Saline Filled versus Silicone Gel Filled Breast Implants: How do you chose?


Picking between Silicone Gel and Saline Filled breast implants is not an easy decision. They feel different, there are cost differences and they require different post surgical follow up. The outer shell is made of solid silicone. The difference is what is used to fill the shell. Saline is basically water and salt. If the shell breaks, the saline is absorbed by the body. The latest Silicone Gel implants are made of a cohesive gel. The cohesive gel is not liquid, it is more like “Jello” . If the shell of gel implant breaks, the gel will not travel or be absorbed. Well, how are they similar ?
  • Both Silicone Gel and Saline filled implants are used to make the breast larger. They are generally both placed behind the breast and usually behind the Pectoralis Major muscle. The effect is to push the natural breast forward and creating a larger cup size.
  • Both Silicone Gel and Saline filled implants were studied for over ten years in women and compared to women who did not have breast implants. The women with breast implants had the same chance of developing breast cancer or auto-immune disease, as women who did not have breast implants.
  • Both Silicone Gel and Saline filled implants have the same three post surgical risks. First: They are implants and they can become infected with bacteria, Patients with any kind of implant have to be careful with dental care and bladder infections. Any Bacteria entering the blood stream can end up on a implant. Second: Infection and Inflammation of an implant can cause capsular contracture. Capsular contracture is when the pocket that forms around the implant becomes tight and firm. This may require surgical correction. Third: both types of implants can break.
To Best Compare and Contrast Review this Chart

Silicone Gel Filled Implants
1. Have a solid silicone shell
2. Cost $1,600 per set
3. Feel close to a natural breast
4. They are available in sizes 100 cc to 800 cc
5. in Profiles of Low, Medium and & High
6. They have a 5% shell failure over 10 years
7. Post Surgical Follow Up involves a Xray study (MRI or Mammogram) every 3-5 years
8. They have a lifetime implant replacement warranty

Saline Fille Implants
1. Have a solid silicone shell
2. Cost $800 per set
3. Feel a little watery
4. They are available in sizes 100 cc to 800 cc
5. in Profiles of Low, Medium and & High
6. They have a 8% shell failure over 10 years
7. Post Surgical Follow Up self exam
8. They have a lifetime implant replacement warranty

So what is Dr Gold’s Recommendation?
Well both Saline and Silicone Gel implants are relatively safe. If you are concerned about having the most natural feel, then go with a silicone gel filled implant. If you have concerns about silicone gel then a saline implant will also work.

I generally will recommend a saline filled breast implant for a breast augmentation where:
  • The patient has at least a B cup of natural breast tissue
  • Is not “rail thin” (a reasonable amount of body fat)
  • Wants no more than 400 cc of augmentation. The bigger the implant the more likely that you will feel the implants edge next to the arms.
For this situation it is hard to tell the difference between a Saline or Silicone gel filled implant. Your are mostly going to feel your breast tissue and body fat.

I would generally recommend a Silicone Gel filled implant for breast augmentation where:
  • The patient has only one cup of breast tissue
  • Is very thin (no body fat)
  • Wants more than 400 cc of augmentation.

Thin patients with no body fat are generally more happy with a Silicone Gel filled implant. That said, I have seen patients with very large saline filled implants that are happy and not concerned about feeling the implant. I think that it becomes a personal choice and personal preference.