Breast Implants FAQ’s – Silicone or Saline Breast Implants?

Silicone or Saline Breast Implants - There is no bad choice!

Silicone Breast Implants Joel Studin Plastic Surgery
Saline Breast Implants Joel Studin Plastic Surgery

Modern Silicone Implants

 Today's silicone breast implants  are much different than the early implants from the 1960s and 70s. After almost 15 years of studying, the FDA released them again in November 2006. As  than breast usually feels more natural  with these implants, they are very popular. Read more below.

Saline Breast Implants

Saline breast implants have improved as well. Some people feel more comfortable choosing implant filled with just  saltwater, however remember that the shell is still silicone.  Therefore, even saline implants are actually made of silicone. Unless someone is very thin and has very little fat under the skin, it is sometimes difficult to tell the difference between saline and silicone implants. Read more below.

Saline Vs Silicone

This is  one of the more important decisions for most people. With modern implants however, both silicone breast implants and saline breast implants are well made, safe and can give you a natural result. While there are differences, they are much smaller than many people think.

 What Are Breast Implants Really Made Of?

Implants are named according to what fills them. In other words, saline implants are filled with saline (sterile saltwater), and silicone implants are filled with a cohesive silicone gel. Regardless of what breast implants are filled with, they all have a solid silicone shell.  Interestingly, there is no such thing as an implant without silicone.

Solid silicone, or silastic, has been implanted in millions of people in pacemakers, artificial joints, heart valves, penile implants, and artificial lenses for the eye. Solid silicone is a very different substance than silicone gel, which fills silicone gel implants.

Many studies have shown these solid silicone shells to be very safe.

History of Saline and Silicone Gel Implants

Both saline and silicone implants have been used since the 1960’s. From 1968 (when silicone gel implants were introduced) to 1992 (when silicone gel implants were temporarily banned by the FDA),  gels were the most popular type of implant due to their extraordinarily natural look and feel. In 1992, the FDA issued a moratorium on silicone gel implants based on concern that they might cause auto-immune diseases such as lupus and rheumatoid arthritis.   From 1992 until November 2006  silicone gel breast implants are only available under an FDA approved studies. Dr. Studin was one of the investigators in the study and performed silicone gel breast implants throughout that period of time.  In 2006, the FDA lifted the restriction on silicone gel breast implants after it was presented with substantial evidence that silicone gel implants did not cause such diseases. It was determined that a woman’s risk of developing these diseases was the same whether she had silicone gel implants or no implants.

Silicone Gel Implants: Pros and Cons

The advantage of silicone gel implants is that they look and feel so soft and natural that they typically cannot be distinguished from breasts without implants as long as there is no over formation of scar tissue. They also have a lower rate of rippling and wrinkling.  Silicone implants impose a higher cost (by about $900- $1000)  for the cost of the implant itself.   Many people have said that a longer scar is necessary as silicone gel implants are pre-filled by the manufacturer.   With the advent of the Keller  Funnel placement device, this is no longer true.   Rarely,  silicone implant may rupture without being obvious to physical exam.  This is not been shown to be dangerous to your health. Physical exam by your plastic surgeon will identify only some of the ruptures, whereas MRI will identify about 90% of ruptures, so women with silicone gel breast implants may consider MRI scans If there is a question of a rupture. The FDA recommends routine MRIs for women with silicone breast implants.   This is a controversial topic and not all doctors agree. 

Gummy Bear Implants

 Mentor, a division of Johnson & Johnson, make silicone breast implants that are have a cohesive silicone gel. Being cohesive, the gel has a tendency to stay together rather than disband in the event of a rupture. They have been likened to Gummy Bears, the soft candy that feels as though it is filled with liquid, but which has contents that do not run out if cut open. The other large implant manufacturer (McGhan/Allergan/Natrelle) argues that all silicone gel implants (including their own) are cohesive in nature and that Mentor uses the term “cohesive” as a marketing ploy.

  Both the mentor and the Allergan  will stay together in the unlikely event of a rupture however, they conform to the shape of the surrounding tissue. There is an implant does not change its shape actually referred to as the “Gummie Bear”  implant by the manufacturer.  Dr. Studin has found  that he is in agreement with most of his colleagues that these implants are not ideal. Shifting of the implant can lead to a misshapen breast  among other problems with this type of implant.

Saline Implants: Pros and Cons

Saline implants have different advantages than silicone.  There is no need for MRI, as silent rupture is not a concern. If a saline implant shell ruptures, the saline generally leaks out and is absorbed by the body within a day or so, resulting in an obviously smaller breast.  They are however, more prone to rippling and wrinkling.  

The primary disadvantage of saline implants is that they can look round and unnatural in thin women with modest breast tissue.