SALINE OR SILICONE BREAST IMPLANTS

Which breast implant is better for me, silicone or saline?

The moratorium on silicone implants was lifted 2 years ago.  This FDA edict began in 1992.  During this time, (1992-2011) only women with breast cancer, or chest deformities, or ruptured implants, were allowed to have silicone gel.  As a result, normal women who wanted breast augmentation during this time were required to have saline implants.  The result of breast augmentation with saline implants is quite good, but there are differences between silicone and saline.

The appearance of saline implants is quite good but not quite as natural as silicone. Saline implants are firmer due to the water component located within the shell of the implant.  A silicone device has silicone gel on the inside of the shell and for this reason silicone gel implants are softer than saline.

The main concern the FDA has about silicone implants is how to detect a leak.  If a silicone implant ruptures, in almost all cases, the breast appears to be normal.  It maintains its softness and symptoms are uncommon.  Occasionally, however there are obvious changes with a rupture.  The symptoms include pain and throbbing and an obvious change in the shape of the breast.  Because detection of a rupture is difficult, the FDA recommends that a woman with silicone implants obtain a MRI of her breast every 3-4 years.  The MRI is the best test available to detect an implant rupture.

However, the MRI is only 85% specific for rupture and not a 100%.  For this reason there are some false negatives and positions with the MRI.  A woman with saline implants will not have required an MRI for implant leak because if a saline implant ruptures it will deflate.  This is easily detected both by patient and doctor and is a 100% safe if it does rupture.

The other concern about implants is capsular contracture.  When this occurs, the breast become firm, misshapen and occasional discomfort; this problem can occur with either saline or silicone.  The literature suggests that there is no difference in contracture with either silicone or saline.

Another difference between silicone and saline is the amount of rippling and palpability of the implant.  Since saline is firmer, this tends to cause more rippling or waviness of underneath the skin. The saline also is more palpable because of the firmness.   A woman with small breasts and a minimal amount of body fat is quite susceptible to rippling and for this reason I always suggest silicone in this type of women.

Another difference between silicone and saline are the cost.  Saline implants are less expensive than silicone.  Silicone costs approximately $2000.00 for a pair and saline about $1000.00.  Both implants have a 10 year warranty by the manufacturer.

In summary, both implants are good, but there are differences between the two.  Every woman has to make her own decision about which is best.

Please contact Dr. Wald with any questions/comments or to schedule a consultation.