The decision between getting saline or silicone implants can be the toughest decision for a woman to make when deciding to have breast enhancement surgery.  Dr. Edward Kole understands how difficult and confusing this decision can be, and he wants his patients to be well informed when they make their choice.  For this reason, Dr. Kole describes in detail the most important issues to consider when choosing saline or silicone breast implants, and discusses which implants might be best for you.

There are four major issues that need to be considered when making this choice.  The first, and in some ways most important, is the look and feel of the implant.  Many surgeons suggest that silicone gel implants feel more natural than silicone implants, and if you are holding each type of implant in your hands you would agree. Saline implants outside of the body are basically a water balloon while silicone implants are made up of a silicone gel and feel more natural when handled out of the body. However when they are inserted underneath the muscle and breast tissue in the chest, saline implants can achieve a natural look and feel, as well.  It is my preference to always place the implant underneath the muscle of the chest, so when I use saline implants the results generally feel soft and natural in combination with the original breast tissue.   One problem with saline implants is that there is a greater risk of rippling, especially in very thin women who do not have an abundance of breast tissue coverage.  In these patients, silicone gel implants may be a better option in terms of look and feel.

Second, the safety of each option needs to be considered.    It is a myth that silicone implants are unsafe.  The reality is that the type of silicone implant that is used today is safe and is approved by the FDA.  In the 1990’s, there was a period of time when the FDA and surgeons found that silicone implants carried a larger risk, especially of rupture and leakage of silicone into the breast tissue and for that reason they became unpopular and stigmatized and were removed from the market for surgeons to use.  However, the silicone gel implant that is used today is safe.  For women who are still concerned and don’t wish to use the improved FDA approved silicone implants, you will still get great results with saline implants and can rest assured that they are safe, as well.

Third, is incision size. Saline implants are filled with a sterile salt water solution during the breast augmentation operation and come empty (without the fluid inside) from the manufacturer. This empty implant has a detachable fill tube and a self-sealing valve that allows the surgeon to roll up the implant like a cigar and place it through a small incision usually about ¾ of an inch in length. Silicone implants on the other hand come prefilled by the manufacturer in similar sizes to the saline filled ones. The main difference is that silicone implants need a significantly larger incision to insert the implants into the body because the silicone is already pre-filled and the actual implant takes up more space than the rolled up empty saline filled implant.  As expected larger silicone implants need larger incisions than smaller silicone implants.

Last, surgeons and patients need to consider the risk of implant leakage when deciding which implant to use.  This falls under the category of safety, but is so important that it deserves its own attention.   Saline implants are safer in this regard:  both implants will eventually leak, as implants will not last forever, but a leak in a saline implant is more visible and therefore easier to detect and replace.  Saline implants, when the leak, will empty the sterile salt water solution they are filled with into the tissues around the implant and this fluid will be absorbed by the body and urinated away leaving only the outer shell. The implant will deflate, leaving that breast flat.  Women notice this immediately, and are able to call their surgeon to replace the breast implant.  Silicone implants, on the other hand, do not show signs of leakage that is obvious to the naked eye and the leakage is not even detectable by mammograms.  For this reason, women with silicone implants are strongly encouraged to get MRI’s every 2-3 years in order to check for any leakage.  This test is both expensive and often annoying to patients: this should be factored into a patient’s decision to choose silicone or saline.

Overall, both options have pros and cons, it is up to the patient to decide what is most important to them.  Ultimately, both saline and silicone implants will look and feel natural when implanted correctly under the muscle, are both safe and backed by the FDA, and can be replaced if leaking is detected.

To discuss your implant concerns and learn even more about breast enhancement, please call the Kole Plastic Surgery Center  at 215-315-7655 and request a private complimentary consultation with Dr. Kole. At that time you can have all your questions answered and learn which type of implant is best for you.