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What’s the Difference Between Silicone Gel and Saline Breast Implants?

March 5, 2019 by Davis

More than 300,000 breast augmentations were done in the United States in 2017, making it the most widely-performed cosmetic surgical procedure. That popularity stems from its value on several fronts.

Breast augmentation—an implant is placed behind the breast and/or the chest muscle—can increase the volume of the breast in naturally small-breasted women, replace the volume that was lost after breastfeeding or major weight loss, change the shape of the breasts, and create better symmetry.

In turn, much of the consideration tends to center less on whether to undergo the procedure or not and more on what type of implant to use. So, today I’ll explore some of the key differences between silicone gel and saline breast implants.

But first, a quick overview

Both types of implants have a shell made out of silicone, the surface of which can be either smooth or textured. The smooth implants mimic the movement of a natural breast, rolling around subtly in the breast pocket, while the texture implants remain in one place, more or less.

That’s not the only nuance to be aware of. For a long time, if I was to say breast implant, the image that would likely come to mind for most is a slow-motion running scene from an episode of “Baywatch.” In other words, large, prominent, and, essentially, one-size-fits-all.

But the breast implant has evolved quite a bit since then. Today, they come in a variety of base widths, projection amounts, and fill volumes. The goal now, instead of a dramatic jump in breast size, is to match the implant with the space and create an improved, though natural-looking, appearance.

Silicone vs. saline

The main differences between silicone gel and saline breast implants involve a few key aspects. For one, saline implants can be filled and adjusted during surgery, which allows the surgeon some discretion to adjust for symmetry. Silicone implants are pre-filled and require larger incisions as a result. Saline implants, because they’re unfilled, can be inserted through tiny incisions underneath the breast, around the areola, or through the underarm.

Saline implants tend to look round, especially in thin women with modest breast tissue, while silicone implants have a more natural look and feel that’s closer to soft breast tissue. (Many women liken the feel of saline implants to a water balloon.)

Saline implants are significantly heavier than silicone, which makes them much more prone to downward displacement because of gravity. Silicone implants also have less of a chance of visible wrinkling or rippling, which makes them a more appropriate choice for post-mastectomy breast reconstruction.

And, not to be glossed over, saline implants are slightly less expensive than silicone.

But are they safe?

In spite of its obvious benefits, silicone gel implants remain stigmatized for many women. Negative media attention in the ‘80s and ‘90s fueled by claims of adverse associated health problems prompted the widespread removal and replacement of older silicone implants with saline ones that continues today.

Since then, extensive clinical research, driven by the FDA, has confirmed no association between silicone gel implants and any chronic immune disease. That said, when discussing the differences between silicone gel and saline breast implants, saline implants will likely continue to be viewed by many as the safer of the two choices.

When a saline implant ruptures, it happens quickly, so you’ll notice it immediately. Your breast will literally shrink before your eyes. Because it’s only saline, it absorbs harmlessly by your body.

A silicone implant-rupture, on the other hand, will probably go unnoticed. The gel, however, is designed to hold together inside the breast capsule and not migrate to other areas of the body. That’s one of the reasons that regular MRIs are recommended for women with silicone implants.


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About Dr. Steven L. Davis

Dr. Steven L. Davis is Board Certified in Cosmetic Plastic Surgery, a Fellow in both The American College of Osteopathic Physicians and Surgeons and the American Academy of Cosmetic Surgery.

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1916 Marlton Pike East
Cherry Hill, NJ 08003
856.424.1700

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Philadelphia, PA 19145
215-334-9900

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2306 New Rd (Rt. 9)
Northfield, NJ 08225
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