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Dr Tim Neavin
Surgery with Symmetry
Dr Tim Neavin

Breast Augmentation: Saline or Silicone Breast Implants?

This article will give you a quick break down on the difference between saline and silicone breast implants.  Of note, gummy bear breast implants, as they’re commonly called, are of the silicone variety.

The Rules of Breast Implants

I saw a woman in the office today who desired larger breasts. We discussed breast augmentation at length. She raised a couple of questions about the difference between saline breast implants and silicone breast implants. There are advantages and disadvantages of both. Some of these are obvious. But most women don’t enter a consult knowing all the perks, such as….

As a rule, silicone breast implants cost twice as much as their saline breast implant cousins. They are softer, and more natural to the touch. They tend to look less like a ball when placed under smaller breasts. Silicone breast implants come pre-filled, unlike its saline counterparts. That means that the incision length necessary to place the breast implants during breast augmentation must be larger (perhaps one to 2 centimeters larger in length). This fact sometimes makes placing silicone breast implants through the areola difficult if not impossible as in the case of very large implants and very small areolas. Forcing large silicone breast implants through a small areola can lead to poor scarring given the trauma necessary to ‘force’ the implant through a tiny opening. It may also lead to implant shell injury. In addition, because the saline breast implants come ‘empty’, they can be filled drop by drop. This often makes creating symmetry a bit easier particularly when there exists a large breast asymmetry before breast augmentation surgery. Of course, no two breasts are ever the exact same size. And as a rule, the silicone breast implants tend to look smaller than its equal volume saline cousins given silicone’s nature to sit more ‘relaxed’ on the chest wall.

In addition, the FDA tells us that women should be at least the age of 22 for primary breast augmentation with silicone. For replacements and ‘reconstructive’ breast augmentations, this rule does not apply. And while it is not ‘illegal’ for a plastic surgeon to put a silicone breast implant in a 20 year old woman for a primary breast augmentation, it is something that is not recommend by the FDA. The FDA feels that in some women breast development may not be complete until age 22, and that a woman cannot make a truly informed decision about their breasts until they are fully developed.