In life, you have lots of choices to make: Coke or Pepsi, fries or a salad, Netflix or Hulu. If you’re thinking about breast augmentation, you’re also going to have a choice: Saline implants or silicone implants.
Beyond that, you’ll need to think about the size of the implants, their shape, and their texture. Learning about all the different breast implant options can help you choose the one that’s best for you. Let’s take a closer look at saline breast implants and silicone breast implants to help guide you through the decision-making process.
Why People Get Breast Implants
People choose to get breast implants for a variety of reasons. The most common reason for breast augmentation with implants is to make smaller breasts larger, according to the Mayo Clinic.
In some cases, a woman has naturally smaller breasts. She might want to enhance their size to make it easier to fit into clothing or to improve her self-confidence.
In other cases, a woman might experience a change in the size of her breasts after pregnancy, breastfeeding, or weight loss. She might decide to get implants to restore some of the lost volume.
Breast implants can also help to make the breasts more even. Asymmetrical breasts are very common and many women just live with them. But there are cases when the asymmetry is very pronounced, making it challenging to find properly fitting bras or creating a deformity in the breasts.
An implant in one breast can help balance it out with the other. Alternatively, a patient might decide to get two different-sized implants to improve the symmetry of the chest.
Although many people decide to get implants for cosmetic reasons, implants are also used in reconstructive breast surgeries. A woman might decide to have reconstructive surgery following a mastectomy.
Breast implants are also occasionally used during “top surgery” for transgender women, the Mayo Clinic notes. Top surgery for gender affirmation increases the size of the breasts and can involve the use of implants or fat, or in some cases, both.
The Two Types of Breast Implants: Silicone and Saline
Generally speaking, if you’re considering breast augmentation with implants, you have two main choices: Saline vs. silicone. Both implant types are approved by the FDA for cosmetic breast augmentation and for reconstructive breast surgery.
There are several notable differences between the two. Understanding the pros and cons of each implant type can help you choose the best option for you.
About Saline Breast Implants
While silicone breast implants tend to get the most attention for their natural look and feel, saline implants have their place, too. For some women, saline might be a better option overall than silicone. Here’s what you need to know about saline breast implants.
What’s the History of Saline Breast Implants?
What is saline? It’s a sterile saltwater solution that can be used to fill a shell made up of silicone to create a breast implant.
Like silicone implants, the first saline implants appeared on the market in the mid-1960s. Those first implants had a few issues, mainly that they would rupture easily, causing the breasts to “deflate.” Women who had ruptured saline implants claimed to be able to hear a “sloshing” sound when the implants leaked.
Luckily, advances in technology soon made saline implants more durable. Later versions featured a double shell, with a silicone-encased pocket of saline. The double layering made leaks and ruptures much less likely.
From 1992 to 2006, any woman who wanted breast augmentation in the US had just one option: saline implants. During that time, silicone implants were banned for cosmetic use over safety concerns (the FDA still approved them for use in reconstructive breast surgeries, however).
Even after the FDA cleared silicone breast implants for cosmetic purposes in 2006, saline implants didn’t disappear from the market. They are still around today.
Who Can Get Saline Breast Implants?
Saline breast implants are FDA-approved for cosmetic and reconstructive surgery. For cosmetic use, they are approved for women over the age of 18. For reconstructive surgery, they are approved for women of all ages. Silicone implants are FDA-approved for cosmetic reasons for women over the age of 22.
What Are the Benefits of Saline Breast Implants?
Perhaps the most notable benefit of saline breast implants is that the implants are filled after they are placed in the breast pocket. Filling after placement offers several advantages. For one thing, the surgeon can make a smaller incision, meaning that any resulting scars will be smaller.
For another thing, filling the implants after placing them means that a woman seeking breast augmentation can get a more precise and custom look. Some saline implants have a special port that allows them to be adjusted after the surgery. Another benefit of saline implants is that they tend to cost less than silicone implants, making them the more affordable option.
If a saline implant does rupture inside the body, it’s usually a lot easier to notice than the rupture of a silicone implant. The saline will leak out of the implant, causing the breast to “deflate” and the body to absorb the saline. Meanwhile, if a silicone implant ruptures, the only way to detect the issue is with imaging and the silicone might start to cause issues within the pocket.
What Are the Drawbacks of Saline Breast Implants?
Saline implants might be the right option for some women, but not for all breast augmentation patients. They do have some notable drawbacks.
One disadvantage is that the edges of the implant can occasionally become visible beneath the skin. If a woman has thin skin, it’s more likely for wrinkles or ripples in the implant shell to become visible. Since silicone implants tend to be smoother, they don’t often cause rippling.
Another potential issue with saline breast implants is the way they feel. Silicone breast implants tend to feel soft and more natural, while saline implants can be firm and hard to the touch. They also create a less natural-looking, rounder shape to the breasts.
Finally, there is a higher risk of capsular contracture with saline implants as compared to silicone. Capsular contraction occurs when scar tissue forms around the implant and “squeezes” it. The condition can be very uncomfortable and usually requires that the implant be removed or replaced.
Are Saline Implants Right for You?
There are a lot of things to consider when choosing between saline and silicone implants. If you’re under the age of 22 and you’re seeking breast augmentation for cosmetic reasons right away, your decision is pretty much made for you.
But if you’re over age 22, you have options. It’s worth looking closely at the pros and cons of saline implants and comparing them to the pros and cons of silicone implants before making your choice. It can also be helpful to discuss your options with a board-certified plastic surgeon and get their expert opinion and advice on the best breast implants for you.
About Silicone Breast Implants
Although saline implants are still the right choice for some patients, silicone implants have proven to be more popular in the past several years. There are many reasons why you might choose silicone implants over saline for breast augmentation. Read on to learn more about these popular implants and what might make them the right choice for you.
What’s the History of Silicone Breast Implants?
If saline implants are made using a silicone shell, what is a silicone breast implant made of? Instead of being filled with a saline solution, silicone breast implants are filled with silicone gel. This creates a soft, realistic look and feel.
According to some reports, more than 1.5 million women in the US have silicone breast implants. The first silicone implants were used in breast augmentation in 1962.
In the mid-1970s, the Food and Drug Administration (FDA) started regulating silicone implants. Under the FDA’s eye, silicone implants became subject to performance standards, controls, and tests for safety.
Although the earliest silicone implants were popular, they weren’t without controversy. By the early 1990s, the FDA had called for a “voluntary moratorium” on the use of silicone implants.
In 1992, many manufacturers began pulling their products from the market. At that point, the FDA recommended that silicone implants only be used for breast reconstruction, not for cosmetic breast surgery.
In 2006, after more than a decade of further study and testing, the FDA once again approved silicone implants for use in cosmetic breast augmentation. By 2010, silicone implants were being used in nearly two-thirds of cosmetic breast surgeries.
Who Can Get Silicone Breast Implants?
Although saline implants are FDA-approved for people over the age of 18 for cosmetic purposes, a woman who wants breast augmentation using silicone implants should wait until the age of 22. Silicone implants can be used for the reconstruction of the breasts in patients of all ages.
What Are the Benefits of Silicone Breast Implants?
Why are silicone implants so popular, especially compared to saline? Largely because they have a few advantages over saline for the right patients.
While saline implants tend to feel firm and less natural, silicone implants are often soft to the touch and feel more like natural breast tissue. They also tend to look more natural than saline implants, which may appear overly round.
Types of Silicone Breast Implants
Silicone implants are available in a wide range of sizes and shapes to meet the needs of different patients.
One option is the cohesive or “gummy bear” implant, which is made from a thicker silicone gel. The thickness of the gel helps the implant hold its shape better and makes it less likely to rupture and cause problems. Gummy bear breast augmentation can be a good choice for women who are worried about rupture.
Other silicone implant options include round implants, which can be used to create fuller-looking breasts. The shell of the implants can be smooth or textured. Smooth-shell implants often move more easily within the pocket, which can look more natural.
Textured shell implants are more likely to form scar tissue that connects to the implant. The scar tissue limits movement, meaning that the implant is less likely to shift out of place.
What Are the Drawbacks of Silicone Breast Implants?
While silicone implants remain popular, they do have drawbacks for some patients. Some types of silicone implants are associated with a slightly elevated risk of a certain type of lymphoma. If you are considering textured silicone implants, it’s important to fully weigh the risks against the benefits of that type of implant.
Another potential drawback of silicone implants is that it is generally more difficult to detect a problem with the implant itself. If a saline implant develops a leak, the implant will usually deflate, making it visually obvious that something is wrong.
In contrast, the gel inside of a silicone implant typically stays put even when there’s a leak. Often, the only way to know that something is amiss is to have imaging performed.
Another drawback of silicone implants is that they come in predetermined sizes and are filled before placement. This means that your plastic surgeon will have to make a slightly larger incision during the surgery. Usually, the incision isn’t an issue for patients, as it is most often placed in the crease of the breast and is easy to conceal.
Are Silicone Implants Right for You?
If you’re thinking about breast augmentation, we recommend going to see a few plastic surgeons for a consultation to discuss your options and decide between silicone or saline implants. A plastic surgeon can help you weigh the pros and cons of each implant type and can recommend the option that seems most appropriate based on your expectations and goals.
Your Guide to Choosing Between Saline or Silicone Breast Implants
Once you’ve decided to have breast augmentation surgery and learned more about your options, the next big decision to make is choosing the right type of breast implant. Size is just one factor when picking out the right implants. You also want to look at what the breast implants are made out of and at how the different materials affect the look and feel of the implants.
Here are a few things to consider when deciding which one is right for you.
Materials for Breast Implants
As we’ve discussed, you have a choice between saline and silicone implants. Although the materials inside the implants differ, both saline and silicone breast implants feature an outer shell made from silicone.
Saline implants have been around for more than half a century. The big advantage of them is that they can be filled after they are inserted into the breast. That means the surgeon can make a smaller incision and more precisely dictate the size of the breasts during the surgery.
While silicone implants are pre-filled and usually require a larger incision to place, they also have a more realistic and natural feel than saline implants. They are also less likely to create a rippled effect beneath the skin.
Your Age
If you’re on the younger side, your age might play a role in determining which breast implants are right for you. Saline implants are FDA approved for women over the age of 18 for cosmetic breast augmentation.
Silicone implants are approved for women over the age of 22 for cosmetic reasons. Either implant is appropriate for women of any age who are considering implants for breast reconstruction.
Results and Longevity
The materials of the implants determine not only how they look, but also how they feel. Saline implants typically create a firmer breast. The breast is also usually rounder, and some might say that the breasts look more like water balloons after surgery.
In contrast, silicone implants create a softer breast that feels more like natural breast tissue. The shape of the breast isn’t quite as round when silicone implants are used, either. Silicone breasts tend to be particularly ideal for thinner patients or for women who don’t have a lot of natural breast tissue.
The FDA stresses the fact that breast implants are not meant to be lifetime devices, although many silicone implants do come with a lifetime warranty. Still, you can expect your implants to last for many years, whether you choose silicone or saline. In some cases, it might be a good idea to have imaging done to check on the state of the implants after a few years.
Changes in your breast’s shape or perkiness, or changes in your taste can affect how long your implants last. For example, you might decide that you’d like smaller or larger breasts after having implants for years or you might decide that you no longer want implants at all.
Although you can expect your breast implants to have a long shelf life, how long they will last or how long you’ll want them can be tough to predict at the start.
Risks and Ruptures
The risks related to breast implants are similar whether you choose saline or silicone implants. One possible risk is the development of capsular contracture, which forms when scar tissue develops around the implant and squeezes it. The formation of a scar capsule around the implant is a normal part of the healing process after breast surgery.
But, in some patients, the capsule eventually shrinks, distorting the shape of the breast and making the breast firm to the touch. In the most advanced stages, capsular contracture can be very painful. Typical treatment involves removing the capsule or removing the implants themselves, along with the capsule.
It’s not uncommon for women to be concerned about the risk of their implants rupturing. Fortunately, modern implants don’t rupture all that often, unless some excessive amount of force is put on the breasts themselves.
Cost of Breast Implants
Saline and silicone implants differ when it comes to price. Usually, silicone implants are more expensive than saline, but not so much as to make them out of reach for many patients. In fact, the cost seems to be of little concern to many patients, as the vast majority pick silicone implants due to their more natural feel and look.
It might seem as though silicone implants have more advantages over saline, particularly for patients concerned about the look and feel of their breasts after surgery. The reality is that each option has its pros and cons and it’s really an individual choice. While many women go for silicone implants, there are still plenty who prefer saline.
Other Factors to Consider When Getting Breast Implants
When all is said and done, you and your surgeon will choose the type and size of implant that works best for your body and for the amount of enhancement you’re seeking. Your surgeon will also help you choose the placement that will work best for you. Here’s what to know about your breast augmentation options so that you can ask the right questions during your consultation.
Implant Size
A major choice you’ll need to make before breast augmentation is what size you’d like your implants to be. Choosing implant size can be one of the trickier aspects of undergoing breast augmentation.
For one thing, implants aren’t necessarily sized the way you might think. Choosing an implant size isn’t like choosing a bra size. If you’ve ever gone bra shopping, you know that what one brand describes as a 34B might actually be the same as what another brand describes as a 36A.
Plus, proportionally speaking, a “C” cup on a person with a 32-inch chest is considerably smaller than a “C” cup on a woman with a 38-inch chest. There’s no uniformity in bra sizing, so it’s not a good way to measure implant size.
Instead, implants are sized based on volume. You might be presented with implants that are 300 ccs (cubic centimeters) or 450 ccs.
Usually, the best way to figure out which size is most appropriate for you is to try a few implant sizers on. You wear sizers under a tight-fitting shirt so that you can see what your silhouette and shape will look like with each size.
Your surgeon can also recommend a size to you based on your frame and aesthetic goals. Keep in mind that a surgeon might advise against going too large with your implants. Choosing implants that are too big can mean you end up with breasts that don’t work with the rest of your proportions or that you end up with implants that are too heavy to be comfortable.
Implant Placement
The final thing to consider when weighing your breast augmentation options is the placement of the implant. Often, choosing implant placement is mostly up to the surgeon, but they should be willing to explain the difference to you and why one option is preferable to the other.
Generally, a surgeon will either place an implant above or beneath the chest muscle. Often, sub-muscular placement is recommended for patients with a limited amount of breast tissue, as the muscle helps to conceal the implant better. The result is more natural-looking augmentation.
Of course, for some women, placing the implant over the muscle can make more sense or create a better result. A woman with more natural breast tissue can often benefit from over-the-muscle placement.
Risks of Breast Implants
Breast augmentation, like any type of plastic surgery, involves risks. In some cases, the risks of the surgery extend to the implants. Some possible complications from implants include:
Change in Breast Sensation
A change in the sensation of your breasts is possible after you get implants. Some people notice a change in nipple sensation once they get implants. They might feel more or less sensation in the area.
A change in nipple sensation could be due to the incision used by the surgeon when placing the implants. Some surgeons use a periareolar incision, making the opening just underneath the areola. There is a chance that the location of the incision will affect the nerves leading to the nipples.
Sensation changes can be temporary, meaning they resolve after a few weeks or months. They can also be long-lasting.
If you’re concerned about nipple sensation, talk to your surgeon about incision options and preferences. They might decide to make the incision in the crease underneath the breasts instead, leaving the nipples alone.
Breast Implant Illness
Even though the FDA cleared silicone implants once again in 2006, concerns about their safety persist in some circles. Some people believe that silicone implants are linked to a condition known as breast implant illness (BII).
The theory behind BII is that silicone implants can increase the risk of developing certain types of autoimmune diseases, according to Healthline. People who believe they are experiencing BII complain of fatigue, rashes, hair loss, and anxiety.
As Harvard Health Publishing points out, the symptoms associated with BII are real. But what’s less clear is whether they are occurring as a result of the implants a person might have or due to another cause. Many of the symptoms associated with BII are also associated with other conditions and circumstances that affect women, such as menopause and thyroid conditions.
If you’re concerned about the risk of BII, you can discuss your concerns with your plastic surgeon. They can recommend types of breast implants that aren’t typically associated with BII or otherwise put your mind at ease.
Ruptures
Both saline and silicone implants can rupture. The FDA notes that several factors can cause an implant to rupture, such as the age and condition of the implant, improper placement of the implant, and stress put on the implant.
What happens after a rupture depends on the type of implant. If a saline implant bursts or leaks, the saltwater solution will seep out. The implant will get smaller, causing the breast to shrink.
Silicone implants are more likely to have what’s called a silent rupture, especially gummy bear implants, which consist of a thicker gel. The implant isn’t likely to change in shape or size and the rupture might only be detectable on imaging.
There are a few things you can do to minimize the risk of an implant rupture. First, make sure you work with an experienced plastic surgeon who understands the importance of properly handling the implants and of properly positioning them in the body.
Next, always make sure to tell other medical professionals you work with that you have implants. The technologist who performs your mammogram should know about the implants, for example, so that they don’t put too much pressure on them when taking the images.
If you’re going to have another type of surgery, letting the surgeon know about your implants means they can avoid poking or damaging them with surgical instruments. It’s also worth noting that the FDA specifically advises against certain procedures or medications in women with saline implants, as some procedures do increase the risk of rupture.
It’s also a good idea to monitor your implants, especially as they get older. Your surgeon might recommend imaging every few years to keep an eye on the implants and to detect any silent ruptures.
Capsular Contracture
As your body heals after breast augmentation, a capsule of scar tissue forms around your breast implants. The capsule is a normal part of the healing process and provides some benefits, such as holding the implants in place.
In some circumstances, however, the capsule can begin to tighten around the implant, squeezing it. The pressure on the implant is known as capsular contracture.
In the earliest stages, capsular contracture doesn’t cause much to change in the breasts. They still feel soft to the touch, look normal, and aren’t painful.
As the capsule tightens and hardens, the breasts can change shape. They might feel hard and uncomfortable. Removing the capsule and the implant is usually the best way to deal with advanced stage capsular contracture.
Your surgeon will likely take steps during the initial surgery to reduce the risk of capsular contracture. Handling the implants as little as possible is one important precaution. Placing the implants under the muscle might also help to reduce the chance of capsular contracture.
Breast Implant-Associated Lymphoma
Breast implants, whether they are filled with saline or silicone, don’t cause breast cancer. But some types of silicone implants, notably textured implants, are associated with cancer of the lymph nodes.
Known as Breast Implant-Associated Anaplastic Large Cell Lymphoma, or BIA ALCL, the cancer is a type of non-Hodgkin’s lymphoma that affects the immune system, specifically the lymph nodes.
The risk of developing BIA ALCL is very low. According to the American Society of Plastic Surgeons, a woman with textured silicone breast implants has a 1 in 2,207 to a 1 in 86,029 lifetime risk of developing it.
Even though the risk is very low, it is still worth knowing what the symptoms are and what options are available for treatment. Signs of BIA ALCL include swelling or breast enlargement, a lump or pain in the armpit, and hardening of the breast.
Maintaining Breast Implants
Although there might come a time when you want to replace your breast implants or take them out completely, for the most part, your implants should last for many years. There are a few things you can do after your breast surgery to help maintain your implants and extend their life.
Immediately following your breast surgery, your surgeon or a nurse will show you how to perform breast implant massage and exercises. The massage and exercise techniques you use will help the implants settle into place and reduce the risk of capsular contracture. For best results, it’s important to do them exactly as directed by your surgical team.
Beyond the massage, there are some common-sense precautions you can take to keep your implants in great condition for as long as possible. Avoid activities that could potentially rupture the implants, such as certain contact sports. When you’re in a car, always a seatbelt to minimize the impact in case of an accident.
If your surgeon advises it, follow up with imaging of the implants as recommended. Imaging can detect any issues that might not be immediately visible.
Exchanging Breast Implants
Your breast implants might not last for the rest of your life, for a few reasons. You might grow tired of them or want to swap out silicone for saline or saline for silicone. You might want a smaller or larger size.
Some women decide that they don’t want any implants at all after a few years. Whatever you decide, breast implant exchange lets you remove or replace your older implants. The surgery is similar to the initial breast augmentation and requires anesthesia and about a week or two off to rest and recover.
FAQs
What is saline?
Saline is salt water. It’s sterile and is used to fill certain types of breast implants. Saline breast implants contain saltwater but have an external shell made of silicone.
What is silicone?
Silicone is a type of rubber that has a plastic-like quality. It’s safe and is used in a variety of products, from baby bottle nipples to breast implants.
What’s the difference between silicon vs silicone?
Silicon is the 14th element on the periodic table. It’s naturally occurring. Silicone, in contrast, is a synthetic material.
Silicone is used in food- and medical-grade products. Silicon is commonly bound to oxygen and is often found in quartz or sand. If someone is mentioning silicone vs. silicon in the context of breast implants, though, they’re referring to the silicone material used in these devices.
What’s the difference between saline vs. silicone in breast implants?
There are several differences between silicone and saline. Saline is a free-flowing liquid, silicone gel is much more viscous. Silicone can feel soft to the touch in a breast implant while saline can create a firm texture when used in an implant.
How old do I have to be to get breast implants?
The minimum age for breast implants depends on the reason for the implants and the type. Saline implants are FDA-approved for women over age 18 for cosmetic reasons. Silicone implants are FDA-approved for women above age 22. Both types can be used in women of all ages for breast reconstruction.
Will my breast implants break?
Breast implants can rupture, but there are things you can do to reduce the risk of breakage or a rupture. Monitoring your implants can also help you detect any issues early on.
Can breast implants make me sick?
There have been reported cases of BIA ALCL associated with breast implants. The risks of lymphoma are very low, however.
Can I breastfeed with silicone breast implants?
Many women can safely breastfeed after getting silicone implants. The silicone doesn’t harm the baby and the implants themselves often don’t interfere with milk production.
Can I get a mammogram with breast implants?
Yes, you can (and should!) get a mammogram with implants. Let the technologist know about the implants before they start taking imaging so that they can adjust the technique or angles used if necessary.
What are smooth silicone implants?
Some silicone implants have a smooth surface on the exterior. The smooth texture helps them feel more natural and move more naturally.
What are textured implants?
Textured implants are also filled with silicone and have a textured exterior surface. They do have a slightly higher risk of being associated with BIA ALCL.
What are gummy bear breast implants?
Gummy bear implants are used in breast augmentation. They consist of a thick silicone gel that is similar in texture to gummy candy. They have a tear-drop shape.
The right breast implant for you depends on your overall goals for breast augmentation and several other factors. Dr. Paul Vitenas is a Houston-based, board-certified plastic surgeon who specializes in breast surgeries.
He can help you choose the right implants and talk you through the breast augmentation procedure, including what to expect before and after. Call 281-484-0088 to schedule a consultation with Dr. Vitenas today.
