Breast Augmentation: Saline VS Silicone
Making the decision to get Saline or Silicone implants is a big decision that needs to be carefully thought out prior to your surgery. Through the help of this blog and Dr. Marouk’s advice during a consultation, we feel confident that we will be able to help you make your best educated decision.
– Contents inside the shell
First off, all breast implants approved for use in the United States have a silicone shell. With that said, the type of implant type is determined by the material contained inside the shell. Saline implants contain sterile saline solution which has a consistency similar to water. Whereas silicone implants contain sterile silicone gel which has the consistence equivalent to thick syrup or molasses. I will discuss the newer cohesive gel or “gummy bear” implants in a later blog post, other than to say they are firm, and in no way feel similar to natural breast tissue.
SALINE IMPLANT PROS:
Saline implants are place into the body unfilled; therefore the incision is much smaller than with silicone implants. The implant shell (with a fill tube attached) is rolled into a cigar shape and placed into the dissected breast pocket though a 1” to 1 1/2 “ incision. This is a smaller incision in comparison to the pre-filled silicone implants. The implant is then filled with the appropriate amount of saline and the fill tube is removed. With saline implants an additional amount of fluid may be added to one or both implants to correct for breast asymmetry or to increase fullness in the upper aspects of the breast. Both the right and left implants may be “overfilled” (giving the implants a more rounded appearance) which some patients desire. There is also the ability to add additional saline to the implant at a later date if the patient begins to see any rippling or desires any increase in fullness. If a leak or rupture occurs with a saline implant, the saline is absorbed by the body without causing any changes in the surrounding tissue. Replacement of the implant is relatively simple with little or no down time in most situations. And finally, studies show the overall capsular contraction rate is less with saline implants.
SALINE IMPLANT CONS:
The primary disadvantage of saline implants is that they do not look or feel as natural silicone implants when placed on top of the muscle or in someone with very little breast tissue. Even with placement under the muscle, one may note rippling on the side of the breast, if there is little natural breast tissue present prior to surgery.
SILICONE IMPLANT PROS:
The primary advantage of silicone implant is their look and feel particularly when place on top of the muscle, or in a patient with less than moderate breast tissue. Therefore in someone who has had a mastectomy, where the muscle and breast tissue have been removed, I always recommend placement of a silicone implant. Although silicone implants can show rippling, they tend to be less than with saline implants. There is also less downward displacement of the Breast when large implants are place, secondary to the lighter weight of the silicone implant. This has less of an effect if the implants are placed beneath the muscle, secondary to the muscle attachment to the ribs, beneath the implant, holding the implant in its place.
SILICONE IMPLANT CONS:
The size of the implant is directly proportional to the length of the incision i.e. the bigger the implant the longer the incision. There is also a higher risk of loss of nipple sensation when placed through an areola incision secondary to a larger incision. Since these implants are already filled, it is more difficult to correct for breast asymmetry or lack of fullness in the upper aspects of the breast. Capsular contraction also tends to be higher with silicone implants. When a silicone implant leaks, the body may react by forming scar tissue around the free silicone. This scar tissue has to be removed prior to the placement (or at the time of placement) of a new implant. This will increase the post operative recovery time as well as postoperative tenderness. Reoccurring capsular contraction is also higher after replacement of an implant after a prior leak. This is thought to be due to the free silicone migrating into the surrounding tissue and causing the body’s natural defense mechanisms to continually try to wall off the silicone particles. Lastly, the cost of silicone implants are approximately $1000.00 higher than their saline counterparts.
There are many factors to take into consideration when contemplating Breast Augmentation. Dr. Marouk spends approximately one hour during the consultation, to ensure the best possible outcome for your surgery. We encourage anyone to visit our before and after photos and procedures page to gain a more detailed understanding of Breast Augmentation and the surgical process involved.
An actual patient of Dr. Marouk’s with Saline Implants.