Saline Breast Implants - What You Need To Know

There was a time when saline breast implants were the only real option for women wanting breast augmentation with implants, and they still remain a viable alternative to silicone gel-filled implants for some. Both saline- and silicone-filled breast implants have their share of advantages and disadvantages. Your choice of breast implant type must be made with your board-certified plastic surgeon. The decision should be made based on your goals, preferences and anatomy.

Saline and silicone breast implants are both composed of a silicone shell with a filler. Saline implants contain a saltwater solution, whereas silicone implants contain silicone gel.

The History of Saline and Silicone Breast Implants

Both saline and silicone breast implants have a long history of use in the United States. However, saline implants were less popular than silicone implants prior to the 1990s, when reports of side effects such as autoimmune diseases and connective tissue disease began to surface in connection with silicone implants. In 1992, the U.S. Food and Drug Administration (FDA) issued a ban on silicone breast implants until they were proven safe. This ban lasted 14 years, during which time saline implants were the only option.

The ban on silicone implants was lifted after the renowned Institute of Medicine concluded that they may cause localized problems such as tissue hardening, but they do not cause systemic diseases. Following the FDA's decision, silicone implants once again surpassed saline as the more popular implant type.

One of the main reasons for breast implant removal today is to exchange saline breast implants for silicone breast implants, now that they are more readily available.

Saline versus Silicone Breast Implants

Both saline and silicone breast implants come in different sizes, shapes and profiles. Saline breast implants can be placed over your chest muscles (subglandular placement), partially under your muscle (partial submuscular placement) or completely under your muscle (complete submuscular placement).

Your incision options are less limited with saline breast implants than their silicone gel-filled counterparts. Saline implants are filled after placement, while silicone implants are pre-filled. Saline breast implants can be placed via incisions around the nipple (periareolar incision), under the breast (inframammary incision), in the armpit (transaxillary incision) or in the belly button (transumbilical, or TUBA, incision). Your incision and scar are smaller when the implant is inserted before it is filled.

Silicone gel implants can't be placed via TUBA incisions due to their size.

Saline implants are also adjustable. Your doctor can use a syringe to put in more liquid or take some out. Standard pre-filled silicone implants can't be adjusted.

Another difference between the two implant types is the ease with which you can tell if one has ruptured. If a saline implant leaks, the rupture is immediately obvious, as the implant deflates. The saline solution is then absorbed by your body, where it causes no ill effects.

By contrast, it's hard to tell if a silicone gel-filled implant has ruptured. The FDA currently asks that women with silicone implants undergo magnetic resonance imaging (MRI) three years after their breast augmentation and then every two years after that to check for ruptures.

Breast implant removal is indicated in the event that either type of implant ruptures.

The biggest disadvantage associated with saline breast implants is how they feel to the touch — like a water balloon. Placing the saline implant behind the chest muscle and slightly overfilling it may make it feel more natural. Discuss this with your surgeon if you are considering breast augmentation with saline breast implants.

Saline implants may also be more likely to show ripples or wrinkles than silicone gel-filled implants, especially in women with thin skin and very little breast tissue. This occurs when the saline interacts with the implant's elastic silicone polymer shell.

Saline Breast Implants Cost

Breast augmentation with saline implants costs approximately $1,000 less than breast augmentation with silicone gel-filled implants. There are many reasons for the difference in price, including the cost of the implant-filling material. In general, the cost of breast augmentation with implants ranges from $5,000 to $15,000. Your choice of implant filler — whether saline or silicone — is just one of the factors that affect the overall cost.

Discuss the benefits and risks of saline versus silicone breast implants with a board-certified plastic surgeon during your consultation.

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    Ronald H. Schuster, MD

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    Joshua A. Greenwald, MD, FACS

    Greenwald Plastic Surgery
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    Arnold S. Breitbart, MD

    Arnold S. Breitbart, MD
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    New York, NY 10021
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