If you are looking into breast reconstruction or augmentation, you have most likely learned that you have two choices when it comes to the type of implants available; silicone gel implants and saline-filled implants. How do they compare? How do you know which choice is right for you? Read our in-depth comparison on saline vs. silicone implants and some recommendations in choosing the right type of implant.
Saline Vs. Silicone Implants: Theory First
Before we jump into choosing the right implant for you, let’s talk about the way they are made. We are going to look at implants’ outside and inside and the main difference in the manufacturing process of saline vs. silicone implants.
The Casing or Outside Layer
The outside layer of an implant is known as “the shell” and both saline and silicone implant shells are constructed from the same silicone polymer. This silicone polymer is comprised of hydrogen, carbon, and oxygen and can be in the form of a gel, a liquid, or sometimes rubbery.
Sometimes people confuse Silicone and Silicon but they are very different. Silicon has metal-like characteristics and is a natural element while Silicone is man-made. Silicone does not react adversely to other chemical compounds and can withstand high temperatures so it is used in many products we use every day such as contact lenses, oven mitts, insulation, surgery centers, and more.
Construction Of Implants
Implant shells are all made by dipping a mold into liquid silicone in a series of “layers” until the shell is formed. Implant shells can be smooth or textured so the mold used for this process will vary. The shell is left on the mold to cure and later removed from the mold and tested to ensure it will not leak. Next, the shell is sealed shut through a specialized process called vulcanization. A small section of the implant is left unsealed and is used for filling the shell with saline solution or silicone gel.
If the shell was manufactured for use with silicone gel, it is injected with the gel and then the previously unsealed opening goes through the vulcanization process to permanently seal it. The implants go through another inspection to check for leaking or imperfections before being shipped to the awaiting surgery center.
If the implant shell was manufactured to be filled with saline, it is left unsealed, and the surgeon fills it during the procedure.
Breast implants are not measured like bra sizes but in cubic centimeters (ccs) because they are comprised of a semi-liquid gel or liquid. The number of ccs used to fill implants can range anywhere from 80 to 800 ccs and normally increase in increments of 150 – 200 ccs which translates to one or one and a half cup sizes.
Silicone Vs. Saline: An Overview of Pros and Cons
Before answering the question “Which type of breast implant is right for you?”, make an informed decision and talk with your doctor. Both types of implants have their unique lists of pros and cons. Below you will find some highlights for both implant choices.
Implants filled with sterile salt water are called “saline-filled” implants. They require a smaller incision to place as they are filled after they are inserted and produce a smaller scar. They can be inserted through an incision under the arm, under the curve of the breast, around the nipple, or even through the belly button. Since they are filled after insertion, the surgeon can ensure both breasts are symmetrical and evenly distributed by adjusting the amount of saline solution added.
Saline implants work best for a woman who has a good amount of breast tissue. One drawback to saline-filled implants is that after surgery rippling may be seen along the edges of the implant if there is not a fair amount of breast tissue, to begin with.
Saline-filled implants do not feel as natural as silicone implants but they are less expensive. If there were a problem and they leaked, which is unlikely these days, the saline would just be absorbed by the body and the implant would deflate. If you did experience a rupture, you would notice fairly quickly. The good news is that the doctor would be able to perform a breast augmentation revision and correct the issue.
Silicone implants still have a bit of a stigma surrounding them since they were taken off the market for a while after being labeled as “unsafe” in past years. Since 2006, new generations of silicone gel implants have been introduced and deemed safe. Women who desire fuller breasts but do not have sufficient breast tissue of their own are great candidates for silicone implants. Silicone creates a more natural look and feel for these women.
In the unlikely event that an implant rupture occurred, it would not be immediately obvious. The gel would hold its shape and would most likely not migrate to other parts of the body. Unless the patient was experiencing any type of pain or noticed the shape of their breast changing, they would be unaware that there was an issue.
Periodic MRIs are recommended by the Food and Drug Administration for people with silicone breast implants.
An MRI should be performed 3 years after augmentation surgery and then on a recurring two-year schedule to ensure the implants are still completely intact and there have been no silent ruptures.
What About Ruptures of Saline Vs. Silicone Implants?
It is rare to experience a rupture with either type of implant. Many women are concerned during their routine mammograms, with all the squishing and pressing, but it would be highly unusual for an implant to rupture.
As we have previously noted, if there was a rupture, the saline solution would be absorbed in the body and the leak would be noticeable rather quickly but silicone gel lumps together and a rupture may not be noticeable except through an MRI. It is important for those candidates who choose silicone implants to adhere to the scheduled MRI scans.
Below you will find 5 things to consider when choosing saline vs. silicone implants.
#1. A Breast Implant Shape
When researching a breast augmentation procedure, it is important to note you have a choice of an implant shape. Breast implants are available in both a round and teardrop shape.
The round shape is most commonly used and can be filled with either saline or silicone. Women chose the round shape because they are less likely to wrinkle and are a bit more forgiving if they shift a bit. Round implants are most often smooth and create a nice full cleavage area.
The teardrop shape gives the most natural authentic-looking breast shape. Some women prefer this shape over the round because they feel that their augmentation would be less obvious. Teardrop shape implants are normally textured to help hold them in place and are most often filled with silicone gel.
Choosing an implant shape is important because this will greatly affect your final results. Depending on your skin and tissue type one shape may produce your desired result better than another.
#2. Look and Feel of Implants
Each woman is unique and has their vision of what they want their breasts to look and feel like. Many like the look of the round implants and the fullness and cleavage it creates. Some women think that the round shape is a tell-tale sign that a woman has had an augmentation so they prefer the teardrop shape.
Many love the natural feel of silicone and also say that silicone feels lighter. Some prefer the saline as it gives the surgeon a lot of control and leaves minimal scarring.
Round, Teardrop, Silicone, or Saline. It is a personal decision that each woman has to make based on her desires after considering all the options. Our procedures are customized to fit each unique individual.
#3. Size of Saline Vs. Silicone Implants
The size of an implant filled with silicone is not adjustable however with saline-filled implants this is an option.
If after surgery a woman decides she would like to increase or decrease her breast size, the doctor, using a specialized technique, can add more saline or remove saline to create the desired outcome.
#4. Age Requirements
The FDA does not recommend breast augmentation for anyone under the age of 18. The age requirement for saline implants is 18 while for silicone it is 22. The FDA has these recommendations in place because of the risk factors of each.
Also, there is a concern that someone under the age of 18 may not thoroughly understand all the risks and aftercare of breast augmentation surgery. Some states also require parental permission to receive any plastic surgery. There is no specific “upper” age for breast augmentation surgery. It is mostly determined by the individual’s health and overall expectations.
#5. Incision Size
Silicone Implants are lighter in weight but are pre-filled so a larger incision is needed to insert them during augmentation surgery. Saline-filled implants are filled after they are inserted so require a smaller incision. The surgeon takes care, in either case, to create the incisions in a place to minimize any visible scars.
Need Some Help Making A Choice Saline Vs Silicone Implants?
If you are considering breast augmentation and would like to discuss all of your options, we would love to assist you. We would be pleased to answer any questions or address any concerns you might have. Do not hesitate to contact us today and set up a consultation. We would love to partner with you in achieving your desired atheistic vision. We look forward to taking this journey with you!
Angelina Postoev, MD, FACS, a triple board-certified cosmetic surgeon, and Christopher Ibikunle, MD, FACS, offer breast augmentation with saline and silicone implants by your choice to patients in Lawrenceville, Suwanee, Johns Creek, Buckhead, and other surrounding areas of Atlanta, Georgia.