We are fortunate for the past few years that the FDA has reintroduced silicone implants as an available choice for cosmetic breast enhancement. In my practice currently, I perform a close to fifty-fifty mixture of saline implants and silicone implants. Saline Implants
Saline implants are filled to size during the silicone toy procedure. As the name implies, they are filled with sterile saline fluid, which is just salt water. Note that the outershell of the saline implant is made with silicone, but this is similar to many medical devices. The difference is the filling, not the shell (which is solid and does not “leak”)
Because they are filled during the procedure, they can berolled like a cigar and inserted into either a submuscular or subglandular pocket via a very small incision. In general, the saline implant will have a slightly smaller scar than the silicone implant. This becomes more of a difference with implants greater than 300 cc.
They do not require monitoring. If an implant leaks, and it is filled with saline, you will know it because the fluid will seep out over the next few days. This is not true of silicone. If a silicone implant shell ruptures, you may not know it until you get the breast examined with a study.
They are less expensive than silicone. In general, they will be around 1,200 cheaper than the silicone implants due to the different costs charged by the manufacturer.
Salines can also be tailor adjusted during the surgery. While you are asleep,the surgeon can adjust the implant cc by cc to get the closest match between the two breasts. In silicone implants, the surgeon would have to order different sized implants, and they typically come in 25 cc intervals.
While I personally think that both saline and silicone implants are safe, if one of my patient is a “worrier”, or is not convinced of the absolute safety of the silicone gel, than I would recommend saline implants. There are enough stresses in today’s life and I would rather not implant a product that cause my patients to worry more! I want my patients to be stress free and beautiful.