Saline Filled Breast Implants

Saline Breast Implants vs. Silicone Breast Implants

Saline-Filled Breast Implants

Reviewed by Donald Revis, M.D., F.A.C.S.

Description of Saline Breast Implants

Saline breast implants use a salt water solution to provide enhanced breast volume after breast augmentation. While the fill is salt water, the shell of the implant that contains the salt water is made of a silicone elastomer. The shell is solid, yet flexible to provide a soft, supple sac to fill with saline. The firmness of silicone implants is determined by the volume of saline in the implant and its capacity. Some surgeons believe in slightly overfilling saline breast implants to decrease rippling. However, this may not be appropriate in some cases. (Please see the article “Overfill ? Please Fill Me In” for more information about overfill.)

Advantages of Saline Breast Implants

The main potential advantages of saline breast implants over silicone are that they are less expensive, require a smaller incision, and ruptures are easier to detect. Saline breast implants cost 20-25% less than silicone breast implants but that doesn’t mean the procedure costs 20-25% less. The implants make up a small fraction of the procedure price. The surgeon’s fees, the anesthesia, the facility, and other costs don’t change so you will save hundreds of dollars, but not thousands.

If you are prone to scarring, you may want to minimize the size of your incision. Saline implants require a smaller incision because the implants are inserted without saline in them (deflated) then filled with sterile saline after your surgeon puts them in place. If scarring is a concern, please ask your surgeon what the difference in incision size will be in your specific case. It may be only ¼ to ½ inch so may not be a reason to choose saline over silicone. If you want no visible scar at all and are willing to consider a TUBA (transubillical incision), then you must use saline. To our knowledge, no surgeons are using silicone implants with TUBA because the filled implant would cause too much trauma as it moves up from the belly area to the implant site in the breast.

Finally, we get to the primary advantage of saline breast implants—the ability to detect a rupture. Saline breast implant ruptures are usually very simple to detect. When a saline breast implant ruptures, the saline leaks out and the implant naturally deflates causing the breast to decrease in size. The change in size is readily noticeable so detection is easy. In addition, we know that the leaking saline from a rupture is non-toxic—it will be absorbed by your body and processed along with other bodily fluids.

Disadvantages of Saline Breast Implants

There are two primary disadvantages of saline when compared with silicone: potential rippling and a less natural feel. Saline implants are more likely than silicone to cause visible rippling. However, if you have a lot of natural breast tissue covering the implant and/or will go sub muscular in your placement, you may not have much rippling even with saline. You should consult with your plastic surgeon on this because it is a very complicated issue!

The other primary disadvantage of saline is that many women believe they feel less like natural breast tissue. There is no doubt that silicone implants feel a lot like a real breast, more so than saline implants do. However, as with rippling, the specifics are important. How much natural breast tissue do you have to work with, how large a breast implant do you require, and will the placement be sub glandular or sub muscular all factor into the way the implant will feel after surgery. You really need to speak with your surgeon so he can review the facts of your case with you and help you to make the proper choice.