Silicone Filled Breast Implants

Saline Breast Implants vs. Silicone Breast Implants

Silicone-Gel Breast Implants

Reviewed by Donald Revis, M.D., F.A.C.S.

Description of Silicone Gel Breast Implants

Silicone gel breast implants use the same silicone elastomer shell as saline breast implants, but use cohesive silicone gel instead of salt water as the fill. Today’s cohesive silicone gel is very different from the old-style silicone liquid that was used in silicone breast implants for approximately 30 years up to 1992. Today’s gel is thick and will not run the way saline or old-style liquid silicone would run. The FDA approved the use of cohesive silicone gel implants in November 2006 because it determined through a series of studies that the implants were safe.

Advantages of Silicone Breast Implants

The two primary advantages of silicone breast implants according to most women and most plastic surgeons are that they decrease the possibility of rippling and feel much more like natural breast tissue. There is no doubt that if you feel a silicone breast implant and a saline breast implant at the same time, you will agree that silicone feels more like natural breast tissue. For this reason, many women want silicone. There is a lot to be said for the natural feel. In addition, as discussed in the saline breast implant section, silicone breast implants tend to minimize rippling.

However, not all women will be at risk for noticeable rippling and not all saline implants will feel unnatural once they are in place on your chest wall. Many factors influence rippling and feel, including the placement of the actual implant (above or below the muscle), the amount of natural breast tissue covering the breast implant, and, of course, implant size. A good plastic surgeon can help you to understand how these issues will impact your specific case.

Disadvantages of Silicone Breast Implants

The primary disadvantages of silicone breast implants are that they cost more than saline, require a larger incision and ruptures are harder to detect. Cost is always relative to your personal situation. Breast augmentation is expensive, but if it makes you feel better about yourself, it’s priceless. The total cost is thousands of dollars (probably $6,000 - $10,000 all-in depending on where you are in the country). Using saline instead of silicone will only save a few hundred dollars off that total cost. If your budget is limited, that may be a reason to choose saline, but the amount you will save is not that much compared to the overall cost.

Incision size may also be a non-factor. You will need to speak with your surgeon, but if your scars tend to heal nicely in general, they will likely heal nicely after your breast augmentation. If you are prone to scarring, ask your surgeon how much larger the silicone incision might be. In many cases, it is only ¼ to ½ inch larger which may be acceptable even if you are prone to scarring.

Finally, we talk about ruptures. We’ve had a lot of discussion about ruptures on our message boards because many women want to know how to detect them in silicone implants. The short answer is that they are generally only detectable with an MRI. The good news is that the failure rate of the new silicone gel breast implants is quite low, at least at the 3-year mark studied by the FDA. There are certain circumstances where you would want to get an MRI to check on the implant. For example, any significant trauma to the chest could rupture an implant. If that happens, see your surgeon and he may advise you to get an MRI. If you’d like to learn more about the long-term care of silicone breast implants, please see the article “Long-Term Care of Silicone Breast Implants.”