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The decision to have breast augmentation surgery is exciting.  However, there are several factors to consider and choices to make.  One of those choices is silicone or saline implants.  Silicone implants had been “off the market” for the general population for many years (1992-2006) and within the last several years have now become available for cosmetic breast augmentation.  While the moratorium was in place, silicone implants were being utilized for breast reconstruction and were extensively studied.  The FDA determined that they were, in fact, safe and allowed the use of silicone for cosmetic augmentation as well in 2006.

So how do you choose?  What are the differences and what is right for you?  Saline implants have a silicone elastomer shell and are placed in the body deflated.  Once placed, they are filled with saline (salt water).  If and when they deflate, the saline is readily reabsorbed into your body.  Typically the deflation is readily noticeable.  The rupture rate for saline implants is around 10% at 10 years.  That means that at 10 years 9 out of 10 breast implants are still intact.  Silicone implants have a cohesive gel filler.  This means that the silicone gel is more like a soft solid rather than a liquid.  If you were to cut an implant in half, the silicone would remain intact and not run out as a liquid.  This means that a rupture of this type of implant may not be noticeable as it would still remain cohesive.  The rupture rate for silicone gel implants is 1% at 4 years and 8% at 11 years after surgery.

Silicone is generally considered softer and feels more “natural” that saline.  Some women complain about a “water bag” feel with saline implants.  Most plastic surgeons will have implants available for you to feel in their office.

Complications of any breast augmentation include, rupture or deflation and capsular contracture.  This is a scar capsule that forms around the implant.  In a small subset of patients, this scar can become hardened and may even distort the breast or be painful.  For silicone breast implants the risk of capsular contracture after 4 years is 13% and with saline implants at 5 years is 11%

A final consideration may be the incision size.  Because the saline implant can be placed deflated it requires a smaller incision (2-3 centimeters) than the silicone implant(5 centimeters).

Both saline and silicone breast implants are available and safe.  The decision is one that you should make with your plastic surgeon based on your goals, your tissue and your comfort level. We look forward to responding to your questions and comments on this and many future topics in cosmetic surgery! Sincerely, Drs. Marissa Tenenbaum and Terence Myckatyn