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Silicone or saline: A personal decision on breast implants

You’ve decided to give your appearance and confidence a boost with breast augmentation. After choosing a cosmetic surgeon, expect to have a conversation about the pros and cons of silicone and saline implants.

Doctors often use medical grade silicone, a common element found in nature, for procedures such as joint replacement and heart stent surgery. Cosmetic surgery is just one application for silicone.

A soft silicone shell surrounds both implant options for breast augmentation. The material contained within the silicone shell is either:

1) A pre-filled silicone disk
2) Liquid saline that your cosmetic surgeon will add during the procedure.

Silicone breast implants

Remember headlines in the ‘90s about the safety of silicone breast implants? In 2006 the FDA re-approved silicone gel implants after independent studies confirmed the product’s safety and effectiveness. (The FDA does not, however, rule out as yet undiscovered side effects.*)

Once again, you have a choice—saline or silicone.

Many women choose silicone gel because it looks and feels more like natural breast tissue. Still others prefer silicone because it is lighter than saline and less likely to cause the breasts to droop over time. Slender women, without extraneous fat and muscle to camouflage the inserts, tend to opt for silicone because it is less likely to show rippling through the skin.

Silicone implants arrive from the manufacturer ready to insert into the breast cavity. Your doctor will need to make an incision large enough for the implant. Women who choose silicone breast implants will unfortunately have a larger scar than those who select saline breast implants. They will also not have the luxury to add more fill to the implant after insertion as with saline implants.

A very small percentage of silicone implants leak. The body won’t absorb the gel-like substance and the defect isn’t immediately noticeable. The gel could migrate outside the implant capsule and any ruptured gel implant should be immediately removed. For this reason, your doctor will recommend having an MRI every 2-3 years to verify the implant remains intact. The cost of the MRI may cost up to $2,000 and is usually not covered by your insurance.

Finally, the manufacturers’ costs for silicone implants are slightly more than saline implants.

Saline breast implants

As natural as tears, the saline in this type of breast implant offers women several benefits. The incision required to insert a saline implant is much smaller than with silicone. Once in place, a cosmetic surgeon will inject saline into the deflated silicone shell.

With today’s tumescent, or awake, anesthesia, you can comfortably consult with your doctor during surgery, as the cc’s of fluid increase your breast size to your ideal proportions.

In addition, should a saline implant burst, the body absorbs the liquid.  You’ll almost immediately notice the problem so your surgeon can replace the implant.

As mentioned earlier, saline implants cost less from the manufacturer than silicone.

To summarize: Both saline and silicone have been deemed safe for breast augmentation. Silicone looks and feels more natural and is recommended for slender body types; saline offers the benefits of smaller incisions and better awareness if the implant ruptures.

Neither will last a lifetime, but both saline and silicone implants will give you the fuller, more voluptuous breasts you desire.

* According to the FDA, there is “the possibility of risks, yet unknown, which in the future could be determined to be associated with a silicone gel implant. Though connective tissue disease is unlikely associated with an intact implant, there is no valid study to rule out a possible association with a ruptured implant.”