Breast Augmentation: Saline vs Silicone

We want you to be confident about your implant selection, especially the type of implant you choose. Therefore, we asked Dr. Martin a few questions about saline and silicone implants. Check out his answers to get a better understanding of the pros and cons of each type.  

Comparing and contrasting implants with Dr. Martin

The saline versus silicone breast implant debate is confusing.  If you are considering breast augmentation, it’s hard to know which type of implant works better for your unique presentation and your desired goals. To bring more clarity, take a look at this question-and-answer session with Dr. Martin. In it, he discusses the pros and cons of the two implant types.  It is a great resource and will help you figure out which type of implant is better for you.  

Question: What are the main differences between saline and silicone implants? 

Dr. Martin: Both saline and silicone breast implants have a silicone outer shell, but they differ in their inner filling. Silicone implants are filled with a cohesive silicone gel while saline implants are filled with sterile saltwater. 

Silicone implants come pre-filled to a set volume from the factory and have more of a natural breast feel. Saline implants come deflated and are filled during the surgery itself.  They also tend to feel less natural than silicone implants. 

Silicone implants are available in a wide range of sizes and max out around 800cc. Saline implants also come in a wide range of sizes including options larger than 800cc.  They can also be overfilled and filled with different amounts from one side to another to address breasts that are different sizes. 

Question: What are the pros and cons of each type of implant?

Dr. Martin: The pros of silicone implants are that they have a more natural feel and are available in a wider range of shapes and projections.  For the newer generation implants, there is less risk of visible wrinkles or rippling. They also are more durable than saline implants.  Since they come pre-filled, the cons of silicone implants is that they require slightly longer incisions, around 25% longer, than compared to saline implants.  They also are more expensive.

The pros of saline implants are that they can be overfilled and come in very large sizes.  The incision for placement is smaller since they are filled once they are in the proper position during surgery.  They are also less expensive. The cons of saline implants are that they feel less natural and are more likely to show wrinkles and rippling if not overfilled. There are also fewer options when it comes to the shape and projection of the implant.  Lastly, they are more likely to fail.

Question: Who would benefit from either a saline or silicone implant?

Dr. Martin: If you are 22 years of age or older, I would recommend a silicone breast implant. They look and feel much more natural.  They are much more durable especially since the cohesive silicone gel holds the implant together more uniformly. There are also a lot more options to choose from. 

Saline implants may be better for patients on a tight budget and for those wanting very large implants, greater than 800cc.  FYI, for patients less than 22 years of age, we are required to use saline implants by the FDA. Lastly, saline implants are sometimes better in cases of breast asymmetry since their volume can be adjusted during surgery.

Question: What else should a patient consider when choosing between silicone and saline implants?

Dr. Martin: It is important to think about your goals, especially your desired look.  If you care about fullness and projection, then a silicone implant is the better choice. If you are only concerned about the incision length, then a saline implant is your best bet. I also think it is important to be open about your lifestyle and fitness routine when considering the type of implant that works for you. Saline implants often don’t offer enough durability in cases of very active patients.

before after

Question:  Any final thoughts?

Dr. Martin: If your primary goal is to have a natural breast augmentation, silicone implants are going to be the superior option. The only reason to pick a saline implant, in my mind, is for those of you less than 22 years of age or when cost is a real issue. Just for comparison, a saline implant is around 50% less costly than a silicone implant, depending on the manufacturer. However, silicone implants yield much better aesthetic results for most patients. There isn’t much difference in the length of the incisions unless you are considering a larger implant, greater than 650cc. A silicone implant is more durable and ripples less than standard-filled saline implants. In my practice, silicone implants are my first, second, and third choice. Also, to this point, many of our patients are surprised to learn that saline and silicone implants have the same silicone shell or covering. If you are inclined to choose a saline implant over a silicone implant out of silicone concerns, it doesn’t avoid exposure to silicone, especially on a microscopic level.  Just remember, the safety profile of these implants is the same.  So if all things are equal on the safety front,  a silicone implant is just the smarter choice.