Silicone vs. Saline Implants

Before undergoing a breast implant surgery, it is important for a patient to understand the difference between silicone and saline implants. While the desire to have bigger breasts is one shared by many women around the world, there is a great deal of confusion when it comes to the differences between these breast implants.

Saline implants have a silicone shell on the outside and saline on the inside. On the other hand, the silicone implant is made up of silicone on the inside as well as the outside.  Even with these differences, both types of implants feel very natural.

DIFFERENCES IN RUPTURING 

There are advantages and disadvantages to both silicone and saline breast implants when it comes to the implant rupturing. The main disadvantage of saline is that if it ruptures, the saline will be absorbed into the body causing the implant and breast to deflate. There could also be more rippling due to the implant being overfilled or under filled.

With both types of implants, the body forms an envelope around the implant in order to identify it, this envelope is called the capsule. If a silicone implant ruptures the silicone will remain within the capsule. It will not travel into the breast, body, or blood stream and cause any medical issues or diseases. Today silicone implants are safer and are slightly firmer than they used to be more than 20 years ago. 

SAFETY

The main questions patients ask before a procedure concerns the safety of using silicone and saline implants for breast enhancement. Now that more people are getting silicone, it is not as much of an issue. Silicone implants are FDA approved for women 22 years of age and older for cosmetic reasons and those under 22 years of age for reconstructive reasons. There is more awareness and education about the safety of the silicone implants.

AGE LIMIT

When it comes to getting silicone or saline implants, a person under the age of 22 can only get saline implants. The FDA only allows those under the age of 22 to get silicone implants strictly for reconstructive purposes.  It is not a safety issue.

COST

There are three main manufacturers approved to sell implants in the USA they make both silicone and saline implants. The costs vary slightly between them but overall saline implants are less expensive than silicone implants.

SIZE LIMITATIONS 

There is definitely a range on how big the silicone or saline implants should be simply because the breast has its normal boundaries. It is the chest wall for every woman. When sizing them, a doctor takes the measurements of the current breast. The lower fold of the breast is the land mark on the breast as well as the outside of the breast. The implant should be sized so it will fit into the breast frame and there is also the range within that frame.  They can be on the smaller end of it or they can go on the larger end of it. If they go too large, the breasts will meet in the middle. It does not look very good and it can also extend outside of the chest wall to the outside near their arm. That is very unnatural looking. To be within the normal looking or natural looking range, there is a limit that is specific to every breast and every chest wall. 

RISKS

There are numerous risks and possible outcomes with breast enhancement with implants. One of the risks for both silicone and saline implants is capsular contracture.  A capsular contracture is the thickened scar or envelope around the implants. The exact cause of capsular contracture is not fully understood so precautions are taken to prevent it as much as possible by minimizing bleeding around the implant and using antibiotics to irrigate the pocket and the implants before placement.

Research has shown that textured implants placed in the pocket over the muscle reduce capsular contracture. However if the implants are placed beneath the muscle, it does not make a difference if it is smooth or textured. 

Another risk is rippling which is the visible folding of the implant under the skin. This is more commonly seen with saline implants and very thin patients.

RECOVERY TIME

The recovery time for silicone and saline implants is the same. There is a small difference in recovery time between placing the implant above or below the muscle. Naturally the breast is above the pectoral muscle so the recovery time is quicker and easier if the implant is placed above the muscle. This placement is an option for women who have enough tissue to cover the implant.  If they have very little tissue, there is no other option but to go under the muscle.

The size of the implants can also affect the recovery time. If a patient chooses a very large implant, there is a lot of stretching of the muscle and the skin which can lead to more discomfort for the patient. In most cases, the recovery is smooth and easy and happens within a week after the procedure.

SCARRING

The length of the scars for breast augmentation can range from 3 to 4 centimeters. The incision can be in the fold or crease underneath the breast but the scar can also be near the nipple. The healing process continues to improve up to a year. The scar fades and becomes soft and imperceptible.

POST-OP INSTRUCTIONS

Following a silicone or saline implant surgery for breast augmentation a small dressing is placed on the incision. Stitches are dissolvable and tight compression garments are not necessary, a soft bra is sufficient for support.

Patients should avoid heavy lifting for 3-4 weeks in order to avoid an increase in blood pressure and possible bleeding. Patients are also restricted from doing upper body exercises during the recovery period.

RESULTS

The patient will immediately see results in the change in volume after having a silicone or saline implant. The  swelling starts the next day and continues for 2 or 3 days before slowly starting to go away. Patients should expect to see a final result about 3to six weeks after any post-op swelling goes away. By 3 months, any tightening of the muscles or skin softens and becomes natural.

A natural result means different things to different people. For example, a patient with big implants and a skinny body will not look natural. It is not necessarily the implant, but the choice of implant, the size of the implant, and also the patient's body that makes the results look better.

FINAL THOUGHTS

A consultation with a board-certified plastic surgeon who performs these procedures on a regular basis is essential. During the consultation a detailed discussion to delineate the goals and to fully explain the procedure and its benefits, risks and outcomes should be addressed and measurements of the breast are taken by the surgeon to appropriately choose an implant for the breast frame. Trying on different samples and feeling them can help make the decision easier. Together with the surgeon the women can get closer to reaching her goal of having a bigger bust.

Written by the Cosmetic Town Editorial Team- MA

Based on an exclusive interview with Dr. Dana Khuthaila in New York, NY