Key Takeaways
- Silicone gel implants are preferred by Dr. Nukta and the majority of patients and surgeons nationwide because they more closely mimic the look and feel of natural breast tissue.
- Saline implants are filled after insertion, allowing a smaller incision, but their firmer feel and rounder appearance are less natural-looking than silicone.
- Silicone gel implants have lower rates of capsular contracture and rippling compared to saline implants, contributing to both better aesthetics and fewer complications.
- Women with thinner skin benefit most from silicone implants because saline implants can create a more obvious, rounded appearance that silicone avoids.
- If a silicone implant ruptures, the gel stays in place rather than being absorbed, so regular MRI screenings are recommended to monitor for silent leaks.
When you decide to get a breast augmentation, you have several decisions to make about your surgery. What size implants do you want? Do you want a more natural look? Do you want over the muscle or under the muscle placement of the implants? One of the most important decisions you make is whether you want saline implants or silicone gel implants. This decision will affect almost every aspect of your surgery, from the size of the incision to the look and feel of your post-operative body to what maintenance (if any) your implants will require through your lifetime.
While both implants have their positives and their drawbacks, our Board Certified Plastic Surgeon Dr. Fadi Nukta prefers the saline gel implants. Before we get into the reasons, lets discuss the basic differences between the two types of implants:
Saline Implants
Saline implants are filled with sterile salt water, and theyre filled once they are in place in the chest, allowing for a smaller incision and flexibility when it comes to how full you want the implant to be. The outer shell of the implant is made of silicone, and they are FDA approved for women age 18 or over (or for reconstructive surgery for any age). Saline implants have a lower rate of hardening than silicone. If a saline implant ruptures, the body will quickly begin absorbing the harmless salt water, and the patient will soon notice an alteration in the size and shape of the breast.
Saline implants give a firm look and feel to the breast after surgery. They are generally rounder in appearance than natural breasts (and silicone implants), and give more volume to the top portion of the breast. Some patients prefer the more dramatic look, but others feel like the appearance of a saline implant is not as natural as they would prefer.
Silicone Implants
Silicone implants have the silicone shell but are filled with a silicone gel instead of salt water. The gel closely mimics the look and feel of human fat, of which natural breasts are largely comprised. Women with thinner skin generally find that silicone implants do not give such a rounded, obvious appearance like saline implants can. When a silicone implant leaks or ruptures, the body does not absorb the silicone, so the leak can be difficult to spot. Women with silicone implants should get regular MRIs of the chest to check for leaks.
Silicone implants are FDA approved for women 22 or over.
Why We Prefer Silicone
While a saline implant does allow for a smaller incision, silicone implants have a more natural look and feel when compared to saline. While saline implants can be inserted through a smaller incision, it doesnt make up for the generally unnatural look and feel they have. Nationwide, silicone gel implants are preferred by patients and plastic surgeons. Saline implants have a greater instance of rippling, and current silicone gel implants exhibit lower rates of scar tissue development around them (also known as capsular contracture). Saline is also heavier than silicone, so the chances of the implant bottoming out are greater with a saline implant. The unnatural look of saline implants is especially pronounced in women who are already thin, have narrow chests, or very small breasts to begin with.
Selecting the type of implant you want is a deeply personal decision, and its one your surgeon will help guide you through. If, after exploring all the pros and cons and hearing the reasons why we prefer silicone, you still want to go with a saline implant, your surgeon can work with you. Women who have thick skin and already large breasts might not need to worry about whether their implants feel natural because their breast tissue will overlay the implant. However, thats not the case for the average patients seeking a breast augmentation.
If you are unsatisfied with both saline and silicone implant options, ask your plastic surgeon about breast augmentation with fat grafting. This gives you the option to have unwanted fat liposuctioned out of an unwanted area and injected into your breasts, giving you more volume without the side effects of implants.
If you have any questions about saline or silicone implants, or would like to schedule a consultation about breast augmentation in Northern Virginia, call our offices at (703) 215-9152.
Frequently Asked Questions
Why does Dr. Nukta prefer silicone gel breast implants over saline?
Silicone gel implants more closely mimic the look and feel of natural human fat, which is what breasts are primarily composed of. They provide a more natural appearance and tactile quality, exhibit lower rates of capsular contracture and rippling, and are the preferred choice of both patients and plastic surgeons nationwide.
What is the main advantage of saline implants over silicone?
The primary advantage of saline implants is that they can be inserted in an empty, deflated state and filled once in position, which allows for a smaller incision. They are also FDA-approved for patients 18 and older, compared to 22 and older for silicone, and a rupture is immediately visible as the breast deflates.
How can you tell if a silicone implant has ruptured?
Unlike saline, silicone gel stays within the implant shell or surrounding tissue when a rupture occurs, so there may be no visible change in breast size or shape. This is known as a silent rupture. Regular MRI screenings are recommended to detect any leaks that might not be noticeable through physical examination alone.
Is one implant type safer than the other?
Both saline and silicone implants have similar safety profiles. Silicone implants were once subject to controversy, but in 2006 the FDA ruled there is no link between silicone implants and systemic illness. Both carry risks including capsular contracture, rupture, and wrinkling, which are reduced by choosing a board-certified surgeon.
Who is the ideal candidate for silicone gel breast implants?
Silicone implants are particularly well-suited for women with thinner breast tissue or smaller natural breasts, where the implant outline might be visible with saline. They are FDA-approved for patients 22 and older for cosmetic augmentation. Patients who want the most natural-looking and natural-feeling result are generally best served by silicone.