Choosing between Saline & Silicone Breast Implants.
Although we’re primarily a breast implant sizing service, we get asked a lot of other questions by our patients. One of the more common questions is “which are better, saline breast implants or silicone breast implants?”
The short answer is: Silicone breast implants are better.
The long answer is a very very long answer! Let’s break it up into sections.
Both silicone and saline breast implants are made of a “shell”, and inside the shell is the “filler”. The shell is the outer ‘baggy’ of the implant, and is always made of silicone which is chemically altered into a super stretchy tough rubber material. That means that regardless of the type of “fill”, the substance in contact with the inside of your body is always silicone.
Saline breast implants are filled with salt water, the same kind of salt water that fills all the cells of your body. About 60% of the weight you see on your bathroom scales comes from all the salt water in your body.
Silicon breast implants are filled with gooey silicone, not rubbery like the shell silicone, but more the consistency of thick honey or set jelly.
Silicon breast implants look more natural. Saline breast implants may develop wrinkling and folding, causing visible bumps or indentations. This can be a real problem if it affects the cleavage area of the breasts which is seen by other people when you’re at the beach or wearing a low cut top. Modern implants are filled up with ‘form stable’ or ‘gummy bear’ or ‘cohesive gel’ silicone, which doesn’t go out of shape.
Silicone breast implants feel more natural. Most saline implants used in 2017 are deliberately ‘overfilled’ by the surgeon during the surgery. This is meant to minimise the chances of rippling or visible dents in the breast. The side effect of ‘overfilling’ is that the implants become quite firm, like a balloon blown up extra big. Natural breast tissue can be quite soft, and silicone breast implants are only moderately firmer than the softness of your own breast tissue.
Silicone breast implants offer more options for size and shape of the implant. Saline implants use is on the decline, and most implant companies only offer a relatively limited range of options. For example, there is no such thing as a teardrop, or anatomical shape, saline implant!
Silicone breast implants don’t ‘slosh’ when you’re working out! Yep, the saline fluid inside the implants can slosh around like water in a bucket, which not only feels weird, but sometimes can actually make a noise!
Saline breast implants are slightly better when it comes to safety. Although modern silicone breast implants are far less prone to leaking (plastic surgeons call it rupturing, just to be dramatic!) than the silicone implants used 10 or 20 years ago, it is still a risk. If saline breast implants leak, the salt water is simply absorbed into the body. If silicone implants leak, the gooey silicone in contact with the inside of your body can cause problems, such as capsule formation, or silicone granuloma disease. Even though modern implants are better manufactured and less risk of leaking, it might be another 20 or 30 years before we can say exactly how long did the implants we used in 2017 last. For this reason, all reputable surgeons will counsel you about this risk before agreeing to operate on you.
If any type of breast implants leak, you will need to have another operation to remove or replace the implant. If your implants are silicone, this “revision surgery” might be technically difficult for inexperienced surgeons. If your implants are saline, even inexperienced surgeons can usually do a good job.
The vast majority of surgeons around the world recommend silicone filled implants. Plastic surgeons always have their own opinions on everything. But if most surgeons are all agreeing about the best way of doing something, there’s usually good reasons!
The real deeply thought out answer to this issue is of course, not ‘which implant is best, silicone or saline?”, but “which implant is best for me.?” Keep asking yourself, and your surgeon, specifically that, and you’ll come to a good decision.