Most women who undergo breast augmentation surgery, whether electively or as a reconstructive surgery, choose between silicone and saline implants. The outer shell of both types of implants is made out of silicone. When your surgeon talks about choosing saline or silicone implants, he or she is referring to the substance that fills the implants.

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Silicone Implants

In 1992, the Food and Drug Administration banned the sale of silicone implants in the United States. This ban was in response to health and safety concerns, especially breast cancer and its relation to silicone implants. In 2006, the FDA approved the sale of two types of silicone implants in the United States. As of March 2012, the FDA has granted three companies, Allergan, Mentor, and Sientra, approval to develop and sell silicone implants in the United States.

Silicone implants are filled with medical grade silicone, a gel-like substance. Surgeons receive these implants filled to a particular size and insert the implant into the breast. The FDA has approved silicone implants for any woman 22 or older for elective augmentation surgery and at any age for women undergoing reconstructive surgeries.

Saline Implants

Saline implants were developed before silicone implants, and during the 1992 – 2006 moratorium on silicone implants, saline were the only legally available implants in the United States. Women 18 and older may receive saline implants through elective breast augmentation surgery and at any age for reconstructive surgery.

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Saline implants are filled with sterile salt water. Most saline implants are shipped to the surgeons empty, and the surgeon fills the implant to the patient's desired size after the implant has been inserted into the body. One benefit of saline implants over silicone implants is the ability to use a smaller incision to insert the implant; when it is empty, the saline implant is simply a narrow, hollow shell.

Which Implant Type Is Best For Me?

Most of the possible complications of breast augmentation (capsular contracture, Mondor's Cord, post-operative infection, and implant rupture or leakage) affect both saline and silicone implants. Both types of implants come in smooth and textured shells and can be placed under or above the muscle.

If a rupture happens, neither type creates a life-threatening problem. When saline implants rupture or leak, the body absorbs the harmless saline solution. After the rupture, the breast will look deflated, and the woman must undergo another surgery to remove and/or replace the implant. If silicone implants rupture or leak, the breast will not look deflated, but the body cannot absorb the silicone. This “silent" rupture can only be detected through an MRI. Women with silicone implants are encouraged to have an MRI every two years to check for ruptures or breaks. These MRIs are rarely covered by insurance companies.

There are some key differences between silicone and saline implants, however.

  • Saline implants are generally slightly less expensive than are silicone implants.
  • Some women feel that silicone implants are more natural looking and feeling than are saline implants.
  • Saline implants are more likely to “ripple" than silicone implants. This ripple may show on the surface of the breast, especially in women with little natural breast tissue.
  • In a study of 672 women who had breast reconstruction after mastectomies, those who had received silicone implants were more satisfied directly after the surgery than those who had received saline implants.

Ultimately, the decision to have silicone or saline implants is the patient's choice. Both have been found to be safe by the FDA, with continual monitoring of silicone implants. Your plastic surgeon will be able to help you choose the right implant for you considering the potential complications and desired incision area.