Silicone Gel vs Saline Breast Implants, Which is better?

Breast Augmentation is one of the most common operations I do. My patients want to look their best on the beach and in today’s revealing fashions. Many patients have always wanted fuller breasts and many others feel less confident about their breasts after having their children.

In 1997 the FDA approved Silicone Gel Breast Implants for use after a 15 year period during which only Saline Breast Implants were approved.

My patients want to know about the safety of the new implants. The new Silicone Gel Implants are safe, but there are many factors you need to consider when choosing which type of implant you want.

My first comment is that breast augmentation or enlargement with silicone gel breast implants or saline breast implants, if done on an appropriate candidate by an experienced board certified plastic surgeon, and with satisfactory healing, should produce an equally pleasing and successful aesthetic or cosmetic result. (Below-Before and After Saline Breast Implants)

Before and After Breast Augmentation

The main difference in the result of breast augmentation with saline breast implants from that with silicone gel breast implants is the feel of the implant. If there are no complications such as hardening of the implant, and the result of the surgery is satisfactory, then a silicone gel breast implant will feel more natural than a saline implant-the silicone gel implant often feels more like breast tissue than does a saline implant. In addition, Saline Breast Implants are more sensitive to temperature change-for example they may feel cold after swimming in water that is less than body temperature.

However, this difference is subtle not dramatic, and there are many people who have saline breast implants in place, and I cannot tell the difference from a silicone gel implant.

There are many factors which contribute to the different feel of the Saline implant and most of them can be predicted or managed. In very thin women with very little breast tissue to cover the implant, the saline will be more palpable. Saline Breast Implants also have more of a tendency to form folds which can be visible along the side of the breast. Folds can also happen around silicone gel implants, but they are less common. Overfilling the saline implants can help minimize folding. (Below Before and After Silicone Gel Breast Implants)

Placing the saline breast implant beneath the chest muscle helps prevent palpability and over filling the implant helps prevent folds. Meticulous surgical technique and avoidance of bleeding during surgery also helps avoid the capsule or scar tissue which can make the implant feel hard. Capsular contracture or hardening of the new Silicone gel implants is less common than with the older implants and much closer to the rate of Saline Implants.

A silicone gel breast implant which has been placed under the breast or muscle which does not form a capsule or hardening does result in the more natural feeling breast. A “perfect result” with a silicone gel implant does feel more natural than a “perfect result” with a saline breast implant, but visually, the way they look, is about the same, in my opinion.

There are however disadvantages to silicone gel implant breast augmentation. The new FDA guidelines require that you have frequent MRI exams to check for rupture-this is expensive. In addition if the implant does rupture and needs to be replaced, the surgery to replace a silicone gel breast implant is more complex than that for a ruptured saline breast implant. Gel implants are also more expensive. You must be 21 years old to have Silicone Gel Implants placed.

Most of my patients find the decision very easy and come in knowing what type of implant they want. Patients who are averse to having anything foreign in their body choose saline. Many younger women, single with no children, who have read a lot about breast augmentation and want the most natural feeling breast implant choose silicone. Patients who want a replacement of a Saline implant for a larger size also usually choose the Silicone Gel implant.

It comes down to your priorities and your situation. Both Saline and Silicone Gel implants can produce a beautiful natural result. In my opinion the most important factor is the skill and expertise of your surgeon and your body’s ability to heal with minimal scarring. Careful technique with minimal trauma at the time of surgery is very important to achieve the best possible result.

If you are considering breast augmentation, the most important thing is for you to find an experienced board certified plastic surgeon who has done many breast augmentation operations and can give you an honest informed opinion. Please call me at (978) 369-4499 with your questions or email me through my website.

Dr Seckel

Concord Massachusetts

Boston, Massachusetts,

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