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What are the advantages and disadvantages of saline and silicone implants?

Q:

I would like to know the advantages and disadvantages following comparison of saline breast implants to silicone breast implants. In addition to the cost comparison between the two.

A:

Great results are possible with both Silicone gel and saline filled breast implants. Both give great results. Silicone gel is softer and more natural feeling with less chance of rippling while saline filled implants are firmer and more likely to show ripples. The disadvantage of silicone gel filled implants are mainly cost. You also will require a slightly larger incision. If the saline implants leak you will have a deflation. If gel implants break or leak, you may not know they are broken. I feel that if you have enough breast tissue in the upper pole of your breast to cover the implant without showing ripples, the sub-mammary placement gives the best results. Because of the much higher chance of seeing or feeling ripples with the saline filled implants, I don't put them under the breast but only under the muscle.

C.W. Lentz, MD

A:

Both silicone and saline breast implants can give very good results. However, I find that the silicone implant generally produces a more natural feeling breast. The silicone implant is slightly more expensive and requires a slightly larger incision. It will, however, not deflate and is therefore, less likely to need replacement.

R.T. Buchanan, MD

A:

While saline or silicone implants can each give an excellent cosmetic result, it is generally agreed upon that the silicone implants give a more natural feeling result. They are softer and feel more like normal breast tissue than the saline implants. However, the cost of a pair of silicone implants is approximately $1000 more expensive than a pair of saline implants. As the silicone implants come pre-filled, the incision to put them in may be slightly longer than for the saline ones, but this is usually not an issue. Finally, silicone implants have less of a tendency to have visible rippling.

J.M. Darrow, MD

A:

 

Women considering breast augmentation now have the luxury of deciding between two kinds of breast implants: cohesive silicone gel (approved for cosmetic use by the FDA in 1996) and saline. There are a number of pros and cons to consider with each type of implant however the most important thing to know is that patient satisfaction is very high with both. You can't really go wrong with this decision - it is merely a matter of deciding which is best for you personally.

It is also very important to understand from the outset that a cohesive silicone gel implant is a very different (and vastly superior) medical device compared to the older liquid silicone gel implants that were available for cosmetic use in the 70's and 80's, but were not approved by the FDA for cosmetic use from 1991 to 2006 (although they still could be used for breast reconstruction). The new cohesive gel implants are manufactured so that the gel material is in a solid state which means that if the implant's outer shell fails, the gel material does not easily leak out of the implant as it would with the older liquid silicone gel implants. The design and manufacturing process for the outer shell has also improved a great deal, resulting in significantly lower implant failure rates. These improvements make gel implants much more appealing as long-term medical devices, and because of the major improvements the FDA cleared them for cosmetic use in 2006.

One very important issue to consider is implant palpability, i.e. whether you can feel the implant or not when you - or someone else - feels your breast. Both silicone gel and saline implants are soft and generally breast-like. Most surgeons and patients agree, however, that silicone gel breast implants tend to feel more natural than saline breast implants. Because saline is non-viscous, it tends to allow the edges of the implant to collapse and this makes the implant edges more easily palpable. This will be quite obvious to you when you examine samples of saline and silicone gel implants during your consultation.

The degree to which this difference is significant varies a great deal with regard to two factors: the amount of breast tissue that exists prior to augmentation, and the size of the implant that is used. A silicone gel implant's more natural feel will be much more important to patients who are slender and who fit in an A cup bra preoperatively, as they have less subcutaneous soft tissue and breast tissue to conceal the implant. In such a patient a saline implant is usually very easy to feel through the skin, and may even be visible externally - especially in the lateral aspect of the augmented breast where the tissue covering the implants is the thinnest. The difference in feel between saline and gel implants will be less noticeable to a patient who is more full-figured and whose pre-operative bra size is a full B or especially a C cup, and in some fuller-figured patients saline implants may be undetectable by palpation (meaning they feel completely natural). Saline implant palpability is primarily a matter, therefore, of how much natural tissue there is to disguise the implant.

 

A:

Salin breast implants can cause visible rippling especially in thin women. Silicone gel breast implants feel more natural and are less likely to cause visible rippling

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