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Dr. Pastrick's Blog: Silicone vs. Saline

June 5th, 2012 11:46 am by By Gregory H. Pastrick, M.D.

Patients often ask about the difference between silicone and saline when it comes to breast implants.

Many have heard rumors about silicone implants that make them apprehensive about choosing them for their surgery. Both types of implants have advantages and disadvantages.

Silicone implants have been extensively studied scientifically, and they have been proven to be safe. They do not cause any systemic medical/health problems even if they leak, as was once believed and, ultimately, the reason they were taken off the market for a while in the 1990s.

Silicone implants have a softer, more natural feel than saline implants, and that's the biggest reason the implants are back in use. (We have the actual implants in our office for you to feel the difference, for those who are interested). They also have a much lower incidence of visible rippling than saline implants, which means it'd be unlikely to see wavy skin contour on the breast from the underlying implant edges. On occasion, that can occur with saline implants.

These reasons are the main reasons patients choose silicone implants, and are often the reasons why some switch from saline to silicone after having a previous saline breast augmentation procedure. I’ve never had someone switch to silicone who wasn’t completely satisfied with the improvement.

The manufacturer’s warranty regarding leaks on silicone implants is better than that on saline implants, and the risk of leak is lower for the newly-redesigned silicone implants compared to saline implants.

Saline implants do have some advantages over silicone implants, however.

Saline implants are less expensive than silicone implants. Saline implant volumes can be adjusted by the surgeon in the operating room to fine-tune differences in breast size, whereas silicone implants cannot. In addition, leak detection is more difficult with silicone implants - usually requiring an MRI - compared to the saline implants, in which a leak is quite obvious to patients immediately. Finally, the incision length is shorter with saline implants since they are inserted empty and filled by the surgeon in the operating room once they are surgically placed. By contrast, silicone implants come to us from Mentor (our implant manufacturer) already filled, thus requiring a slightly longer incision.

Silicone implants, by the way, are restricted by the Food and Drug Administration for use only in patients 22 years of age or older, but don’t ask me to explain that one, as there really isn’t a good scientific rationale for it.

So which implant should you choose? I always leave the ultimate decision to each patient, as it's the patient who has to be comfortable with them in her body. Overall, the risks are very low and patient satisfaction is very high for breast augmentation with either type of implant.

Gregory H. Pastrick, M.D., is certified by the American Board of Plastic Surgery. He practices at The Plastic Surgery Center, located at 1 Sheridan Square, Suite 200, Kingsport, Tenn. Check out all of his services at or call 423-392-4884.


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