Silicone or Saline Breast Implants?
Silicone and saline implants differ in how they feel, how they behave if they rupture, and how they are inserted. This page compares the two on the criteria that actually differentiate them.
Both types have a silicone outer shell. The difference is what is inside it, and that determines almost everything else — how the implant feels, how it is inserted, and what happens if it fails.
Silicone implants
Feel and appearance A silicone gel fill is softer and lighter, and more closely resembles the feel of breast tissue.
Insertion Placed through a small incision in the inframammary fold, around the areola, or in the armpit. The implant is pre-filled, so the incision must be large enough to admit it at full size.
Placement Either sub-muscular, beneath the chest muscle, or sub-glandular, behind the breast tissue and in front of the muscle.
If it ruptures Rupture is uncommon. Because the gel is cohesive it does not disperse, which means a rupture can occur without any visible or palpable change — a so-called silent rupture. This is why periodic imaging surveillance is recommended for silicone implants; your surgeon will advise on the interval appropriate to your implant and your history.
Who they suit Patients with limited natural breast tissue, and anyone whose priority is a natural feel.
Saline implants
Feel and appearance Firmer and heavier, producing a rounder, fuller shape.
Insertion Inserted empty through a small incision under the breast or in the armpit, then filled once correctly positioned. The incision required is therefore shorter.
If it ruptures The saline leaks out and is absorbed by the body without harm. The deflation is immediately obvious, so no surveillance imaging is required to detect it. The shell still needs to be removed surgically.
What applies to both
Neither type is a lifetime device. Implants may need to be replaced, and revision surgery is a realistic prospect over a long period rather than an unusual complication.
The risks associated with breast implants include:
- Capsular contracture — scar tissue forming around the implant and tightening, which can distort shape and cause discomfort.
- Rupture, as described above.
- Breast pain or discomfort.
- Infection, as with any surgery.
- Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) — rare, and associated with textured implant surfaces.
- Breast implant illness — a reported constellation of symptoms including fatigue, joint pain and cognitive difficulty.
Recovery
Strenuous activity and heavy lifting are avoided for some weeks. A supportive bra is worn as directed. Swelling and bruising in the early period are expected.
Making the decision
The choice is usually made on feel and on how much natural tissue there is to cover the implant, since thin tissue coverage shows the edges of a firmer implant more readily. Discuss both options at consultation, and ask specifically about surface texture and about what monitoring your chosen implant will require.
The procedure this relates to
Surgery to increase breast volume and alter shape, using implants, the patient's own fat, or a combination of the two. The choice between them, and of implant plane and incision, follows from tissue quality rather than from preference alone.
Before you act on this
Everything here is general. What applies to you depends on your anatomy, your history and what you are trying to achieve, and none of that can be assessed from a page. If a question here is yours, bring it to a consultation.