Breast Implants: Silicone vs. Saline

Parker Center for Plastic Surgery

Which implant type should you choose?

It’s really not a question of whether silicone gel, newer form-stable silicone, or saline is the “better” one. Whether you choose saline or silicone implants for your breast augmentation is a personal decision; while most of our patients choose silicone gel, thousands of women are perfectly happy with their saline implants.

Saline Breast Implants: Cost-effective option for precise symmetry

Saline implants are delivered unfilled by the implant manufacturer to our surgical facility. The implant’s outer shell, constructed with several layers of silicone, includes a fill valve. After inserting the unfilled implant into the breast cavity, Dr. Parker fills the implant to the desired size using disposable plastic tubing. This tubing is then removed and the valve closed. They do feel firmer and less natural than silicone gel, which can be more pronounced in women with less existing breast tissue. Currently, saline breast implants are FDA-approved for patients 18 and up.

Facts about saline implants

  • Cost: $650 per implant
  • Range in size from 125cc to 960cc.
  • Feel: Saline implants feel somewhat firmer and less viscous, or gelatinous, than silicone implants. The best results with saline implants, however, can approach the best results with silicone implants.
  • Volume: Saline implants are filled and adjusted on the operating table by the surgeon to a desired volume. When a preexisting asymmetry is present between two breasts, this allows the surgeon to make the breasts more equal.
  • Rippling: In many patients, the lower edge of the saline implant can be felt along the bottom of the breast, particularly in thin patients. This usually cannot be seen and is not medically harmful to the patient. It can be minimized to a certain extent by “overfilling” saline implants within the prescribed guidelines by the implant maker.
  • Incisions: Saline implants can be inserted through inframammary, peri-areolar and transaxillary incisions by Dr. Parker. He makes every effort to keep these incisions as short and unnoticeable as possible.

Silicone Gel Implants: The gold standard for a natural look and feel

Silicone gel implants come pre-filled to the correct volume with a cohesive gel material. This is less likely to lose its shape and have the silicone migrate outside the implant, but the implants cannot have their size adjusted. Silicone gel implants feel the most similar to natural breast tissue of all options, and help to create a nice, full breast.

Facts about silicone implants

  • Cost: $850 per implant
  • Feel: Silicone gel implants feel softer and more natural than saline.
  • Volume: Silicone gel implants are delivered to us pre-filled and their volume is not adjustable. The difference from one size implant to the next is 25cc, which is roughly the equivalent of a shot glass, so we’re not talking about large amounts between one implant and the next size. Most patients have some degree of asymmetry between their breasts. Dr. Parker will discuss pre-existing asymmetries with his patients during the consultation and work out a plan to optimize breast symmetry.
  • Rippling: Silicone gel implants are less prone to rippling than saline implants. This is an advantage in thin patients.
  • Incisions: Silicone implants can be inserted through inframammary and peri-areolar incisions by Dr. Parker. He makes every effort to keep these incisions as short and unnoticeable as possible.

What is silicone anyway?

Silicone is a synthetic polymer known for its stability, durability, and versatility. Silicone can be formed into consistencies ranging from a thin liquid (found in machine lubricants) to a very hard plastic (such as that used in heat-resistant cookware).

The consistency of silicone is achieved through a process called cross-linking. Silicone with lower cross-linking will be softer, while higher cross-linking creates more bonds between the silicone particles, resulting in a firmer consistency.

Breast implant manufacturers refer to the consistency of the medical-grade silicone gel used in their products as “cohesive” or “highly cohesive.”

Cohesive silicone gel has been the standard for breast implants since the early 1990s and is designed to hold its shape uniformly throughout the implant, yet retains some malleability or a “natural give” to feel more like an actual breast. This silicone consistency can best be compared to that of Jell-O. FDA approved implants using cohesive silicone gel include Mentor MemoryGel.

Newer highly cohesive silicone gel implants have enhanced cross-linking in their structure, resulting in a firmer gel consistency that is a little firmer and better suited for use in contoured implants. FDA approved highly cohesive silicone implants include Sientra and Mentor’s MemoryShape, both of which are shaped implants.

While technically both used silicone gel, the highly-cohesive shaped options are different enough in look and feel that we tend to talk about them as a separate implant type altogether.

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