Silicone gel filled implants or saline implants – how do you choose the best option? There are advantages with each of these implant types. We will thoroughly review these options at your consultation to help you make the best decision. There are many factors that contribute to this decision including your anatomy, existing breast shape and size and genetic scar potential.
Both saline filled implants and silicone gel filled implants share an outer shell made of non-reactive silicone. Saline is sterile water with a small amount of salt in it formulated to equal the concentration of your own body salt. Silicone gel is a type of silicone that has a density similar to gelatin. The newer silicone gel filled implants that we use are filled with a type of silicone called cohesive gel. Cohesive gel is thought to prevent the migration of silicone through your body if an implant were to rupture. Currently the FDA recommends that one be at least 22 years old to receive silicone gel filled implants.
Each implant type has advantages. Silicone gel implants are often considered to have a softer, more natural feel and better approximate the feeling of a large natural breast. Saline implants are also quite soft although not quite as soft as silicone gel. If a woman has minimal breast tissue and minimal body fat, she may be considered a better candidate for silicone gel.
Another advantage of silicone gel filled implants is that there is a smaller possibility that one could feel the edge of the implant with one’s hands compared to saline implants. Again, this is more important for women with minimal breast tissue and body fat.
Saline implants have their advantages also. Unlike silicone gels (which are pre-filled), when saline implants are placed, they are empty and then filled with saline. We are able to use a shorter scar when placing saline implant, no matter what size implant is placed. This may be especially important for women whose genetic skin type may predispose them to a more prominent scar. For women with a smaller areola, the implants may be placed via a small incision on the bottom border of the areola which I believe is the most cosmetically hidden location.
Other advantages of saline implants may include the ability to improve asymmetries from one breast to the other and obtain some specific desired shapes. Augmentation with saline implants is also significantly less costly and are perceived by some patients as safer if an implant were to rupture.
Are silicone gel filled implants safe? In the early 1990’s, the FDA halted the use of silicone gel implants for first time breast augmentation because there was insufficient safety data. There were questions as to whether silicone gel could cause autoimmune type diseases. After 15 years of intensive study, the FDA determined that there was no significant data to support this and that gel filled implants appeared safe. The current FDA recommendation is to replace your implants if there is evidence that they have broken.
We will review all aspects of this choice that you have. It is important to remember that both silicone gel and saline implants have very high patient satisfaction ratings.