If you're considering breast implants, you might wonder how to choose between saline-filled and silicone gel-filled implants. Here's help evaluating the options.
What's the difference between saline and silicone breast implants?
Saline and silicone breast implants both have an outer silicone shell. The implants differ in material and consistency, however.
Saline breast implants
Saline implants are filled with sterile salt water. They're inserted empty, and then filled once they're in place.
Saline breast implants are available to women 18 and older for breast augmentation and to women of any age for breast reconstruction.
Silicone breast implants
Silicone implants are pre-filled with silicone gel — a thick, sticky fluid that closely mimics the feel of human fat. Most women feel that silicone breast implants look and feel more like natural breast tissue.
Silicone breast implants are available to women 22 and older for breast augmentation and to women of any age for breast reconstruction.
What are the risks of breast implants?
Saline and silicone breast implants pose similar risks, including:
- Scar tissue that distorts the shape of the breast implant (capsular contracture)
- Breast pain
- Changes in nipple and breast sensation, usually temporary
- Implant leakage or rupture
Correcting any of these complications might require additional surgery, either to remove or replace the implants.
What happens if an implant ruptures?
If an implant ruptures, the approach might vary depending on whether the implant is saline or silicone.
Ruptured saline implant
If a saline breast implant ruptures, the implant will deflate — causing the affected breast to change in size and shape.
The leaking saline solution will be absorbed by your body without posing any health risks, but you'll probably need surgery to remove the silicone shell. If you wish, a new implant can likely be inserted at the same time.
Ruptured silicone implant
If a silicone breast implant ruptures, you might not notice right away — or ever — because any free silicone tends to remain trapped in the fibrous tissue (capsule) that forms around the implant. This is known as a silent rupture.
Leaking silicone gel isn't thought to cause systemic or long-term health problems — such as breast cancer, reproductive problems or connective tissue disease, such as rheumatoid arthritis. Still, a ruptured silicone breast implant might eventually cause breast pain or changes in the contour or shape of the breast.
If this happens, your doctor will likely recommend surgical removal. If you wish, a new implant can usually be inserted at the same time.
If an MRI scan detects an implant rupture but you don't have any signs or symptoms, it might be up to you and your doctor to weigh the risks and benefits of keeping the implant in place or having it removed.
Is the safety of breast implants actively monitored?
Both saline and silicone breast implants are considered safe for breast augmentation and breast reconstruction. Long-term follow-up studies on new devices — in which researchers look for evidence of continued safety and effectiveness of saline and silicone breast implants — are ongoing.
What factors should I consider before getting breast implants?
If you're thinking about breast augmentation or reconstruction, it's important to understand what it means to have breast implants. In addition to changing your appearance, remember that:
- Breast implants won't prevent your breasts from sagging. To correct sagging breasts, you might need to consider a breast lift in addition to breast augmentation.
- Breast implants aren't guaranteed to last a lifetime. Implant rupture is a possibility. Also, your breasts will continue to age after augmentation — and factors such as weight gain or weight loss might further change the way your breasts look. Any of these issues might lead to additional surgery.
- Mammograms might be more complicated. If you have breast implants, routine mammograms might require additional, specialized views.
- You might need routine MRI scans. The Food and Drug Administration recommends monitoring silicone breast implants with routine MRI scans every two years, starting three years after the initial implant surgery. Debate continues, however, on whether the benefit of routine MRI scans justifies the cost. There's also a concern that routine MRI scans have the potential to lead to unnecessary surgery.
- Breast implants might hamper breast-feeding. Some women are able to successfully breast-feed after breast augmentation, while others aren't.
- Insurance might not cover breast implants. Unless it's medically necessary — such as the need for implant reconstruction after a mastectomy — breast augmentation might not be covered by your insurance plan. Be prepared to handle any expenses that accompany breast augmentation, including related surgeries or future imaging tests.
- You might need additional surgery after breast implant removal. If you decide to have your implants removed, you might need a breast lift or other corrective surgery to help your breasts maintain an aesthetically pleasing appearance.
What's the bottom line?
Based on your breast anatomy, body type and other factors, your surgeon might recommend one type of implant over another for optimal cosmetic results. Ultimately, however, the choice between saline and silicone is up to you.