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Summary: There are a number of decisions that need to be made before breast augmentation: implant size, profile, and which surgeon to choose, just to name a few. One of the options that women often find most difficult is whether to choose saline or silicone gel breast implants. Both can deliver beautiful, natural-looking results, but each has its pros and cons. How can you know which is right for you?


by Dr. Jeremy Pyle

Silicone Gel Implants

Silicone gel breast implants are the more popular choice for women who are considering breast augmentation these days, and it’s not hard to see why. The consistency of silicone gel is firmer than saline, giving breasts a more natural look and texture. Additionally, the implant edges are more difficult to feel after surgery compared to saline, so they can be almost undetectable. They’re also for reconstructive surgery because they don’t need an extra cushion of natural tissue to look more natural.  No other implant offers more flexibility than a smooth round gel implant which can be put above or below the muscle for a natural result.

In terms of drawbacks, silicone gel implants cost a bit more up front. Plus, there will be additional costs for the periodic MRI scans recommended by the FDA to detect for implant ruptures. The FDA recommends periodic MRI screening and if you choose to have these, the costs may be out of pocket.  Since silicone implants come pre-filled, they may require a slightly longer incision than saline implants, and your incision placement locations may be limited. Your surgeon will most likely recommend placement via the inframammary fold, where the incision is concealed by the natural fold below the breast.

Saline Implants

Saline implants have some advantages over their silicone gel counterparts. Their lower cost is one clear benefit, both immediately and over the long-term, since saline implants don’t require MRI scans every two years after placement to check for ruptures or tears. Any leaks or ruptures can be detected (and implants replaced) very quickly with saline implants. They also can be inserted while deflated, which allows the surgeon to use a somewhat smaller incision.

However, there are several drawbacks to saline implants as well. While saline implants can look fantastic on the right candidates, the key words here are right candidates. Saline implants are filled with a sterile saltwater solution and the shell has a tendency to wrinkle as the liquid inside moves around. In women without much natural breast tissue to cover the implant, the wrinkling or rippling effect may be visible externally. They may also feel and move less naturally.

Making Your Decision

Even when looking at the pros and cons of both implant types, they may still seem pretty evenly matched, especially for the average woman who has very little prior experience with breast augmentation herself. This is where your plastic surgeon comes in. With an experienced eye and the assistance of 3D imaging, your surgeon can work closely with you to determine which type of implant is going to be best for meeting your expectations.

While a significant majority of women in my practice now select silicone gel breast implants, there simply isn’t only one right answer for every woman when it comes to implant type. Some women are thrilled with their saline implants, while many others can’t imagine having anything but silicone. The right decision will be the one that works with your budget, your body, and that ultimately meets your cosmetic goals for the best breast augmentation results.

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