Breast Augmentation: Silicone or Saline?

Silicone or Saline? What are the advantages to each type of breast implant?

Silicone or Saline? As I tell my patients in their initial 45 minute free consult with me, “there are no bad implants.”  However, there are certain advantages to each type of implant.

What are the advantages of a saline implant? First to clarify: a saline implant has a silicone shell which is what is holding the saline in place. Of course you cannot just put saline inside the breast or it would be absorbed immediately. So the container/bag holding the saline is silicone. Therefore, the woman who does not want to have any silicone put in her body, needs to realize that she is still having some silicone put into her body. However, silicone is very inert and well tolerated and there is no evidence that this is harmful. In fact, almost everyone, including men, have measurable levels of silicone since it is so ubiquitous in our society.

The biggest advantage of saline implants is that they cost quite a bit less than silicone implants. The price difference is going to vary from surgeon to surgeon and also which type of saline or silicone implant will be selected. However the difference in price can be at least $500 and some more than $800 per implant. It is a significant price difference. Also, silicone implants require a funnel which can cost about $200. Thus, there is a significant cost saving by going with saline implants.

Who is the best patient to go with saline implants?

If you have a considerable amount of breast tissue already and you are fine going with a smaller implant size, I think it is less important in this situation to pay the extra money for the more natural feeling silicone implants since so much of your own breast tissue will be covering the implant. Also, I always put the breast implants under the muscle.

I have had many patients, who I have seen in follow up (by which point I have long forgotten whether I have put saline or silicone implants, unless I look at the OR report) and they have felt so natural that I assumed I had put silicone implants in place but, in fact, had put saline implants.

The only other advantage of saline implants, is that because they come empty and I fill them up once they are under the muscle, is that a smaller incision can be used. This is less important for most patients because the silicone implants can be placed with a fairly small incision, provided a Keller funnel is used. 

More Natural Feeling

Silicone has the advantage of feeling more natural. The density of silicone is very close to the density of fat. Breast tissues have a moderate amount of fat. This is just a more natural feel than saline (saline is like filling up a plastic bag with water) I always put the silicone implants in with a funnel since it allows a much smaller incision. This more natural feel is more implant for the patient who has small breasts, and especially, if they have low body fat. Also this type of patient is more prone to showing possible rippling which is less likely, in a silicone implant.

If you are interested in a breast reduction, I encourage you to schedule a consultation to discuss your options. Everyone is unique and they weigh benefits differently. The only way to really make a decision is to consult a board certified plastic surgeon who can help guide your decision.