Choosing Between Saline and Silicone Breast Implants

Choosing between silicone gel or saline breast implants is often one of the most confusing and difficult decisions Seattle breast augmentation patients must make. Each implant material has its pros and cons, so there is no clear way to say which type of implant is best, and each patient must decide based largely on their personal goals and preferences.

Look and Feel

Both silicone and saline implants can give you a natural look, particularly if the implants are placed under the chest muscles, however silicone breast implants have a reputation for providing a more natural feel. This makes sense, given that silicone implants today are made of a cohesive gel material that more closely mimics the weight and suppleness of natural breast tissue than liquid saline solution. Patients who are very thin or have little natural breast tissue to cover their implants are often good candidates for silicone gel implants because the implants are softer and less prone to rippling, allowing for a more natural look and feel. Patients with pronounced asymmetry in the size of their natural breasts may also be good candidates for saline implants, as the volume of saline solution in each implant can be adjusted to even out the breasts.


Saline breast implants are composed of an outer silicone shell and a filling of liquid saline solution. Because the saline solution can be added after the implant shells have been placed in the chest wall, the incisions needed to place saline implants are slightly smaller. There are also more options as to where incisions can be placed with saline implants. Unlike silicone implants, which can be inserted only through incisions in each breast fold (inframammary incisions) or along each armpit (transaxillary incisions), saline implants can also be inserted through incisions around the border of each areola (periareolar incisions) and even through the belly button (TUBA incision). Thus, saline implants result in smaller scars (about half an inch smaller) than silicone implants and offer more options for patients in terms of where their breast augmentation scars are located.


In 2006, the FDA ended a 14-year moratorium on silicone breast implants that was instituted because lawmakers felt there was insufficient evidence to rule that the implants were safe. After years of rigorous testing, the FDA allowed silicone implants to re-enter the market because no scientific data had been produced to link silicone implants to systemic diseases they were previously assumed to cause. From a scientific standpoint, the safety of silicone implants and saline implants is identical. The only difference between the two from a legal standpoint is that patients must be 22 to have silicone implants, whereas they can be as young as 18 to have saline implants. Patients who choose either option can rest assured that all FDA approved breast implants are safe and will not directly affect your health and wellness in any way, positively or negatively.

Breast Implant Cost

Breast implant manufacturers charge about $1,000 more for silicone breast implants than saline breast implants, so breast augmentation with silicone implants is slightly more expensive initially. Also, consider that patients with silicone implants should have an MRI three years after surgery and every two years thereafter, as there is no other way to detect breast cancer or implant ruptures with silicone implants. Saline implants, on the other hand, do not require an MRI to detect cancer and will visibly deflate if they are ruptured. Due to the cost of periodic MRIs, the cost of maintaining silicone implants can be slightly higher in the long run.

The Bottom Line

It is easy to get overwhelmed evaluating the pros and cons of saline and silicone breast implants, but before you do, remember that you have a guiding light in this process: your cosmetic surgeon. Dr. Jonov has decades of experience and has helped hundreds of Seattle breast enhancement patients choose the best breast implants to meet their unique needs. Trust Dr. Jonov to help you make this important decision, and feel free to ask questions, talk to other breast augmentation patients and look at plenty of breast augmentation before and after photos before you decide on silicone or saline breast implants.

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Are Silicone or Saline Breast Implants More Popular?

Breast implantsWhile a recent informal user poll at found that women interested in breast augmentation say they are more likely to get silicone breast implants, plastic surgery statistics show that last year women were equally divided between silicone and saline implants.

The poll, which received 481 responses from women who said they were planning to have breast augmentation surgery, found that 58 percent said they would choose silicone breast implants; 24 percent would choose saline breast implants; and 17 percent were undecided.

Statistics from the American Society of Plastic Surgeons (ASPS) showed that in 2009, 50 percent of women in the U.S. who underwent breast augmentation received silicone implants and 50 percent saline.

However, comparing data from ASPS since the FDA approved silicone gel breast implants in November 2006 shows that silicone has been gaining on saline each year. In 2007, 65 percent of breast implants were saline; in 2008, 53 percent were saline; and last year silicone use matched saline use.

Implant Differences

  • Saline breast implants are filled with saline, usually at the time of surgery.
  • Silicone breast implants are pre-filled with silicone gel a thick, sticky fluid that mimics the feel of human fat.

One advantage of saline implants that the surgeon can fill the implant during surgery, which allows for a smaller incision. The size of saline implants can also be changed over time without additional surgery. Saline implants feature small valves in which a doctor can insert a needle and either add or subtract the liquid to change the implant’s size.

Silicone implants have the advantage of looking and feeling more natural. Saline implants have sometimes been criticized for feeling hard, although improved surgical techniques have lessened these complaints.

Both types of breast implants are approved by the FDA, so they have been thoroughly researched and tested and reviewed by an independent panel of physicians for safety. Saline breast implants are available to women 18 and older for breast augmentation, and silicone implants are available to women 22 and older (both are available to women of any age for breast reconstruction).

Saline Implants May Have Shielded Her From Incoming Bullet

Recently published in the LATimes was a story of dramatic workplace violence that left a woman in California with scars and deflated breast implants. Her plastic surgeon is now hoping the story will elicit a contribution of supplies from implant manufacturers, to contribute to her reconstructive surgery procedure.

When a man opened fire in the dental office where Lydia Carranza worked last year, she was shot twice: The bullet fragments were millimeters from her heart and her vital organs, said Dr. Ashkan Ghavami. The shooter also claimed the life of her co-worker.

According to a firearms expert interviewed for the story, what saved Lydia’s life may have been the presence of her saline breast implants. Of course he advises against getting breast enhancements as a means to deflect a possible incoming bullet.

Read more about this story here on

Getting Natural Breast Augmentation Results: Factors to Consider

Which type of breast implant feels more natural: saline or silicone?

This is a common question for women considering breast augmentation or breast reconstruction. Surgeons generally agree that silicone implants mimic natural breast tissue more closely than saline. However, natural results can be achieved with either implant. If you’re concerned about a natural look or feel in your breast implants, there are a few factors to consider:

  • The amount of tissue covering the implant will affect the way it looks and feels, so you may want to consider sub muscular or partial sub muscular implant placement.
  • The implants and tissue may soften during the months following breast augmentation with saline implants.
  • Women with a thin body and thin breast tissue will often be advised to choose silicone implants due to the possibility of visible implant wrinkling caused by a lack of adequate coverage.
  • Choosing the proper size is critical for achieving a natural result that matches your body proportions.

Breast Implants – What Can’t They Do?

In August, 2008 a Florida woman named April Pinkard told her surgery story to a local newspaper. The headline read, “The Woman Whose Heart Was in the Wrong Place” and the story focused on Ms. Pinkard’s rare heart condition. Well, rare conditions call for rare solutions and the one chosen for her by surgeons at the Jacksonville Mayo Clinic is nothing short of that.

Three years prior to the story, during what was probably a routine medical exam, her doctor revealed something terribly strange. She recalls “he listened [for] my heartbeat one day and it just wasn’t there.” Further inspections led doctors to conclude that her heart had shifted, into an open area that her lung once occupied. Ms. Pinkard once suffered from a congenital lung disease, prompting the removal of one lung at age 4. Over the course of about 30 years of life, her heart became mobile – apparently an unintended consequence of the lung removal.

Her condition was critical. To save her life, doctors had to operate quickly.

Dr. Choudhury referred her to the Mayo Clinic, where surgeons opened her up, “filled her chest cavity with water and floated it into the correct position.” To prevent further movement of the heart, they placed breast implants in her chest, to fill the void left by her missing lung. She tells reporters “you can hear it move. If I push on my chest you can feel the squishes.”

She still faces some health issues, like the possibility of a lung transplant sometime in the future. But Pinkard is strong willed and has a very positive outlook about the whole experience. Of course, it doesn’t hurt to have such talented medical professionals on her side.

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