Breast  implants used in breast augmentation have been around since the 1960’s.  Over the years, breast implant technology has gotten better and better and breast implants have continued to improve.  So the breast implants currently available are the best in history.  But there are still a number of confusing issues.  The first is silicon or saline?

Silicone breast implants were the most common implants for much of the history of breast implants.  Then about 15 years ago Connie Chung ran an expose which claimed that implants were responsible for all kinds of health problems.  This led to lawsuits a huge windfall for lawyers and the subsequent ban on silicone implants.  Shortly after this, the ban became worldwide.  This lasted for years until more than 100 clinical studies showed that breast implants don’t cause cancer, lupus, scleroderma, or a host of other problems.  Eventually, a federal judge threw out the lawsuits, declaring them junk science and sent the lawyers packing.  This led to the present re-introduction of silicone implants and their approval by the FDA.  Interestingly enough, most of the rest of the world re-introduced them many years ago.

Saline breast implants have always been available and continued to be available as a choice.

Apart from the differences in history and reputation, what’s the actual difference between the two?  Both are made of a silicone shell.  One has silicone gel inside; the other one has salt water.  But how do they act in the body?

Silicone breast implants are softer squishier and move better.  They are less likely to cause wrinkling, rippling, malposition, and sagging.  With larger sizes more than 400 cc silicone implants perform better and are less likely to cause severe sagging.

Saline breast implants are more likely to be felt under the skin because the shell is thicker.  This is not a problem for average or slightly heavier women.  In thin women, this can be an issue.  This also applies to wrinkling and rippling.  If there is enough tissue to cover the implant well then said implants do very well.  The other issue is that when the implant fails, as all implants do eventually, saline implants go down completely within a day.  When silicone implants break, the material stays in the pocket or implant space and allows more time until replacement surgery.

Fortunately now the type of  breast implant used is a woman’s choice.  Her body type and her concerns all influence her choice.  In my practice Advanced Concepts in Plastic Surgery in Sacramento, I have performed breast augmentation surgery on many women who made their own choices of either saline or silicone breast implants and were very happy with the results.