Breast implants come in two main types: Silicone and Saline. They both have their own unique advantages and disadvantages and there is no right or wrong decision. Put very simply, saline implants are slightly safer and easier to manage but look and feel less like real breast tissue than silicone breast implants.
First, lets explore the anatomy of a breast implant. Whether it is to be filled with saline or silicone, both types of implants use silicone for the outer shell. Both types of breast implants come in all different types of sizes and shapes depending on the needs of the patient.
Saline implants can be placed in a number of different locations underneath the breast, including subglandular (over the muscle tissue), partial submuscular (only the top 2/3 of the implant covered by muscle tissue) and complete submuscular (entire implant is under the muscle tissue). Something else for the patient and doctor to consider is the type of incision and the location. Some of the possibilities include inframammary (directly under the breast crease), periareolar (nipple), transaxillary (armpit), or TUBA (bullybutton).
Since silicone implants are filled after they are inserted, they tend to involve smaller incisions than with silicone implants, which are filled before they are inserted. The surgeon uses a syringe to carefully administer the correct amount of saline, and can increase or decrease it as needed. With silicone implants, the correct size must be determined before it is inserted because it cannot be adjusted. The only option if the patient of doctor is unhappy is removing the old one first, then inserting the new, correctly sized implant.
Minimal Risk of Rupture with Saline Implants
Saline is simply a salt water solution, and about 60% of the body is already composed of saline. Therefore, should the implant break, the saline is completely harmless to the body. In the event of a rupture, a noticeable size difference will be immediately noticeable with saline implants, which is a good thing. With silicone breast implants, the silicone gel leaks out very slowly and the patient might not even be aware a rupture has take place. For this reason, the FDA recommends that special MRI’s be performed on women with silicone breast implants about every three years.
How Do They Feel?
The main drawback of saline implants is how they feel. Silicone gel feels more like real breast tissue than saline. Some women complain that saline feels like a water balloon. However, thanks to advancements in surgical techniques such as placing a saline implant underneath the chest muscles, a more natural feel is achievable with saline. It depends on other factors too, such as the amount of natural breast tissue the patient has prior to the implant. Overall though, silicone is generally agreed upon to give a more natural feel that resembles real breast tissue better than saline.
The Risk of the Ripple Effect
Saline implants are more likely to have a visible “ripple” or wrinkling effect than their silicone counterparts. The ripple effect is caused by the saline filler and the casing of the implant interacting with one another. This effect is more noticeable in women who have very little breast tissue to start with and thus have thinner skin over the implant. This effect can be minimized with more modern techniques such as placing the implant underneath the muscle. If the women has a fair amount of breast tissue to start with and the implant is placed underneath the muscle tissue, the risk of a noticeable ripple effect is greatly minimized.
Saline implants are cheaper than silicone, by about $1,000. The materials used are cheaper than those used in silicone implants. Saline implants with all costs (surgeons free, anesthesia, etc.) cost between roughly $4,000 to $,6000.
The Final Decision
It is imperative to discuss the pros and cons of silicone vs. saline implants with your doctor. There are lots of things to consider in making your final decision including how much breast tissue you have to start with, your goals, your budget, your personal anatomy, etc. Make sure you discuss these things with an experienced, board certified plastic surgeon.
Although there is a lot to consider, what the decision will generally boil down to is this: Silicone implants provide a more natural look and feel at a higher cost and with a slightly higher risk of complications, while saline implants, despite many advancements in surgical techniques, do not usually feel as natural as silicone, but they are cheaper and have an even lower risk of complications.