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The Differences between Silicone and Saline Implants

Breast augmentation, or mammaplasty, is the most common type of plastic surgery performed in America. According to the American Society of Plastic Surgeons (ASPS), nearly 296,000 breast augmentation surgery procedures were performed in the United States in 2010. Women choose to have breast augmentation for a number of different reasons, including:

    • Enhancing body contour
    • Correcting a reduction in breast size after pregnancy
    • Reconstruction after breast surgery or removal
    • Making asymmetrical breasts equal in size
    • Correcting congenital micromastia, a condition that results from breasts that don’t develop during puberty
    • Correcting loss of elasticity in breast tissue that results from aging

Breast augmentation is performed by placing an implant behind the breast. The result is a fuller bust line, firmer breasts, more symmetrical breasts, and an increase of one or more cup sizes. Modern breast augmentation has been tested, refined, and improved for over fifty years, so it is now a very safe and commonplace procedure. There are two types of breast implants available today: silicone (gel filled) and saline (salt water filled).

Silicone Breast Implants versus Saline Breast Implants

A brief overview of silicone and saline implants reveals the pros and cons of both types of breast augmentation. One choice is not better than the other; rather, it depends on your individual situation, reason for choosing breast augmentation, and personal preferences.

    • You must be 22 years of age in order to receive a silicone implant, while saline implants are available at age 18.
    • The consistency of silicone implants is more similar to natural breast tissue than saline implants, which are harder and firmer than natural breast tissue.
    • Silicone implants require a larger incision in the breast during surgery, which could result in a more noticeable scar.
    • Rippling of the implant is less likely to occur with silicone implants than with saline implants.
    • If the implant happens to rupture, the damage is more difficult to detect in silicone implants than in saline implants.
    • Silicone implants are more expensive than saline implants.


Silicone Breast Implants

Silicone breast implants of the sixties, seventies, and eighties were filled with liquid silicone, not the silicone gel that is used in modern breast implants. Silicone breast implants gained an unfavorable reputation because the liquid silicone leaked into the body in cases of implant rupture, causing the FDA to limit their use from the early nineties until quite recently. In November 2006, the FDA approved the use of silicone gel implants in breast augmentation. From 1992 through 2006, saline implants were used in most breast augmentation surgeries, so the majority of women who received breast implants in the last two decades have saline implants.

The most common reason that women choose silicone implants over saline implants is that silicone feels more like natural breast tissue. The second most common reason is that silicone implants are less likely to ripple. Rippling implants can be noticeable and may warrant a second breast augmentation surgery that most women would prefer to avoid.

Although silicone implants are more expensive than saline implants, the price difference between the two is can be up to a few thousand dollars. Medical insurance will not cover breast augmentation, except in the case of medical necessity, which is not warranted by most breast augmentation surgeries. However, you may be able to pay for breast augmentation on a payment plan, so consider this option if price is the only thing keeping you from choosing silicone over saline.


Saline Breast Implants

The outer shell or casing of all breast implants is made from silicone, but silicone implants are filled with silicone gel, while saline implants are filled with a salt water saline solution. The firmness of saline implants is achieved by filling the shell with more or less saline, so if you prefer saline implants but are concerned about their consistency being less like natural breast tissue, talk to your surgeon about this factor.

Saline implants are more likely to have a noticeable ripple than silicone, because they are water filled. Some surgeons will “overfill” the shell in order to reduce the chance of rippling, but this will give the implant more firmness, another factor to consider and discuss with your surgeon.

If you are prone to scarring, you may want to consider saline implants, which necessitate a smaller incision to insert behind the breast’s natural tissue. But an incision is required in either case, and there are measures you can take to reduce scarring post-surgery.  Keep in mind that most breast augmentation surgeries are achieved with minimal to no noticeable scarring.

While saline implants are less expensive, it is only the implants themselves, and not the actual surgery, that are cheaper than silicone implants, which is why the difference in price between the two surgeries overall can be quite minimal. Discuss the cost of the entire surgery and all related procedures with your surgeon to get an accurate estimate of the price before making any decisions.

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