracture significantly. Scar tissue is less likely to form around the implanted material.
What Are The Disadvantages Of Saline And Silicone Breast Implants?
Despite their advantages, saline and silicone breast implants come with various downsides.
The primary disadvantage of saline implants is how they feel. Saline tends to be firmer and bouncier than natural breast tissue. Patients wanting a natural feel should use a different material.
Another disadvantage is the risk of capsular contracture. Shell technology to prevent this process is improving, but it isn’t perfect.
Saline implants can also ripple, causing visible, unnatural-looking dimples on the surface of the breasts. Surgeons can fix this issue, but it requires a return trip to the clinic.
Silicone implants also come with downsides. The primary risk is rupture. Unlike saline implants which deflate completely, silicone implants rupture slowly, making them harder to detect. At the same time, silicone gel in the body may lead to so-called “breast implant sickness,” a yet-to-be-defined condition some breast implant patients report to their doctors.
Silicone implants also increase the risk of scarring. Surgeons must make breast incisions, usually around the areola. They can’t insert implants via the underarm area.
Lastly, silicone implants are less affordable than their saline counterparts. That’s one of the reasons why the latter remains popular.
Should You Get Breast Implants?
Whether you should get breast implants is a personal decision that depends on your circumstances. You should always consult with your physician about your decision.
Before getting breast implants, you should bear the following in mind:
You May Need Additional Surgery After Implant Removal
Surgeons may need to carry out additional work on your breasts if you decide to remove your implants in the future. You might require a breast lift or detailed work to change their appearance. Implants alone may not provide the aesthetic you want.
Some reconstructive surgeries require multiple follow-up visits. The first surgery places a tissue expander under the skin while follow-ups gradually fill it out until it is the desired shape.
Your Insurance Company May Not Cover The Costs
Insurance companies cover medically-necessary procedures, such as reconstructive surgery. However, they may not pay for your breast implant procedure if it is for aesthetic purposes.
Patients must prepare to pay for the surgery and all future costs, such as return visits, medications, PPE, and imaging tests. They should include these considerations in their financial plan to avoid being out of pocket.
Your Implants May Impede Breastfeeding
Implants can also make breastfeeding more difficult. Patients can occasionally nurse children after implants, but many can’t.
Generally, breast implants below the muscle impact milk feeding more than those above the muscle. Furthermore, techniques that detach the areola from the rest of the breast tissue and then replace it after surgery are also more likely to result in milk flow interruption. How much milk you can make depends on the number of nerves and connected ducts that continue to supply the nipple, and this can vary between patients.
You Might Struggle To Get A Mammogram
Mammogram screening helps to detect breast cancer early. However, getting breast implants may make this procedure more challenging. You may need specialized views.
Tell your healthcare provider if you have breast implants, and they can make the necessary adjustments. You should continue to get screening, even if you have had implants.
You May Require Follow-Up MRI Scans
The FDA recommends breast implant patients get follow-up scans with ultrasound or MRI five years after surgery and then every two to three years after that.
MRI scans are helpful for detecting ruptures in silicone implants. These can occur slowly and be difficult to detect, requiring scanning equipment.
However, some clinics and researchers argue that follow-up MRIs are not necessary. Therefore, you should discuss the issue with your surgeon.
Your Breast Implants Won’t Last A Lifetime
Unfortunately, breast implants do not last a lifetime. After ten to twenty years, you’ll need to take the old ones out and replace them with new ones. Most people have one or two replacements in their lifetime but you may require more. At follow-up surgeries, you can replace your existing implants like-for-like, or you can choose a different size, shape, and material.
Your Implants May Fail
Breast implants are prone to rupture. When this happens, you’ll need to return to the clinic for another procedure. This process involves removing the defective implants and replacing them. You can also choose to remove the implants entirely if you no longer want or need them anymore.
Note that implant failure rates are low. Incidence for primary augmentation is just 1.1 percent, rising to 3.8 percent for primary reconstruction.
Your Breast Shape Will Change After Surgery
The shape of your breasts may change after surgery. Factors including aging, weight loss, weight gain, and how your body reacts to the implant can all have an effect. Therefore, you may need to return to the clinic.
Some evidence suggests that massaging the breasts after surgery when it is comfortable can mitigate capsular contracture. Scar tissue may develop in a more favorable manner.
Breast Implants Won’t Prevent Sagging
Finally, implants alone may not correct the sagging because it results from loose skin on the chest. Dealing with sagging requires a breast lift (or mastopexy), a procedure similar to a facelift but for the breast area. During a breast lift excess tissue is remove and the breasts are reshaped. The resulting effect is less sagging and tighter, more youthful surrounding skin.
Which Type Of Breast Implant Should You Choose?
Choosing between saline and silicone breast implants is a personal decision – something you’ll need to weigh up yourself. Patients looking for a more affordable way to increase the volume of their breasts who aren’t as concerned about how they feel may want to choose saline. These implants are safe and minimize scarring.
Others who want a better texture and can pay more should consider silicone. While the risk of rupture is higher, these implants may let you recreate the look and feel of breast tissue more accurately.
Ultimately, it's best to consult with a board-certified plastic surgeon to create a customized breast augmentation surgery plan and decide on what type of implant to use based on the surgeon's recommendation and the results you're looking for.