One of the decisions you will need to make when undergoing breast augmentation or reconstruction surgery is whether you want a saline or silicone gel breast implant. Each choice has its own advantages and disadvantages. In some cases, your plastic surgeon may recommend one of the other, but often, the final decision is left to the patient.

Both saline and silicone gel implants are available in a variety of sizes, shapes, and textures so that the patient is able to get the look she desires. You may remember that silicone implants were virtually banned by the FDA and only allowed for limited use from 1992 to 2006. The implants prior to 1992 were filled with silicone liquid that would leak into the body, making some women sick. Today, plastic surgeons use saline or implants that are filled with silicone gel, which does not leak the same way that the silicone liquid implants did.

When you visit your plastic surgeon for any type of breast augmentation, lift, or reconstruction, you will be asked to choose the type of implant you prefer. To make this decision easier, we have listed some advantages and disadvantages to each choice.

Saline Implant: These implants are filled with a saltwater solution to enhance breast size and volume when properly inserted. One reason that women choose saline implants is that they are less expensive than silicone. Because the plastic surgeon is able to insert these implants when deflated, there is a smaller incision site. The saline is then added once the implant is in place. This is a good choice for those patients who may be prone to scarring. Saline implants are approved for use in women age 18 and over.

The primary advantage to saline implants is the fact that a rupture is very easy to detect. When a rupture occurs with this type of implant, the saline will leak out and the breast will decrease in size as the implant deflates. Because saline is a non-toxic substance, the woman will not become ill should a rupture occur. The body is able to absorb the saline safely.

There are some disadvantages to the saline implant as well. Visible rippling is more common in saline implants than silicone. Also, saline implants are harder and feel less like a real breast than silicone.

Silicone Gel Implant: Silicone gel is very different than the silicone liquid that was used in implants prior to 1992. The gel is thick and will not leak into the body the way that the liquid did. Silicone gel implants were determined to be safe by the FDA in 2006. These implants are more expensive than saline and require a larger incision site as they are filled prior to placing them in the body. Many patients believe that they feel more natural and more similar to natural breast tissue than saline. They are approved for use in women age 22 and over.

Unlike saline, it is difficult to tell when a silicone gel implant has ruptured. The woman will need to undergo an MRI to determine if there is a leak. There have been very few occurrences of this problem since silicone gel was approved in 2006.

There is no right or wrong choice when choosing a breast implant. The plastic surgeon may recommend one over the other due to the patient’s unique characteristics. It is important that you choose a board certified plastic surgeon who has experience working with both saline and silicone gel implants.