How to Choose between Saline or Silicone Implants in Breast Augmentation
Since silicone breast implants have been re-introduced to the commerical market in late 2006, this has provided women with a choice in breast augmentation. While some plastic surgeons may favor one type of breast implant over another, the reality is that both breast implants have their advantages and disadvantages. Whether one type of breast implant is better than another depends on what implant characteristics the patient can accept. My mission as a plastic surgeon is to educate my potential breast augmentation patients as to the different features of saline vs silicone breast implants. It is up to the patient to decide what breast implant features they desire. Or to put it more simply…..which of the breast implant liabilities (disadvantages) can you live with the best? (the potential health-related issues of silicone breast implants has now been sufficiently refuted and therefore do not enter into any discussion here)
One important concept to grasp…..both saline and silicone breast implants can do the job. Both work and can look equally well. One type of breast implant doesn’t necessarily look better than the other, contrary to the suppositions of some. However, the choice of one implant over the other does control several issues about the breast augmentation procedure……and besides choicing an experienced plastic surgeon is the most important decision about your breast augmentation procedure.
Saline and silicone breast implants differ in the following diametric ways. Saline breast implants are surgically inserted deflated, silicone breast implants are inserted at their listed volume. Therefore, saline breast implants can be put in through a very small incision in the armpit while most silicone breast implants need a larger incision in the lower fold of the breast. Saline breast implants will develop a phenomen of rippling, most of which can be felt at the bottom and sides of the breast (in very thin patients this rippling can be seen), silicone breast implants remain smooth and do not develop this cosmetic rippling issue. If a saline breast implant fails, it is known as deflation as the implant becomes like a flat tire. While this causes no harm, it is dramatically seen and is a cosmetic ’emergency’ so to speak. If a silicone breast implant fails, it is not called deflation but is known as silent rupture. In other words, there is no visible sign that the implant has ruptured as it does not change shape or deflate. (since what is in it is not water, but a jello-like substance that does not flow) It is possible that a patient may never know that it has ruptured as long as the breast is soft, looks good, and is pain-free. What this suggests is…..the likelihood of the need for breast implant replacement due to ‘failure’ over one’s lifetime is most likely less for silicone than for saline breast implants. The last difference between the two is cost. While surgeon’s fees and other surgical expenses may differ, the purchase cost of a pair of silicone breast implants is higher than for saline. Sinc most plastic surgeon’s merely pass the cost of the breast implants onto to the patient in the overall fee, silicone breast augmentation is more expensive than saline breast augmentation.
In summary….which liability can you live with……..saline breast implants and the issue of rippling and possible deflation……or……silicone breast implants which are more expensive and require a bigger incision to insert.
Dr Barry Eppley
Indianapolis, Indiana