Breast implants: Saline vs. silicone

Molly Walsh, D.O.

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If you're considering breast implants, you may wonder how to choose between saline-filled and silicone gel-filled implants. Here Molly Walsh, D.O., a plastic surgeon at Mayo Clinic in Rochester, Minn., explains the options.

What's the difference between saline and silicone breast implants?

Saline and silicone breast implants both have an outer silicone shell. The implants differ in material and consistency, however.

• Saline breast implants. Saline implants are filled with saline, usually at the time of surgery. Saline implants have been criticized for feeling hard or unnatural, but improved surgical techniques — such as placing the implant behind the chest muscle and slightly overfilling it — have lessened these complaints. Saline breast implants are available to women age 18 and older for breast augmentation, or women of any age for breast reconstruction.
• Silicone breast implants. Silicone implants are pre-filled with silicone gel — a thick, sticky fluid that closely mimics the feel of human fat. Some women feel that silicone breast implants look and feel more like natural breast tissue. Silicone breast implants are available to women age 22 and older for breast augmentation, or women of any age for breast reconstruction.

What are the risks of breast implants?

Saline and silicone breast implants pose similar risks, including:

• Breast pain
• Potentially permanent changes in nipple or breast sensation
• Infection
• Scar tissue that distorts the shape of the breast implant
• Implant leakage or rupture
• Need for additional breast surgery

What happens if an implant ruptures?

If a saline breast implant ruptures, the implant will deflate — causing the affected breast to change in size and shape. The leaking saline solution will be absorbed by your body without posing any health risks, but you'll probably need surgery to remove the silicone shell. A new implant can likely be inserted at the same time.

If a silicone breast implant ruptures, you may not notice right away — or ever. There's no evidence that leaking silicone gel causes serious, long-term health problems — such as breast cancer or connective tissue diseases — but a ruptured silicone breast implant may eventually cause breast pain or changes in the contour or shape of the breast. If this happens, you'll need surgery to remove the ruptured implant. A new implant can likely be inserted at the same time.

The Food and Drug Administration recommends monitoring silicone breast implants with routine MRI scans every two years, starting three years after the initial implant surgery. If an MRI scan detects an implant rupture but you don't experience any signs or symptoms, it may be up to you to weigh the risks and benefits of keeping the implant or having it removed.

Is the safety of breast implants actively monitored?

Both saline and silicone breast implants are considered safe for breast augmentation and breast reconstruction. Long-term follow-up studies — in which researchers will look for evidence of continued safety and effectiveness of saline and silicone breast implants — are ongoing.

Are other types of breast implants being developed?

Another type of silicone breast implant called a "gummy bear" implant is in development. The gummy bear implant is made of a more cohesive silicone gel, which may help the implant better keep its shape over time. Today, gummy bear implants are available only to women enrolled in clinical studies to test the product's safety and effectiveness.

What factors should be considered before getting breast implants?

If you're thinking about breast augmentation or reconstruction, it's important to understand what it means to have breast implants. In addition to changing your appearance, remember that:

• Breast implants aren't guaranteed to last a lifetime. You'll likely need additional surgery at some point to correct leakage or cosmetic issues. If you decide to have your implants removed, you may need a breast lift or other corrective surgery to help your breasts return to their pre-implant appearance.
• Breast implants may interfere with breast cancer screening. Although it may be easier to see or feel breast lumps if you have breast implants, the implants may complicate routine mammography to screen for breast cancer. You may need additional images offering special views of your breasts, and the images may be harder to interpret because cancers can be obscured by the implants.
• You may need routine MRI scans. If you have silicone breast implants, you may need routine MRI scans to ensure that the implants aren't leaking.
• Breast implants may hamper breast-feeding. You may produce only limited breast milk, or you may not produce any milk at all.
• Insurance may not cover breast implants. You may need to pay out-of-pocket for any fees associated with elective breast implants, including follow-up screening and corrective surgery.

What's the bottom line?

Based on your body type, your surgeon may recommend one type of implant over another for optimal cosmetic results. Either type of breast implant is safe, however. Ultimately, the choice between saline and silicone is up to you.

Related

• Breast exam
• Mammogram
• Breast augmentation
• Breast reduction surgery
• Breast implants and cancer: Any connection?
• Sagging breasts: Inevitable after breast-feeding?
• Slide show: Female breast anatomy
• Natural breast enhancement: Does it work?
• Silicone breast implants: What happens if they rupture?
• Breast cysts
• Fibrocystic breasts
• Breast pain
• Breast lump: Early evaluation is essential
• Breast cancer prevention: How to reduce your risk