Breast Augmentation Surgery: Silicone vs. Saline Implants

Women seek breast augmentation surgery for a myriad of reasons, from genetic to cosmetic. The best candidates in any case are women who are emotionally well adjusted and who have a complete understanding of the procedure. If you’re planning a breast augmentation procedure, your choice of breast implants plays an important role in your final results. A great deal of thought must go into the type, size and placement of breast implants to achieve the best results possible.

We offer both saline and silicone breast implant options at Newman Plastic Surgery & Laser Center. Here you can begin to learn more about your implant options.

Saline Breast Implants

Saline implants first appeared on the U.S. market in the 1970s. They gained Food and Drug Administration (FDA) approval in 2000. Saline implants consist of a rubber shell that is inflated during surgery with sterile saline. You may choose between a fixed or adjustable volume implant, four different insertion locations, and a variety of sizes, shapes, profiles and textures.

Advantages of Saline Implants

Saline breast implants are filled after placement into the breast pocket. This provides the patient with a slightly smaller incision and scar compared with pre-filled silicone-gel implants. Adjustable volume implants can be filled with different amounts of saline once placed, so we’re able to adjust the size of each implant in an effort to avoid breast asymmetry. Saline breast implants are very similar to natural body fluids, and if the breast implant ruptures, the saline will be harmlessly absorbed by the body and the rupture will be readily apparent. In general, these implants are less expensive than silicone breast implants.

Disadvantages of Saline Implants

Disadvantages of saline implants are mainly cosmetic. Some women may be unhappy with the way saline implants look, as they are more likely to show rippling and wrinkling. Patients have said this implant type does not feel like natural breast tissue, and they occasionally complain of being able to hear the solution “sloshing” inside the implant. One functional concern with saline implants is an increased rate of implant deflation over time. This requires surgical correction although, if deflation occurs, saline is harmlessly absorbed by the body. Further, large saline implants have a higher rate of downward displacement due to their weight as opposed to silicone implants of comparable volume.

Saline breast implants also can be more difficult to use when a patient has limited tissue. Those who have had a mastectomy or who have very small breasts may find silicone gel implants to be a better choice.

Silicone Breast Implants

In 2006, the FDA declared silicone gel-filled breast implants to be safe and effective. This gave plastic surgeons the opportunity to offer their patients the choice of both silicone and saline implants. Silicone breast implants have been the subject of continued improvement and study over the years. The filling and shells have been modified many times to upgrade both the safety and feel of the product.

Silicone implants consist of a rubber shell filled with a fixed amount of silicone gel. Though silicone breast implants are not adjustable, you may still choose between a variety of textures, shapes, profiles, volumes and shell lumens.

Advantages of Silicone Implants

Silicone’s popularity stems from two key advantages: it’s a material that is highly compatible with the body and it creates breasts that have a very natural look and feel. Silicone breast implants also have a lower rate of rippling or downward displacement. For women who are thin or have small breasts, this is a distinct advantage, as rippling can sometimes be felt or become visible under the skin. I have performed many procedures to replace saline implants with silicone to resolve the problem of rippling. In every case, rippling was no longer an issue.

Silicone implants are also slightly lighter than saline implants. Women with modest breast tissue also have the option to place the implant over the pectoral muscles without sacrificing aesthetics.

Disadvantages of Silicone Implants

Silicone gel implants are more expensive than their saline counterparts, costing about $1,200 more than similar saline implants. Because they must be filled prior to insertion, silicone implants require a larger incision to adequately place the implant, therefore leaving longer scars. Silicone implants have a higher rate of capsular contracture, a tightening of the area around the implant during the healing process. Although this condition is not a health hazard, it may cause some discomfort and makes the breast implant feel hard. Patients with saline implants may also develop capsular contractures, but the incidence is definitely lower. The risk of capsular contracture is reduced when silicone implants are placed under the breast muscle.

Additionally, silicone implants have the potential to rupture “silently,” such that there is no outward evidence that the rupture has occurred. This may require you to undergo an annual MRI.

I’ve always believed in the safety of silicone implants. Noting that there was no direct evidence the implants caused problems and that the devices were never banned in other countries, plastic surgeons offered them to their eligible patients when possible. In addition, I was chosen to participate in current FDA-sanctioned trials of new high-strength cohesive-gel silicone implants, also known as “gummy bear” implants.

Silicone Breast Implants Today

Reaction around the country to the FDA’s decision to re-approve silicone breast implants has been positive. Silicone gel has always been held in high regard by patients and doctors for creating a soft, natural look and feel for enhanced breasts.

Ironically, another advantage of the silicone gel material contributes to the main disadvantage of the implants. The cohesive silicone filling holds together if the shell should rupture, causing what the FDA terms a “silent rupture.” Though the material is not likely to migrate out of the breast, the FDA advocates women have periodic MRI tests to ensure their implants remain intact.

Since FDA re-approval, silicone gel implants are available from Mentor and Allergan. The products come in a variety of shapes, sizes and profiles, giving you and I offer the choices you need to create the perfect breast for you.

I am one of only a handful of plastic surgeons in the country who is studying the next generation of silicone gel devices. As a participant in this study, I have some options not available to other surgeons. For the right candidates, these advanced silicone gel implants can offer important durability advantages while still looking and feeling like natural breast tissue.

Don’t feel dismayed by the wide range of implant choices available. I have the experience to help you decide which one is right for you.

When making the choice between silicone or saline implants, be assured that comparable and excellent results can be obtained with either type of implant. The choice is determined by patient circumstances and physician consultation.

If you live in Westchester, Manhattan, New York City or anywhere in the state of New York and are considering have a breast augmentation, please contact Dr. Scott E. Newman and his compassionate staff at Newman Plastic Surgery in New York City to schedule your initial consultation.

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