Choosing Between Saline and Silicone Gel Breast Implants

saline vs silicone implants

Making the decision to undergo breast augmentation surgery is just the first step in the process. Along with deciding on the procedure, you’ll also need to decide how large you want your breasts to be and the type of implant you prefer. Patients today have the choice between saline and silicone gel implants. Although both are considered safe, some patients are better suited for silicone gel implants and some patients are better suited for saline implants.

Saline implants feature an outer shell that’s made of silicone rubber. The implants themselves are filled with sterile salt water. Silicone implants also have a silicone outer shell that is filled with a silicone gel. Many patients believe that silicone implants provide a more natural feel and look than saline implants. Silicone gel is closer in texture and substance to actual breast tissue than saline is. Women who have thin skin in the breast area are more likely to see ripples or texture if they choose to get saline implants instead of silicone.

Silicone Safety Concerns

Silicone implants have a long history, and some of that history can make patients concerned. In the early 1990s, there was controversy and concern about the use of silicone implants. Some patients claimed that their implants caused them a number of health problems, including auto-immune disorders. The panic was great enough that the FDA banned the use of silicone breast implants in 1992.

It wasn’t until 2006 that the FDA once again offered approval of silicone implants. Modern day silicone implants are more advanced than the implants on the market in the early 1990s. They are designed to be  more durable and  less likely to rupture. The gel used inside the implants is thicker, so that it is less likely to leak out if the implant is punctured.


Along with choosing the implant material, your consultation with a plastic surgeon will also involve choosing the right size. You’ll be allowed to try on several different sizes, under your bra, until you find the size that you believe is best. At the Bitar Institute, Dr. Bitar uses photographs to help patients decide on the appropriate size implant, too. In many cases, you’ll have two opportunities to try on implants, to make sure the size you pick is really the right one.


One potential difference between saline and silicone implants is the ability to adjust the size of the implant. Post-operatively adjustable  saline implants feature a small valve that can be accessed after surgery. They allow a surgeon to adjust the volume of saline for a period of time after the initial procedure, meaning that if a patient isn’t happy with the size of her breasts, the surgeon can remove extra saline or add more after the initial surgery to decrease or increase the size as desired. A post-operatively adjustable saline implant needs to be selected before surgery as they differ from standard saline implants.

Silicone gel implants are pre-filled before insertion. If a patient isn’t happy with the size of her implants after surgery, her option is to have the first implants removed and replaced with a larger or smaller set.

Risk of Rupture

Rupture used to be a major concern when it came to silicone implants, as well as saline implants. One advantage of saline implants is that it is very obvious if the implant ruptures. The saline seeps out into the body where it is harmlessly absorbed, and the breast has a deflated look. Since saline is only  saltwater, patients don’t have to worry about suffering any ill effects from having it leak.

Rupture and leaks were big concerns as far as older model silicone implants were concerned. It was once recommended that patients with silicone implants undergo an MRI every few years to make sure that the implants weren’t leaking. If a silicone implant ruptures, it tends to be much less obvious than when a saline implant ruptures. The breast doesn’t deflate. Silicone leaking into the body is also more of a health concern than saline.

However, modern silicone gel implants are better made than older models and are more likely to last longer. While a patient with them can decide to undergo an MRI every  three or so years, it’s typically not required or expected.

The FDA stresses that neither silicone nor saline implants are meant to be lifetime devices. You might need to replace your implants after a period of years, either because they’ve worn out or because they are no longer the right fit for your body.

Discussing your implant options with a board certified, experienced surgeon is an important part of the process. To learn more about your implant options, contact Dr. George Bitar located in the Washington, D.C. area. Call the office at (703) 206-0506 to schedule your in initial consultation today.