Saline vs. Silicone Breast Implants

Medically reviewed by Dr. Laura Roider & Dr. Nick Slenkovich

When looking to achieve fuller, more voluptuous breasts, there are many things to consider. One such decision is the choice between saline and silicone breast implants. Both options can produce natural-looking enhancement to the breasts, and both are safe, according to the FDA. At Colorado Plastic Surgery Center, Dr. Nick Slenkovich and Dr. Laura Roider generally recommend silicone, and the vast majority of our patients choose it. However, saline still remains an option if the patient desires it.

Modern Breast Implants Safe, Customizable Options for Your Ideal Look

While you may recall a time when silicone breast implants were controversial and even considered unsafe, the FDA reapproved them in November 2006. They have become increasingly popular for Denver breast augmentation patients due to their natural appearance, soft, cohesive feel, and resemblance to breast tissue. Saline implants filled with a sterile saltwater solution are also available and remain a reliable choice. Colorado Plastic Surgery Center provides both options, ensuring that each patient’s unique goals and body contours are met with the highest standards in safety and aesthetics. During your personalized breast augmentation consultation, Dr. Slenkovich and his expert patient care coordinators will guide you through the pros and cons of each implant type, helping you make the best choice for your desired look and lifestyle.

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Pros and Cons of Saline Breast Implants Pros and Cons of Silicone Breast Implants Which Kind of Implant is Safer? Which Kind of Implant Lasts Longer? Follow-Up Care Dr. Slenkovich's Thoughts on Saline Implants What Are the Differences? Breast Implant Education and Considerations

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Pros and Cons of Saline Breast Implants

Pros:

Requires smaller incisions than silicone implants
You'll immediately know if an implant leaks
In case of rupture, the saline is easily absorbed by the body

Cons:

Less natural look compared to silicone implants
Less natural feel
Not advised for women with little breast tissue due to the increased risk of a “rippling” appearance
Higher chance of popping/deflating
In case of rupture, rapid deflation will occur

Pros and Cons of Silicone Breast Implants

Pros:

Form-stable, cohesive gel that maintains shape
Won't leak and deflate in the event of rupture
More natural look
More natural feel
The best option for those with little breast tissue in order to decrease the risk of a “rippling” appearance

Cons:

Requires a slightly larger incision than saline implants
In the rare case of rupture, it would be a "silent" rupture—it wouldn't deflate like saline; we recommend routine imaging to assess the implant’s integrity

Which kind of implant is safer?

Both saline and silicone implants are considered to be safe options for breast augmentation. Both types of implants come with the same kinds of risks:

Capsular contracture
Breast pain
Temporary, or rarely, permanent, changes to sensation
Post-operative infection rupture

Part of the commitment you make when you choose to have breast augmentation is to the long-term maintenance and care of your implants. Having your implants examined routinely will allow you to ensure they are still structurally sound and performing as they should. The FDA recommends that women with breast implants get routine imaging every three years after their breast augmentation surgery.

In the rare case of a silicone implant rupturing, the silicone is not only highly cohesive and form-stable, which therefore would not leak, but it tends to stay within the scar tissue capsule that forms during the healing process following your breast augmentation. For this reason, the rupture of a silicone implant is referred to as a “silent rupture.” You may not even notice that it happened, which is why we recommend routine imaging to check on implant integrity.

It is important to note that when we discuss silicone implants here, we are generally referring to modern silicone implants, those placed after 2006. For the purposes of this page, we are not referring to the older generation of implants but are happy to discuss them, if needed, during your consultation with us. For example, women who currently have an older generation of implants in their breasts and are exploring their breast surgery options may want to review this information with us.

Which kind of implant lasts longer?

While both saline and silicone breast implants are long-lasting, neither choice is guaranteed to last a lifetime. Each implant carries its own warranty time frame set by the implant manufacturers, with most generally recommending that the implants be exchanged after ten years. However, at Colorado Plastic Surgery Center, Dr. Nick Slenkovich believes that if you are happy with your breasts, are not experiencing any issues, and have been routinely monitoring the status of your implants through imaging and self-assessment of any changes, you do not need to undergo a subsequent elective procedure. Breast implant rupture is a rare occurrence and is less common in the initial years following breast augmentation. In the event of implant rupture, surgery will be required to replace the affected implant. No matter which type of implant you choose, Dr. Slenkovich and his team commit to partnering with you for the long-term health and success of your implants.

Follow-Up Care

As all implants are artificial devices, we can anticipate that they will require replacement at some point in the future. Just as without implants, you will need to monitor your breasts for changes and any abnormalities and continue with recommended mammograms. For silicone implants, the FDA has recommended that patients monitor their implants with screening ultrasound or MRIs beginning five to six years after surgery and then at two to three-year intervals thereafter.

Many surgeons question the usefulness of obtaining postoperative imaging this frequently. Dr. Slenkovich, who was a researcher on the 5-year approval study to re-assessing the safety of silicone gel breast implants, recommends that patients obtain a screening ultrasound or MRI of the implants at least every five years, or if there is a change in the breast that may indicate that a silicone implant shell has ruptured. Many Denver breast augmentation patients who had silicone breast implants placed 15 years ago still have absolutely beautiful, natural-appearing, soft breasts and have never had a problem. Today’s silicone implants are increasingly safer and better than those of former generations.

As your partner on this journey, we are committed to being transparent, honest, and forthcoming about all risks and long-term implications of any surgery. We expect that when you get an implant, you will need or want future surgery for a number of potential reasons. We will discuss this with you more during your consultation so that we can empower you to make informed decisions on your personal journey of self-improvement.

Dr. Slenkovich’s Thoughts

On Silicone Implants

“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 Denver breast implant 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 autoimmune 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, the choice between silicone or saline implants is ultimately the patient’s choice.”

What Are the Differences?

If you have thin skin or a slim, petite frame with minimal tissue to cover the breast implant, silicone gel implants are often preferred. Compared to saline implants, silicone gel implants are less likely to show visible rippling or wrinkling. When rippling or wrinkling does occur, it is generally seen on the side of the breast or in the cleavage area (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 Denver breast augmentation patients with thick enough skin and plenty of breast tissue for coverage, saline implants have fewer of these issues and are an excellent option.

Choosing the Right Implant for Your Body

At Colorado Plastic Surgery Center, Denver breast augmentation surgeon Dr. Nick Slenkovich generally recommends silicone, and the vast majority of our patients select this option. However, saline still remains an option if desired by the patient, and we are happy to discuss this if you would like to during your consultation. Regardless of the type of implant you choose, Dr. Slenkovich recommends that the breast implant be placed under the pectoralis muscle for the most natural result. For patients who have more tissue at the top of their breasts, placing the implant over the muscle becomes an option. In all cases, great care is taken to optimize the breast shape and symmetry and enhance the cleavage and contour.

Caring for Your Breast Health With Implants

When you have silicone or saline implants, mammograms are slightly adjusted to ensure the best visualization of breast tissue. A “diagnostic” mammogram, which captures images from multiple angles, is typically used for more accurate results. Breast augmentation patients should continue to practice self-examinations and other necessary evaluations for breast health. Importantly, with all types of breast implants, natural sensation in the breast and nipple and the ability to breastfeed usually remain unchanged, with issues in these areas being very rare.

Breast Implant Education and Considerations

To Learn More

Choosing between saline and silicone implants is an important decision in creating the breast size you desire. Dr. Slenkovich and the team at Colorado Plastic Surgery Center know how many Denver breast augmentation patients live dynamic, active lives—we are here to guide you every step of the way. Schedule a consultation today to explore which implant option is best suited to your body, lifestyle, and aesthetic goals, and take the first step toward a more confident, radiant you!

Saline vs. Silicone Breast Implants

Modern Breast Implants Safe, Customizable Options for Your Ideal Look

Select a section to jump to

Explore Our Results Naturally Stunning

Pros and Cons of Saline Breast Implants

Pros:

Cons:

Pros and Cons of Silicone Breast Implants

Pros:

Cons:

Which kind of implant is safer?

Which kind of implant lasts longer?

Follow-Up Care

Dr. Slenkovich’s Thoughts

On Silicone Implants

What Are the Differences?

Choosing the Right Implant for Your Body

Caring for Your Breast Health With Implants

Breast Implant Education and Considerations

To Learn More

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