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So, you are thinking about getting breast implants. That’s a life-changing decision that needs a lot of thoughtful consideration.
But once youโve made up your mind, you will have to decide between the two main options for breast implant material: silicone and saline. So, what exactly is best for you? Well, it depends on your specific goals and situation.
Here are 12 key facts to help you choose.
1. Silicone implants often look and feel more natural
A major difference between silicone vs saline implants is that silicone implants often have a more natural look and feel than saline. The silicone gel more closely resembles natural breast tissue. On the other hand, saline implants can sometimes look ripply or wrinkly, especially for women with little natural breast tissue.
If you want a very natural look and feel, silicone may be the way to go. This is especially so when you consider that silicone implants come in teardrop shapes that are made to mimic the slope of natural breasts.
Saline implants are almost always round.
2. Saline implants commonly have a lower risk of capsular contracture
One potential complication all breast implants have is capsular contracture. Thatโs when scar tissue squeezes the implant, causing firmness or misshapen breasts. Studies find saline breast implants have a lower capsular contracture rate than silicone.
Up to 18% of silicone patients get significant capsular contracture after 8-10 years. Only 8-10% of saline patients do. So, if avoiding firm scar tissue is important to you, saline implants may be better.
3. Silicone implant rupture is โsilent,โ saline is noticeable
All breast implants can potentially rupture over time. But with silicone implants, the gel usually stays within the scar tissue, so you may not notice. This is called โsilent rupture.โ
With saline implants, the leaking saline is harmlessly absorbed by the body. But it will cause visible deflation. While the silent rupture sounds better, it means silicone rupture goes undetected without an MRI to find it.
4. Saline implants have a lower risk of some complications
While silicone implants feel and look more natural to many women, some studies find saline implants have a lower risk of certain complications:
- Capsular contracture risk is up to 2X higher with silicone
- Reoperation rates within 3 years are higher for silicone
- MRI scans are needed to monitor silicone implants for silent rupture
While saline implants have more visible wrinkles and folds, they may avoid some frequent problems. You have to weigh up what matters most to you.
5. Silicone implants are better for breast reconstruction
If you are having breast reconstruction after mastectomy for breast cancer treatment, silicone implants are strongly recommended by plastic surgeons. The natural feel and teardrop shapes work much better to rebuild the removed breast mound.
6. Silicone vs Saline Implants: Short-term risks are higher for saline
While saline implants carry lower long-term complications risks in some studies, short-term risks just after surgery are higher compared to silicone. This includes things like:
- Visible wrinkling or rippling, especially for very thin women
- Higher chance of wound infection in the first 3 years
- More postoperative pain up to 6 months after surgery
If youโre very lean or worried about short-term pain and complications, silicone may work out best.
7. Silicone implants usually cost more
Because silicone gel feels more like actual breast tissue, silicone breast implants are more expensive, by $1000 or more typically. The silicone material costs more to make. The newer โgummy bearโ style cohesive gel implants that hold their shape can run $2000+ more than basic saline implants.
If cost is very important in your implant decision, saline is the more affordable option. Just know they can sometimes fold and wrinkle more noticeably.
8. Silicone implants usually last longer
Studies tracking breast implants over decades find silicone implants generally last longer before needing replacement compared to saline:
- Over 10 years, 3% of silicone implants leak and require surgery. 12% of saline implants deflate and need replacing.
- After 13 years, 20% of saline implants required removal or replacement due to issues. Only 10% of silicone implants did.
If you want implants that will last many years without surgery, silicone tends to hold up better before eventual replacement is needed.
9. Silicone implants come in more sizes
Another upside of silicone breast implants is there are more size options. Silicone implants often go up to 800cc volumes. Saline implant sizing maxes out at about 500-550cc.
Bigger sizing translates to more fullness for women wanting a very large difference. But be careful not to go too large, or it can give that โobvious implantsโ look. Your surgeon can guide you on appropriate sizing.
10. Silicone gel is safe based on years of testing
If youโve heard concerns about silicone implants leaking gel inside the body, multiple major studies, carried over decades, have found that the silicone material does not cause cancer or autoimmune disorders for most women. The gel stays safely within the surrounding scar capsule.
In rare cases, silicone particles may escape into nearby breast tissue without major issues. Evidence confirms silicone gel-filled breast implants are safe overall despite some lingering myths. But each woman’s body differs, so consider your personal health history.
11. Saline implant leaks get absorbed without harm
As mentioned before, a nice feature of saline-filled breast implants is that your body harmlessly absorbs the saline if the implant’s outer shell leaks. The saltwater gets flushed out in urine without ill effects. The deflation will require surgery.
While the deflation risk is higher compared to silent silicone rupture, you donโt have to worry about silicone particles escaping into breast tissue if the implant fails. For some women, that peace of mind helps outweigh some cosmetic disadvantages of saline.
12. Rare lymphoma cases mostly occur with textured implants
You may have heard news reports about women diagnosed with a very rare lymphoma called BIA-ALCL (breast implant-associated anaplastic large cell lymphoma). It forms in the scar capsule around breast implants. And its main symptoms are persistent fluid build-up or swelling.
But nearly all confirmed cases of this lymphoma involved textured surface implants, not smooth implants. U.S. cases are estimated at 1 per 3817 for textured implants. And it’s even more rare for women with smooth implants like most saline and silicone models.
While the reports may seem alarming, your risk of getting BIA-ALCL is extremely low. However, you should be aware of the symptoms as a precaution, especially if you choose textured implants.
Monitoring changes is key.
Silicone vs Saline implants: Conclusion
As you can see, there are good reasons why both saline and silicone breast implants are popular options. For you, your choice should come down to your cosmetic goals, cost considerations, and health priorities in both the near and long term.
Book in-depth consultations with experienced board-certified plastic surgeons in your area. Examine before and after photos and implant samples. And be very clear on the differences between implants and which tradeoffs matter most to you.
While it is a significant decision, breast augmentation can help many women gain confidence in their body. And so once you are fully informed, focus on what excites you rather than stresses you out. And then stay realistic but positive.