Breast Implants: Saline VS Silicone

The recent trend in breast augmentation has been the use of silicone breast implants.  No doubt silicone has its advantages (feels softer, looks more natural, less rippling).  However, there are some reasons why one may prefer saline breast implants.

1. Cost

Saline breast implants cost roughly $1,000 less than their round, silicone cousins. This usually translates into a cost savings of about $1,000 for you, the consumer. (Shaped silicone implants can cost up to$2,500 a pair).

2. Breast size discrepancy

For example, if you look on the attached chart, if the left breast took a Smooth Round Moderate High Projection breast implant of 335 cc and the native right breast was just 10cc larger (which would be hard to identify, actually), then one would place the desired amount of 325cc in the larger right breast to match the left breast’s volume. However, to keep the same breast shape the next closest implant size available among the Smooth Round Moderate High Projection breast implants is 315cc. But, there is a 325cc Smooth Round Moderate Plus Projection breast implant available. The difference between the two is how much projection (PROJ) they have and the width (WTH) of their base (see chart).   You can see how switching implant shapes (PROJ and WTH) to adjust for volume discrepancies may yield slightly different shaped breasts .With saline implants, adjustments in volume can be made cc by cc since these implants come empty and are filled by the plastic surgeon during surgery.

In practice, this is more academic than real.   A 20cc size difference in a 250cc implant is more noticeable than a 20cc implant in a 375cc breast implant, naturally. And as silicone breast implants go up in size, so does their volumes to the tune of 50 cc in some cases (see chart). Thus, it is the really, really big breast implants and the really small ones that may have some issues when trying to correct for volume differences – the outliers. Silicone breast implants come pre-filled in many sizes.

Often, implants in the same profile (shape) have their sizes differ about 20cc – 50cc. One could switch over to a different shape to correct for a mild size discrepancy (one less than 20cc), but that is usually not necessary as 20cc size discrepancies usually aren’t that noticeable in women who have B cups or more, and, trading implant shape to adjust for size discrepancy may result in different shaped breast.

3.  “Lift”

Is that the implants (and hence, breasts) will feel more firm. Saline breast implants when overinflated can generate a more perky appearance to the breast. This may be helpful in women who have a little bit of droopiness or “deflation”. The downside of over iinflation (meaning putting in more volume than the actual unstretched shell can hold)

4. Desire for smaller incision

Because saline breast implants come “empty” and silicone implants come “filled”, plastic surgeons can get away with smaller incisions with saline implants since saline implants are filled once inside the breast. This also means that there is more versatility to:

5. Versatility to incision placement

There are 4 main approaches to breast augmentation: Breast fold, around the areola, armpit (transaxillary) and belly button (transumbilical). Larger silicone breast implants (particularly the textured models) may require up to 5 cm incisions. Such necessary large incisions may prohibit approaches through the areola and armpit. Transumbilical incisions are for saline breast implants only. Thus, in women who don’t scar well and/or have small areola may benefit from the small incisions that saline breast implants can afford.

For the Gallery of before and after photos click here.

Sientra chart
Sientra chart
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