The key to the breast augmentation operation is the implant itself, and currently saline and silicone implants are available.  In 1993 silicone implants were taken off the market for general use due to health concerns and a high rate of rupture.  The implant was dramatically improved and redesigned, and then was reapproved for women over the age of 22 by the F.D.A. in 2006.  Multiple studies have shown that the leak rate is extremely low, and the implant is considered safe.  Each type of implant has its pros and cons.

Saline Pros
The saline implant is made from a silicone shell and filled with salt water during the surgery. Because the saline implant comes empty, it requires a smaller incision for placement.  Once inside, it can be inflated and potentially overfilled.  If one breast is smaller, the implant on that side can be overfilled more to correct minor asymmetry.  The incision length is usually less than one inch, and can be placed on the underside of the breast, under the nipple-areola complex, the axilla-armpit region or the umbilicus.  The axilla method and the umbilical method require specialized endoscopic equipment.

The saline implant can deflate, but since the implant contains saline there is no health risk to the patient.  The leak rate is very low.  Also, the saline implant is typically less expensive.

Saline Cons
Due to the nature of saline, the implant feels similar to a water balloon.  There may be palpability issues and rippling.  If a woman has very little breast tissue, the implant may be easily felt under the skin.  Most plastic surgeons place the implants under the chest muscle, but this muscle usually covers the upper inner half of the implant.  If the implant is large or placed above the muscle, there may be visible rippling of the implant through the skin.  This rippling is most commonly seen in a bending or leaning forward position due to deformation of the implant by gravity.

Silicone Pros
The silicone implant feels very similar to natural tissue. Once placed inside the breast, it usually feels superior to a saline implant.  The silicone implants that are currently available are called cohesive gel.   The cohesiveness or “stickiness” of the gel molecules significantly decreases the chance of gel migration if a rupture of the shell were to occur.  The leak rate is very low.

Silicone Cons
The most concerning issue with the silicone implants is the potential for the silicone to leak.  The chance of rupture in some studies is less than 1%.  Many of these leaks are undetectable on physical exam, and for that reason the US-FDA has recommended that a woman with a silicone implant have a MRI starting at three years after implantation and then every two years thereafter.

If the implant were to leak, it is highly unlikely to cause a health risk.  Because the gel is cohesive, it is typically contained within the implant capsule.  Sometime a leak can cause the capsule to get hard.

Because the standard silicone implant comes pre-filled, once it is placed under the breast the size cannot be adjusted.  Additionally, the incision size is about twice the length of a saline implant.  This 2 inch scar is usually placed under the breast. Also, silicone implants cost 2-3 times more then saline implants.

The Bottom Line
Both the saline and silicone implants are fantastic implants.  The appearance of both types of implants will be almost identical.  Each has it’s own pros and cons.  The decision to have one or the other is a personal choice. We always recommend that questions related to plastic surgery are addressed from a member of ASPS (American Society of Plastic Surgery). Dr. Joshua Kreithen is a Bradenton / Sarasota Plastic Surgeon that is approved by the ASPS along with countless other professional affiliations in plastic surgery.

We encourage any Bradenton / Sarasota Breast Augmentation questions to see what type of implant is best suited for you. Book your consultation today at 941-907-8174.