Silicone or Saline

Silicone Implants vs Saline Implants

Silicone (gel) and saline (water) implants look identical in pictures, video and real life. Visually, there is no difference between these two implants. In case 1 shown above, there is no way to know if those implants are saline or silicone, however saline and silicone feel different.

Breast Augmentation-Silicone

Before surgery, the patient is 34 B. After surgery, the patient is 36 C with 330 cc silicone implants

Silicone implants have a feel that’s indistinguishable from normal breast tissue, whereas saline implants feel like water baloons. However, silicone implants are $2,000 more expensive and require a slightly bigger incision. Although saline implants feel less natural than silicone, this difference is not very obvious in most cases because the breast covers the implants anyway. Thus in the real world, the implants are covered by breast tissue anyway, which reduces the differences in feel.

Case 2: This patient has 330 cc above muscle silicone implants. Although both saline and silicone implants cause lift, saline implants give more lift. Some women like more lift, and a perkier look (see case 3) others prefer a tear-drop look, as seen here.

Larger the pre-operative breast sizes, allow for more coverage of the implant. A pre-operative A-cup covers 40-75% of the implant, a B-cup covers 90% of the implant, a C-cup covers 95% of the implant. Silicone implants are especially an advantage in A-cup women, because they won’t be covered by a lot of breast tissue. Once a patient is B-cup or larger, the advantages of silicone are less and less.

Case 3: The patient here has 400 cc silicone implants placed above the muscle, using a periareolar (nipple incision). Notice how 400 cc causes more lift when compared to 339 cc. Also this patient has never been pregnant (unlike case 2) which means she has less ptosis (sagging) than case 2.

Case 4: This lady here has 339 cc above muscle saline implants. Compare this look to cases 3-4.

Pre-operative Photo: 34 B with ptosis (nipple drooping) and asymmetry.
Two week post-operative photo after silicone 339 implants and nipple re-positioning.

Cases 3-4 have silicone implants, case 4 has saline implants of about the same size. Notice how saline implants here give a “perkier” look for the same volume. Saline implants also give more pronounced cleavage. About 50% of women prefer the perkier look of saline, the other 50% of women prefer the tear-drop look of silicone. A smaller silicone volume can simulate a tear-drop look. Also, larger volume silicone will give a perkier look.

Besides price, and smaller incision, saline implants have the advantage of being able to be inserted via a navel incision.

Pictures and video can not convey the difference in feel between these implants. At our office, patients are able to feel and try out saline and silicone implants. Once our patients choose the size and type of implant (saline or silicone) we implant that exact size and style of implant. If patients want some time to think about it, they may come in a few days or weeks before surgery and try the different implants.

However, most patiets find it easier to “match” their desired appearance to our database of existing patients. Once a patient chooses the “look and feel” from our database, we can match the implant.

The bottom line is this. If you want a very good implant and the smallest incision, but do not want to spend a lot of money, a saline implant is the way to go. If you want the most natural implant, regardless of price, then silicone is the best option.