Silicone or Saline Breast Implants

Which Implant is Right for Me?

Both silicone gel and saline breast implants are great devices that have been used for decades.  There is not one “best” implant in all situations and there are things that they have in common and some differences as well.  Below are some comparisons between silicone and saline.

HOW THEY ARE SIMILAR

Safety

There appears to be no correlation between breast implants and breast cancer, lupus, autoimmune disease, or thyroid disease.  All the things that they were nervous about in the early nineties have been studied and both implants have been found to be similar in safety.

Outer Shell

The outer shell in both types of implants is a silicone rubber.  One is filled with sterile salt water. The other is filled with a new silicone gel.

Longevity of Shell

The outer shell of the implant does not last forever. Both implants have a life span of approximately, on average, 10 to 12 years.  They may last 15 to 20 years or they may last only 5 years but the average is about 10 to 12.  One of the rumors of breast implant surgery is every 10 years you have to get your implants changed and that is not true.  It may be 10 years.  It may be 12 years. It may be more or less but you do not have to set your clock and at your 10 year anniversary have your implants exchanged. Click here for more information on breast implant replacement.

Warranty

First of all, in my practice, if a patient’s implant ever leaks, breaks, deflates, or ruptures, there is no surgeon’s fee to go back to the operating room and change the implants out.  I do not ever want cost to be a reason for a woman to walk around with a broken implant.  The next part of the warranty is in all cases when an implant breaks or leaks, replacement implants are sent from the manufacturer, free of charge, for the life of the patient. The third part of the warranty is if the implant breaks, ruptures or leaks within the first 10 years there is money available by the manufacturer to help cover anesthesia and facility fees for those first 10 years, and there is an upgrade for a small fee available as well to increase the amount of that financial coverage within that first 10 years.

HOW THEY ARE DIFFERENT

Cost

Silicone implants are almost twice the cost of saline implants.

Incision and Adjustability

The incision with silicone implants is usually a bit bigger than a saline implant because saline implants come flat and can be rolled up from the factory, inserted through a smaller incision, and then filled.   Since silicone implants come already filled, they usually have to be inserted through a bigger incision.  Saline implants are adjustable. For a surgeon in the operating room, that is a real benefit because they can be fine tuned down to 1 cc so that if there is some unevenness between breasts, which is common in most women, these can be easily adjusted in the operating room at the time of surgery. With silicone implants, they are manufactured in certain sizes, so fine tuning for size difference will not be as precise with silicone implants.

Rupture and How You Will Know

One of the biggest differences between the implants is the ability to tell when the implants finally crack, leak, or break. With a saline implant, it is very easy.  The implant will deflate, in most cases, over 48 hours and it will become easy to tell.  Many women think this might be during a period of exercise or trauma.  But many times, that is not the case.  The nice thing about a saline implant is you really do not need any special investigation to tell how your implant is. Just look down! If you are full, you are fine…If you are flat, you are not!   The downside is that this may happen at the most inopportune time.  It may happen on the first day of your Hawaii vacation or the day before someone’s wedding. In most cases, we try and get back into surgery within 48 hours.  We always advise patients to please let us know as soon as this occurs. In many cases, once the saline implant starts to shrink down, so does the capsule around it and that makes replacement a bit more difficult. 

With silicone implants, it is much harder to tell. The old silicone gel implant material used to be more like syrup. When the implant would break the silicone gel would leak out much like an egg yolk.  The new silicone gel is much more cohesive.  In fact, the implants can be cut in half and they do not leak like the old ones used to. With the old silicone gel, the leaking of the implant could be seen many times on routine mammogram. However, with the new cohesive gel implants, it becomes a bit more difficult. Neither the patient nor I, in most cases, would be able to tell.  It might take an MRI to be able to notice any sign of rupture and even then it is not 100 percent.  The challenge of MRI is they can be a bit claustrophobic and expensive.  The FDA currently makes timetable recommendations about women getting MRIs to evaluate their breast implants.  Some women choose to follow those guidelines and others do not. New technology is evolving as well which may eliminate the need for MRIs in the future. All of this can be discussed during your visit.

Which Implant is Right for Me?

The bottom line is there are psychosocial reasons to pick one implant over the other and there are physical reasons.  The psychosocial reasons we talked about. Some women are worried about deflating on a vacation so they want silicone implants. Other women are nervous about being able to tell when their implant ruptures so they want saline implants.  But the physical reasons are as follows. The thinner a woman is, the more we lean towards silicone implants because in those women the implants will look more natural, feel more natural, and, in many cases, ripple less.  For my patients that are 5 feet, 7 inches, 105 pounds, we recommend silicone implants.  Patients who have thin breast tissue or that I can see ribs on them, may lean towards silicone implants. Patients who are fairly normal with some breast tissue and good thickness to their skin can probably do well with either implant.  And patients who have thicker breast tissue and thicker skin could do just fine with a saline implant and probably do not need the extra expense of silicone.

Ultimately, it is a woman’s choice as to which implant she receives. One of the other misnomers about breast implants is that silicone is always the better implant choice in everyone, and that really is not the case. It is a very individual choice and a procedure that still carries with it a very high degree of patient satisfaction…

To learn more about breast augmentation and which breast implant is right for you, contact us for a personalized consultation with our experienced Scottsdale breast surgeon, Dr. John Corey.  We serve patients from Scottdale, Phoenix, Chandler, Mesa, Gilbert, Tempe and surrounding areas in Arizona.