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Breast Implants

Deciding Between Silicone Gel and Saline for the Best Results

Dressing up her bra.

By Dr. Jeremy Pyle

In the early days of augmentation, the only choice was whether or not to choose breast enhancement surgery at all. But now, almost 50 years later, women have a choice of multiple implant types, styles and profiles, which can achieve excellent outcomes but which also make selecting the right implant much more complex. When looking at the two basic choices for breast implants—silicone gel vs. saline—is there a better option from the surgeon’s perspective?

The short answer is: “It Depends.” But, for the majority of women seeking breast augmentation these days, silicone gel implant options will provide a more satisfying outcome. That’s not to say that there is no place for saline implants in modern breast augmentation procedures. For starters, this implant type is the only option for women age 18-22. Saline implants are slightly lower in price and some women like the fact that, in the event of a tear or rupture, the saline fluid inside the implant will be immediately and harmlessly absorbed by the body. But silicone gel implants offer greater advantages in the eyes of most plastic surgeons and women considering breast enhancement.

Focusing on Silicone Gel Implants

Ever since they were approved in the U.S. in 2006, newer generations of silicone gel implants have become very popular. According to the American Society of Plastic Surgeons, silicone gel implants were used in 62% of breast augmentation surgeries and saline implants were used in 38% of breast augmentation surgeries in 2012. With newer silicone gel implant types available, it is likely that even more women will choose silicone implants in coming years.

Here are a few reasons why silicone gel implants are often preferred:

  • Implant Palpability: The gel material within a silicone implant feels a lot like natural breast tissue. In contrast, saline implants feel more fluid – which makes sense, because they contain a fluid, not a gel. Even when a saline implant is placed under the chest muscle, it is likely that the breast will not feel as natural as compared to if a silicone gel implant were used.
  • Implant Appearance: The gel within silicone implants also behaves much more like natural breast tissue. As a result, this implant type more easily “blends in” with surrounding tissue, and does not exhibit the rippling or wrinkling that can be seen with saline implants.

Women who are naturally thinner and have less breast tissue are in most cases better candidates for silicone gel implants. Women with more existing breast tissue may consider saline implants, though even here silicone gel implants are likely to look and feel better.

A Note on Incision Preference

A strong patient preference for one incision placement technique over another may affect the type of implant that can be used. For example, axillary incisions (within the armpit) are quite small and are most appropriate for saline implants, which are fully deflated when inserted and then filled once in place. Silicone gel implants come prefilled from the manufacturer, and volume cannot be adjusted. This makes silicone implants larger at the outset, necessitating a slightly longer (usually inframammary) incision.

The Role of Surgical Skill

Keep in mind when you are considering your implant options that a skilled plastic surgeon can achieve a beautiful breast augmentation outcome for most women using either implant type. Many doctors and patients prefer silicone gel implants, but a skilled breast augmentation surgeon can achieve attractive results with saline implants as well. In fact, surgical skill and experience are extremely important considerations, and deserve just as much attention as your decision about implant type.

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February 11, 2014
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