Saline vs Silicone Implants: 8 Questions You Forgot to Ask

Updated on: November 2, 2018

Silicone versus saline--which implant really comes out on top? Here are some frequently asked questions patients have when considering which implant type is right for them.

Which implant is most popular, saline or silicone?

Since 2006, silicone implants have made a huge comeback with patients who have chosen to have a breast augmentation.

It has quickly become the most widely used implant and a top choice for patients and surgeons across the globe.

Despite silicone’s rise in popularity, saline is still a solid staple. With its cost-effectiveness, this completely customizable implant is a good choice for many patients.

How old do you have to be to get silicone or saline breast implants?

In the United States, silicone implants are approved for patients 22 years of age and older, per the Food and Drug Administration (FDA). This is purely a recommendation and not a law.

Still, many surgeons abide by it because they want to ensure their patients' bodies have finished developing and that they are mature enough to deal with the emotional ups and downs that come with changing one's body is such a way. Especially in the first days, weeks and months post-augmentation.

However, there are instances when surgeons can place silicone implants sooner, such as a patient with a breast deformity.

For patients who want an augmentation and are under 22 years old, and do not have a diagnosed deformity, saline implants would be ideal. In this case, your surgeon would recommend the patient be at least 18 years old.

Which implants are best for correcting asymmetrical breasts?

Unlike silicone implants, saline implants are adjustable once inside your body to correct asymmetry.

Despite this, surgeons widely use silicone implants to correct asymmetry, as they are offered in many profiles and cc amounts.

Surgeons use sterile sizers in the operating room to determine which silicone implant combination is the best fit for you.

Is a rupture easier to detect with saline implants?

A rupture is very easily detectable in saline implants. It can be the rare slow leak that may take time before becoming noticeable, or it is rather quick.

Many patients do not feel comfortable with the risk of immediate deflation and would rather avoid having two very different breasts while awaiting surgery.

If a saline implant ruptures, your body will absorb the solution. When a silicone implant ruptures, the silicone is usually contained within the scar capsule that has formed around the implant.

To detect a ruptured silicone implant, surgeons recommend MRI scans to diagnose the rupture.

Which implant looks and feels more natural?

Both saline and silicone implants can look very natural. If you are thin with very little breast tissue, silicone is usually the best choice.

There’s very little rippling with silicone, unlike saline implants, unless the surgeon overfills it beyond the manufacturer’s recommended maximum capacity.

You face two possible downsides of overfilling--if you are looking for a very natural look and feel, the implant may feel more firm and look less natural than what you are hoping for.

Most silicone implants are very soft and feel much like breast tissue. The more form stable silicone implants, such as anatomical implants, may feel more firm to the patient than smooth, round implants.

Textured implants may also feel firmer than implants with a smooth outer shell. This is because the textured coating; it makes the shell a little thicker than the smooth implant shell.

All anatomical implants have a textured coating. The texture not only minimizes the risk of rotation that is associated with anatomical implants but also prevents it from being mobile in the surgeon-created pocket.

Round implants are also available with a textured coating and may feel slightly firmer than the smooth implants and softer than the more form stable anatomical implants.

Your surgeon may have both textures in office so you can feel the difference and pick the one that you are more comfortable with. The choice is up to you.

Which implant type is most budget-friendly?

Undoubtedly, saline implants are the more frugal option. Some patients would never choose an implant based on cost alone, however, there are many that do.

Silicone implants can cost around $2,000 more than saline implants. If silicone just isn’t in your budget or you are looking to have more than one surgery, saline is the way to go for your breast augmentation.

Which implant is safest?

The FDA considers both silicone and saline implant safe. Older silicone implants were much less viscous than the silicone implants of today, and are no longer in use. As mentioned above, once a silicone implant ruptures, the cohesive gel of the implant remains within the scar capsule in most cases.

Silicone implants have been wrongfully blamed for a multitude of health problems recently. In 1992, the FDA restricted the use of all silicone implants for regular breast augmentations in the United States to investigate these claims.

Only patients having reconstruction were able to receive silicone implants at that time. In 2006, the FDA lifted the moratorium on cohesive gel silicone implants after concluding that there were no connections to the claims and the implants.

Which option is best for me?

Saline or silicone, smooth or textured, the choice is up to you. Regardless of implant filler, the FDA considers both of them safe and will give you a beautiful result if you have an experienced, board-certified plastic surgeon performing the procedure.

Updated May 2017

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