Making the Choice – Silicon Gel versus Saline Breast Implants

Congratulations!  You’ve made your decision to undergo breast augmentation surgery and are looking forward to a beautiful result.  It’s now time to select what type of implant will be used for your procedure – silicone gel versus saline-filled implants.  There are many advantages to both types of implant.  Ultimately, the decision should be one with which you are comfortable and happy.  Following are several factors to consider:

 Safety of Materials

Saline implants are filled during your procedure by your surgeon with a normal saline solution, which contains 9 grams of sodium chloride (NaCl) dissolved in 1 liter of water.  In the event of a rupture, the saline will be absorbed by your body without any adverse affects. 

Silicone gel implants are composed of silicone in a gel form.  Silicone gel is derived from silicon – a naturally occuring semi-metallic element that in nature combines with oxygen to form silica.  Silica is then combined with carbon and heated to a high temperature to form silicon.  Further processing converts silicon into a polymer called silicone, which comes in a liquid, gel, or rubbery form and is found in many household items. 

The Institute of Medicine concluded, “There is no evidence that silicone implants are responsible for any major diseases of the whole body.  Women are exposed to silicone constantly in their daily lives.”

 Mammograms and Cancer Screening

It is very important to continue regular cancer screening with self-exams and mammography as recommended by your physician after having breast augmentation.  Studies have concluded that there is no evidence that implants cause cancer.  However, it is equally important for every woman to complete regular screening regardless of wheather or not she has undergone augmentation. 

 Implants, both saline and silicone, will make routine mammogram screening more difficult.  Additional views will be necessary to produce a thorough evaluation.  It is very important to inform the mammography technician that you have undergone augmentation so that the procedure may be adjusted accordingly. 

 If silicone implants are selected, it is also recommended that a mammogram be performed every three to four years to check for rupture of the implant.  With the use of cohesive silicone gel filled implants, a ruptured implant will remain within the breast capsule.  However, it is still important to detect a ruptured implant and remove the device. 

 Patient Body Type and Specific Goals

Saline and silicone implants may produce different results depending on patient body type.  Thus, it is important to consider your goals and what look you would like to achieve in determining which implants to use. 

 -         Silicone gel implants have a softer texture and feel than saline.  In patients beginning with less breast tissue, the softer more cohesive feel of a silicone gel implant may result in a more natural feel with less possibility of implant palpability and visible implant rippling. 

-         Patients beinning with more breast tissue may not need to factor palpability and rippling into their decision with as much priority due to having adequate breast tissue to cover either type of implant. 

-         As saline implants are filled during surgery, your surgeon may choose to overfill the implant in order to reduce potential rippling.  This means that saline implants come with a fill volume range, and your surgeon may opt to fill the implant to the upper end of the range or use the median volume depending on your needs. 

-         Silicone gel implants come filled by the manufacturer in specific sizes, so once the implant is in place, the surgeon does not have the option of increasing or reducing the volume in the implant.

 Patient Skin Type

 Saline and silicone gel implants require different length incisions due to the size of the implant prior to placing it in the breast capsule. 

-         Saline implants require a shorter (2-3 cm) incision

-         Silicon gel may require a slightly longer incision depending on the size to be used

 This may be something to consider if your particular skin type has a tendency toward scarring and/or incision size is a priority factor for you.

In making your decision of silicone gel versus saline implants for your breast augmentation, it may be helpful to set a list of factors to consider in their order of priority for you.  Your beginning breast tissue, desired feel of the implant, cost, size goals, and incision length may be factors to include your personal list.  Rating these factors on their priority level for you, and then noting if saline or silicone gel implants will help you better reach your goals can help lead you toward the best decision for you. 

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