When looking to achieve fuller, more voluptuous breasts, there are many things to consider. One of the decisions that needs to be made is the choice between saline and silicone breast implants. Both options can produce natural-looking enhancement to the breasts, and both are safe according the FDA.
While you may recall an era where silicone breast implants were controversial and even unsafe, in November of 2006, silicone implants were re-approved by the FDA and have become increasingly popular for Denver breast augmentation patients.
Pros and Cons of Saline Breast Implants
Pros:
- Requires smaller incision than silicone implants
- Costs less than silicone
- 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
- More possibility of popping/deflating
- In case of rupture, rapid deflation will occur
Pros and Cons of Silicone Breast Implants
Pros:
- Form stable cohesive gel - shape stays the same
- Won't leak and deflate
- More natural look
- More natural feel
- Best option for those with little breast tissue
Cons:
- More expensive option
- Requires a slightly larger incision than saline implants
- In the rare case of rupture, it would be a "silent" rupture - wouldn't deflate like saline
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
- Loss of nipple sensation
- Post-operative infection
Part of the commitment you make when you choose to have breast augmentation is to the maintenance and care of your implants to ensure they will be long-lasting. Having your implants examined each year will allow you to ensure they are still structurally sound and performing as they should. If a saline implant leaks, it is not as obvious as a rupture in a silicone implant.
In the rare case of a silicone implant rupturing, the silicone tends to stay within the scar tissue which forms following your breast augmentation. For this reason, the rupture of a silicone implant is referred to as a “silent rupture.” Smooth implants are currently considered safer than implants with a textured shell.
Which kind of implant lasts longer?
While both saline and silicone breast implants are long-lasting, neither choice is guaranteed to last a lifetime. Both saline and silicone implants can last between ten and twenty years, and in some cases, longer. 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, you can be sure that Dr. Slenkovich will be there to monitor your health and that of your implants.
Follow-Up Care
Silicone breast implants require more “homework’ both before and after surgery. As part of the re-approval of silicone implants in 2006, the FDA has made several recommendations that we ask patients to learn about and consider. After surgery the most significant FDA recommendation is that patients get an MRI of the breast three years after surgery, and every other year moving forward.
Despite this recommendation many surgeons – including Dr. Slenkovich, who was a researcher on the 5-year study assessing the safety of silicone gel breast implants and whether or not to approve them for future use – question the usefulness of obtaining MRIs this frequently. Dr. Slenkovich recommends following the ASAPS MRI recommendation standard of an initial MRI, after 10 years and every 5 years thereafter. 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 breast implants 15 years ago still have absolutely beautiful, natural appearing, soft breasts and have never had a problem. Today’s silicone implants are even safer and better than the earlier versions.
Dr. Nick’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, and/or are thin or petite with very little skin to sufficiently cover the breast implant, silicone gel implants are less likely to cause visible rippling or wrinkling than saline breast implants. 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. In addition, women who have thinner skin and little existing breast tissue may desire a moderate size increase with a more natural shape. These women are an excellent candidate for an anatomical (tear dropped) shaped, silicone gel implant.
By contrast, for Denver breast augmentation patients with thick enough skin, and plenty of breast tissue for coverage, saline implants have less of these issues and are an excellent option.
While some plastic surgeons feel that silicone delivers a more natural shape, Dr. Slenkovich feels that in a large majority of women the shape results are equal. At Colorado Plastic Surgery Center, he has used both silicone and saline breast implants in about equal numbers for breast augmentation and gets great results with both.
Despite the type of implant you choose, the breast implant is most commonly inserted under the pectoralis muscle for the safest and most natural result. This positioning allows Dr. Slenkovich a greater control of the positioning of the breast implant pocket and has been shown to further minimize the probability of capsular contracture along with other surgical protocols.
Mammograms are different with 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 with all of the breast implants, with problems with either of these areas very uncommon.
If you are considering a breast augmentation surgery and would like to learn more about implant options, please contact our plastic surgery office today to schedule a breast augmentation consultation.
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