Silicone vs Saline Breast Implants – The Pros and Cons of Each
While you may recall an era where silicone implants were controversial and even unsafe, in November of 2006, silicone implants were re-approved by the FDA and have become increasingly popular.
Comparison of Saline and Silicone Options
There is a wide range of surgeons’ opinions on whether saline or silicone implants are preferred. Many surgeons feel that silicone gives a better result; others feel that is definitely not true. Here’s what is true: Under clothes, there is very little difference in appearance; we get great results with both silicone and saline. With your clothes off, often there is a difference in appearance as saline implants look less natural when naked because in certain positions the implant shape is visible, such as when leaning over or being viewed from the side. Also, to the touch, silicone feels more like natural breast tissue.
If you have thin skin, and/or are thin or petite with very little skin to sufficiently cover the implant, silicone gel implants are less likely to cause visible rippling or wrinkling than saline. Rippling or wrinkling, when present, are seen generally on the side and bottom of the breast (for example while leaning forward with your clothes off). Also for thin people with little breast tissue or skin covering, saline implants can feel like there’s a water bag under the breast. In general, patients with thinner tissues and less native breast tissue are more likely to appreciate the benefits of silicone gel implants. By contrast, for breast augmentation Denver patients with thick enough skin, and plenty of breast tissue for coverage, saline implants have less of these issues.
While some surgeons feel that silicone delivers a more natural shape, Dr. Slenkovich feels that in a large majority of women that the shape results are equal. In his practice, he does both silicone and saline in about equal numbers and gets great results with both.
In both cases, the implant most commonly is inserted under the pectoralis muscle for the safest and most natural result.
Mammograms are different with either a silicone or saline implant in place, and a “diagnostic” mammogram (which takes pictures from more angles) is done to best visualize the breast tissue. Sensation in the breast and nipple, and success at breast feeding are the same for both procedures, with problems with either of these areas very uncommon.
Pros and Cons of Silicone
Silicone delivers a great result including a natural shape and natural feel.
The biggest drawback to silicone implants is that if there is a problem, it is likely to be a “silent” rupture (saline, unlike silicone, is absorbed by the body and therefore a saline rupture is very noticeable). While older silicone implants were in liquid form with a weaker casing, today’s implants have the silicone in the form of a “cohesive gel” and the implant shell is very durable and safe. With these newer silicone gel implants, migration of silicone into the breast tissue is now very rare.
Silicone implants also require more “homework’ both before and after surgery. As part of the re-approval of silicone implants, the FDA has made several recommendations that we ask patients to learn about and consider. After surgery the most significant issue is the FDA recommendation that patients get an MRI of the breast every two years starting at year three. Despite this recommendation many surgeons – including Dr. Slenkovich who was a researcher on the 5-year study assessing the safety of Silicone implants and whether or not to approve them for future use – question the usefulness of obtaining MRIs this frequently. Of course, if there is a change in the breast or a clinical question arises about the status of the implants, an MRI is recommended.
Many Denver breast augmentation patients who had silicone implants 15 years ago still have absolutely beautiful, natural appearing, soft breasts and have never had a problem. And today’s silicone implants are even safer and better than the earlier versions.
Dr. Nick’s position on silicone is as follows: “I think that the silicone gel is a great implant. However, if a patient has reservations about silicone, then typically saline is still a great option that in most patients gives an equivalent shape. I recommend that my breast implants Denver patients read the FDA recommendations forms, and that they don’t just blindly sign it, but I personally, do not have reservations about silicone. Indeed, the 1992 FDA statement that silicone implants were being pulled off the market because of safety concerns, but that if a patient had an implant, they did not recommend that it be removed, was very confusing to many. Either silicone was unsafe or it wasn’t, and since they weren’t recommending removal, one had to wonder. Further, numerous reviews of all of the silicone implant studies have concluded that there is no scientifically identifiable association between silicone implants and auto-immune diseases (lupus, arthritis, MS). I feel that those claims are unsupportable and I am completely comfortable with silicone. I would use silicone for family and on my staff (some of whom have silicone implants). I think most medical professionals would agree that silicone is great. However, this is ultimately the patient’s choice and about half of my breast surgeries are silicone and half are saline."
Pros and Cons of Saline
The saline used in a saline breast implant exactly matches the salinity of the human body, so if there is a leak or rupture, there is no health danger. Depending on how you look at it, this fact that your body will absorb the saline from a ruptured implant is either an advantage or a disadvantage. It is an advantage in that you generally don’t need an MRI to detect a leak as the breast would simply go flat as the saline is absorbed. It is perhaps a disadvantage in that a rupture and rapid deflation leave little opportunity for conveniently choosing a time for any needed surgery to replace the implant.
The disadvantages are: a less natural feel because water feels less like breast tissue than silicone gel; rippling or wrinkling of the skin; and visibility of the implant from certain angles when naked (such as leaning over or when viewed from the side). These drawbacks are significantly minimized when there is sufficient skin and breast tissue to completely cover the implant (only an examination can make this determination) and when the implant is inserted beneath rather than on top of the muscle, which is now standard procedure for saline.
What To Expect When You Come In For Your Breast Enlargement Consultation
Our philosophy is that educating and giving our Denver breast augmentation patients full information in order to make an informed decision is a key to a successful breast enhancement procedure with a good outcome. It’s important that you be involved in the process from start to finish, and keeping your informed and involved is a responsibility we take very seriously. Here’s what to expect at your breast enlargement consultation:
- Before meeting with Dr. Slenkovich, you will meet with his medical assistant. She will listen carefully to your desired outcomes and your questions and concerns. We will provide an explanation of different breast enhancement procedures including advantages and disadvantages of each.
- Dr. Slenkovich will meet with you after he has reviewed your conversation with his assistant. He will take with you in more detail about your goals and concerns and provide additional information. Patients often tell us that they are very encouraged by the warmth, honesty and openness of everyone at Colorado Plastic Surgery in engaging in a true dialogue where the patient’s needs, hopes and concerns are considered so carefully.
- Next, we will review a presentation that will help you understand more about breast enhancement. This presentation will include actual examples of different breast sizes and shapes and many different ages of patients in the before and after photos. This will help you begin to form a realistic picture of where you’re starting from and what you can realistically expect for results. Most patients are excited and encouraged to see how beautiful their breasts can be. You’ll also receive printed materials outlining all of your options, answers to frequently asked questions about breast enhancement procedures, and what to expect during surgery and recovery. This will be yours to keep, so you can refer back to it as often as necessary.
- Next you will change into a robe and be examined by Dr. Slenkovich so he can get a detailed picture of your size and shape, breast structure and tissue, and body structure. This forms the basis of his opinion of what will be medically healthy, realistic, proportional, and help you reach your breast enhancement goals. He will show you several before and after pictures of patients that have similar tissues that serve as good examples of what he anticipates you would be able to acheive.
Dr. Slenkovich says: "I want to be as clear as possible about what you can realistically expect if you decide to have a procedure. After your exam, we’ll have an in-depth conversation where we will openly talk with each other about what you want and what is possible, and I will also address your questions and concerns. This open sharing is one of the most important steps in providing you with the most pleasant and rewarding experience possible."
Dr. Slenkovich cautions those seeking breast enhancement, “The last thing in the world you want at this point is a 'salesman' who will promise you the world. Now is when you want a caring surgeon who will provide you with an honest and realistic picture of what to expect, and who understands that these procedures are not right for everyone. Take your time in thinking over everything you’ve learned and make the decision that is right for you. No matter what you decide, my staff and I will be supportive because what we want for you is your comfort, safety, and peace of mind. I promise you’ll find the whole experience to be encouraging, easy, and reassuring."
- If you choose to have a breast enlargement procedure at Colorado Plastic Surgery Center, we also schedule a detailed pre-op teaching session. Our entire education process from start to finish brings new clarity and assurance to your desire to pursue breast enhancement. You’ll also be secure knowing your procedure is supported by the years of expertise, knowledge, and skill the doctor brings to every procedure.
Why Do We Go To Such Lengths To Educate You About Breast Enhancement?
At Colorado Plastic Surgery Center, we are committed to each of our patient’s total well-being and health and we believe that patient education and communication is an integral part of this. Our happy and satisfied patient results seem to support this belief:
"When I met Dr. Slenkovich, I knew I'd made the right decision. He was totally cool, upbeat, a good listener, and highly competent. He made me feel completely safe. I didn't feel pressured to have any procedures done, just comfortable knowing all my questions were answered. My procedure was great. I look fabulous now!. Everything fits together. Before I felt like crying every day when I got undressed. That’s something you should be able to fix if you can. You don’t have to settle for less. I took the opportunity, and I couldn’t be happier. The surgery went smoothly. Within a week, I was back at work, looking and feeling entirely new. I am deeply grateful to Dr. Slenkovich and his team for doing such a great job on my new form; for creating a comforting atmosphere before, during, and after surgery; and for treating me so personably. I've already recommended the Colorado Plastic Surgery Center to several friends who've noticed the amazing difference in me – and hope to have similar results in their own lives." -- N.B. Cheyenne, WY