The Surgeon Minute

Breaking Down the Saline vs. Silicone Debate

Breaking Down the Saline vs. Silicone Debate

Saline vs. silicone is kind of the “to be or not to be” of breast augmentations. It’s really one of the first (of many) decisions that breast augmentation patients need to make. The problem, and a good one to have, is options are aplenty in modern breast augmentation. There is so much information about saline breast implants and silicone breast implants on the internet that it can feel downright overwhelming.

As a woman with breast implants herself, this is a decision that board certified plastic surgeon Dr. Mary Gingrass of Nashville, TN understands intimately. She really enjoys helping her breast implant patients to make the right decision for their individual needs. Below, she walks us through the three main differences in the saline vs. silicone breast implant debate.

Saline Breast Implants Are Less Expensive

“I love trying to help people decide saline vs. silicone,” says Dr. Gingrass. It is probably the most common question that patients have regarding their breast augmentation. Thankfully, there basically three main differences between saline and silicone:

  • cost
  • feel
  • what happens when the implant ruptures

Silicone breast implants.

Cost is a pretty straight forward decision; it comes down to very simple arithmetic. Saline is a little less expensive than silicone. Some patients are on a strict budget and saving this extra bit of money can really help. While costs are a factor, the point of breast augmentation isn’t to save money. It’s to impart a change, meaning feel and implant durability are really want patients want to know about.

Silicone Breast Implants Feel More Natural

The feel of implants once implanted is very important. During the consultation, Dr. Gingrass will have patients feel each type of implant with their eyes closed. While there are some patients who don’t feel much of a difference, a lot of people think that, “silicone feels more like a breast.” A breast is squishy and soft. It moves around a little bit but holds it’s shape, like silicone, while saline is a bit more watery. “A saline implant kind of feels like a bag of water, because it is!” says Gingrass.

Saline vs. silicone - the feel.

What Happens If Your Implant Ruptures?

The last big difference between saline and silicone breast implants is what happens if they rupture. “[A saline implant is] idiot proof. It’s almost like it comes with a check engine light” explains Dr. Gingrass. If it ruptures, you will know immediately because the breast deflates. Patients will call her in a panic saying that they have a “flat tire,”and she will get the patient into the office as soon as possible to change out the implant. One of the advantages of saline implants is that they can often be changed out under local anesthesia. This can be a big plus for some patients.

Silicone implants, on the other hand, are a little more high-maintenance. Patients won’t know that they have a rupture unless they get a mammogram or an MRI. However, most women over the age of 40 get an annual mammogram. It’s covered by insurance and the test is pretty good at picking up any rupture. On the off chance that this happens, there is no mad rush to get into the office as there is with saline because the breast won’t deflate. However, you will want to change out the implant. This will require surgery under general anesthesia as Dr. Gingrass likes to also remove the capsule that forms around the implant since this is what comes into contact with the silicone.

Sasline vs. silicone - saline before and afters.

Rupture Rates Are Actually Higher with Saline

Many patients still have a fear that if their silicone implant ruptures, the silicone is going to leak out into their bodies. This is simply not the case. Silicone breast implants today are much different than those of the past. They are more cohesive which means that the gel inside the outer shell is firmer. Furthermore, the outer shell is much thicker. Both of these facts has helped to greatly reduce the rupture rate. In fact, “the rupture rate for saline is a little bit higher than it is for silicone,” explains Dr. Gingrass. Also, on the off chance that your silicone breast implant does rupture, 99.9% of the time that silicone stays inside the scar tissue capsule that normally forms around any implant or foreign object that is put in the body.

Saline vs. silicone - silicone before and afters.

Saline vs. Silicone is a Personal Decision

Dr. Gingrass is happy to give her patients guidance when making the decision about which type of implant to use, but she wants her patients to understand that this is a very individual decision. There is a lot of value to peace of mind, so she encourages her patients to make the choice that is right for them. You have to feel good about your decision. Your family, friends, partner and surgeon can all weigh in with their opinion, but you are the one that needs to live with this implant.

A lot of patients think that if they get saline, they are getting the “cheap stuff,” says Dr. Gingrass. And this is simply not true. In many instances, she can’t even tell if a patient has silicone or saline without looking at the chart. At the same time, silicone implants are just as safe as saline. They are “the most studied medical device out there. Literally,” explains Dr. Gingrass. It is what she chose to have for herself.

Bottom line, every patient has to make the choice that is right for their body, their pocketbook and their lifestyle.

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