Most plastic surgeons are able to use both types of implants. Although silicone implants are by far the most common and very safe, some surgeons may prefer saline....discuss with your surgeon...main differences: saline slightly less expensive, more rippling, may be easier to match asymmetries, more obvious when they "fail" or rupture, some prefer saline due to uncertain silicone "fears".

Published on Jul 11, 2012

It is very difficult to determine the exact type, size and shape implant you will require to best match your ideal breast image without an examination by a board-certified plastic surgeon--not just any board certified plastic surgeon, but one with many years of frequently performing breast augmentation surgery including different approaches, techniques and implant choices.

Breast implants come in a variety of shapes, sizes, firmness and profiles in order to offer a custom-fit and natural-looking physique. It is also important to consider the substance and texture of an implant. The surface of round implants can be smooth or textured, whereas shape implants are all textured to maintain their alignment. In particular, those implants approved by the U.S. Food and Drug Administration (FDA) are filled with silicone or saline. All implants at this time use cohesive silicone gel, meaning that the gel maintains its shape like “gummy bear” candy or jello, with more anti-leak properties unlike the gel prior to 2006, which was more like honey or molasses in consistency. These materials impact the feel and look of a breast implant, and thus are an important consideration in determining the desired appearance of your breasts.

For example, silicone is most popular world-wide as their feel and appearance most closely mimics the desired breast feel with less rippling. Standard saline implants have a higher rate of becoming hard (capsular contracture) and tend to exhibit more waviness or rippling if there is less breast or fat covering the implant. A newer breast FDA approved saline implant, IDEAL Implant^®^, is a double lumen “hybrid” implant that has the feel close to silicone, less risk of capsular contracture, and the peace of mind of saline; that is, if there is a leak, you can tell just by looking in the mirror rather than requiring a MRI.

Published on Jul 11, 2012

Yes, of course you should be concerned. A qualified plastic surgeon is able to offer patients both options: saline and silicone. He or she should also be able to clearly state the merits of each.

Maybe this doctor has a backlog in stock and is trying to get rid of them. This is not ethical; he must offer you both.

Published on Jul 11, 2012

Not necessarily. Saline is less problematic. If you read the pkg insert on silicone, it will state you need a MRI at 3, 5, 7 and 9 yrs. They will also need to be replaced at 10 yrs. Why pay more for silicone when you will have to deal with these hassles. In any event, I recommend high profile implants and under the muscle.

Published on Jul 11, 2012

Yes, you should see a board-certified plastic surgeon who is able to customize your choices to your desires and needs, not just to a limited ability.

Published on Jul 11, 2012

I would visit a few ABPS certified/ASAPS member surgeons. Saline is fast becoming part of the history books, with 90% of augmentations being performed with silicone gel implants.

Published on Jul 11, 2012

In my experience, saline is a thing of the past! The main benefit in the past was that it produced less capsular contracture, but since the implants have changed several years back, I am seeing about the same % of capsular contracture with saline as with silicone. The negative with saline is that they deflate in about 5% of cases and you normally can see rippling even under the muscle on the sides and underneath the areola.

Published on Jul 11, 2012

There are pros and cons to both types of implant. I do have my own bias as to which I prefer as well--which type of implant I think will work better in a particular patient. I know several surgeons who still feel silicone implants are unsafe despite overwhelming evidence that they are indeed safe. Part of your initial consultation should involve a discussion about saline verses silicone implants, shaped verses round, textured verses smooth, and the different profiles of round implants that are available. In the end, it is the surgeons' responsibility to explain the options to you and provide you with enough information for you to make a good decision for yourself. If he or she has a strong opinion of what kind of implant is best, then they should make it clear to you as to why they feel that way. I would be concerned if your surgeon is not giving you a choice. Is this a board-certified plastic surgeon?

Published on Jul 11, 2012

I'm actually shocked that anyone is pushing saline. Silicone is better in every way, and the hysteria around silicone in the '90s was just that -- hysteria over nothing. The medical evidence has put that issue totally to rest.

Are you under 22 years of age? Silicone is only approved by the FDA for use in women over 22. So, if you are younger, then the surgeon's advice makes sense.

If you are over 22 and your surgeon was suggesting saline, these are the reasons I could imagine: 1) saline is less expensive 2) only saline can go through the belly button 3) they can put in large implants, which require smaller incisions with saline, 4) he/she thinks it is fundamentally less "foreign" and therefore safer and more natural.

Ideally, a surgeon should be adapt with saline, silicone, and the highly cohesive teardrop implants. It indicates a seriousness about mastering breast surgery, but moreover no one of those three implants is the best choice for everyone. As they say, "if you have only one arrow in your quiver, then you make it a spear." You want your surgeon to be an expert with a wide range of options.

Published on Jul 11, 2012

Second opinions can often help patients decide what is right for them. We do encourage our patients to make sure that they are as informed as they can be so that they can make the decision that is best for them. Best of luck!

Published on Jul 11, 2012

You should make a consult with another board-certified plastic surgeon, as the vast majority patients truly benefit from a silicone option.

Published on Jul 11, 2012

I can appreciate your concern, but if the surgeon has over his/her experience preferred one over the other, then I would be confident that they are helping guide you in what they truly believe would be the best for you as a patient. Over years and thousands of patients, as surgeons, we all develop certain preferences for what we deem to be the best outcomes in our hands. That doesn't mean that we have the only or "correct" answer; we simply recommend what we think would be for the best interest of the patient. That said, no patient should ever just limit themselves to one consultation if they have any other questions or concerns. Best of luck!

Published on Jul 11, 2012

Thank you for asking. While some practices use predominantly saline, this is generally not what most plastic surgeon's use today. Many practices actually use almost all silicone due to the improved feel. It is not unsafe to use saline, but silicone has largely replaced saline implants. Talk with a board-certified plastic surgeon and consider a second opinion. Best wishes!

Published on Jul 11, 2012

If over the age of 22, implant type, saline or silicone, is generally a patient's preference. Any patient seeking breast augmentation under the age of 22 may only be a candidate for a saline implant. Most plastic surgeons should be able to offer silicone and saline breast implants in differing volumes and shapes.

Published on Jul 11, 2012

Each surgeon has his/her preference. Personally, I do both. How old are you? Silicone is not recommended by the FDA for someone under the age of 22. There are pros and cons to each of the implants. If someone is really skinny, you might see rippling with the saline implants. Placement of saline implants can be done through a smaller incision because they come empty and are filled at the time of the surgery. Saline implants can rupture. In fact, there is a rupture rate of 10% per year, which theoretically means that you will have to have them replaced in 10 years. Silicone implants usually last longer. While these are but a few of the differences, I would suggest you consult with another plastic surgeon and get his/her recommendations. Best of luck.

Published on Jul 11, 2012