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You Decide: Do Silicone Breast Implants Look Different Than Saline?

Silicone vs Saline breast implantsWhen women come in to discuss breast augmentation, one of the big decisions is whether to go with saline or silicone breast implants. This was not always a choice.

As most of you know, silicone implants were taken off the market quite a while ago (a decision most definitely not based on science — but don’t get me going on this!), but were approved for general use in November of 2006. Before I go any further, I must stress that there is nothing wrong with saline implants. If I thought so, I just wouldn’t use them.

Why I Like Silicone
I do like silicone implants, and if pressed I would have to say that they are better than saline. Does this mean that saline implants are a bad, or a poor second choice? Absolutely not, but placed side by side, in most cases I think silicone is a little bit better. And we have seen this with the increased selection of silicone breast implants by women since late 2006. Currently, the majority (as in 80%) of implants that my patients choose are silicone.

I believe there are several advantages to silicone. These are generalities and do not apply to all cases, but silicone implants usually last longer, are lighter, softer, and less likely to have rippling.

But, do they look better than saline? Good question.

Here’s my take, and I will ask for your corroboration on this: I would suggest to you that silicone implants look “more natural.”  By this I mean saline implants look slightly more obvious (more like implants and not naturally larger breasts). Certainly this is not true in all cases but generally, I think that saline implants look more round and are more visible in the upper portion of the breast, which is not how a natural breast looks. Silicone gives a more normal slope to the upper breast. Also, the rippling can be an issue with saline which you rarely see with silicone. Natural breasts don’t ripple. Right?

Which Looks Better? You Decide.
So should you take my word for which looks better? No. On my website there are about 32 photos of women with saline implants (before and after) and about 59 for silicone. (Watch out saline, here comes silicone.) They all look great. I just have a personal preference and you probably will too.

The great thing is that we have options. Some people only want saline, and others only silicone. Fortunately both are available. Have a look and let me know which you prefer.

By the way, if you or one of your friends are wanting to learn more about breast augmentation, our staff has written an informative and entertaining 37-page eBook called A Girlfriend’s Guide to Breast Augmentation. It’s a free download, so you might want to check it out.

All the best,

Dr. David B. Reath

David B. Reath, M.D.

20 Responses to You Decide: Do Silicone Breast Implants Look Different Than Saline?

  • Mireya says:

    Hi I’m thinking of getting breast implants. I’ve got two kids, I breastfed both. I was size 36b before I had my second child, and my weight is about 180 lbs. Now my breast seem smaller all my bras are loose from the cup. My question is if I get implants at my current weight will they look any different if I loose weight or vice versa? And wich would you recommend I want something natural looking and feel

  • David B. Reath, MD says:

    Thanks for your comment. Weight gain or loss will not affect your breast implants, but will affect the shape of your existing breast tissue. Sometimes this is an issue and other times not.
    In most people I prefer silicone implants as they look and feel more natural.
    All the best.

  • courtney says:

    Hi, I am 5’9 and very thin at about 135 lbs, two years ago I got saline implants of 450cc in the right and 430cc in left. The results I was initially please with but after 2 years I’m not to thrilled with the very round fake look I’m seeing in the mirror. I’d like to go back and switch to silicone in the hopes that I can not just add another 100 cc to each but that my results will leave me with a less obvious and very round appearance. I also have the issue of being able to feel the implants at the bottom of my breast, they feel like a plastic shopping bag you have filled with water when I run my fingers across the lower part of my breast. Can you feel the very noticeable outline of the saline implants at the bottom of the breast where it is not covered by muscle?

  • David B. Reath, MD says:

    Thanks for your comment. What you are feeling is fairly typical with relatively large saline implants especially in thin women. You will probably be more satisfied with silicone implants. In terms of adding more volume, this is something that you should carefully consider. The larger the implants, the more obvious they may be. But, silicone will almost always look better.
    All the best.

  • kayla says:

    Hi! I’m 15 and have severe assymetric breast. .. left is a DD right is a B.. I’m waiting for my surgery datell now and was wondering if I made the wwrong decision.. my Dr is going to reduce and lift the left on and put an expandable saline implantern in the right one along with a small lift.. we are aiming for a size between full c and full d.. do you think this procedure will end up looking natural?

  • David B. Reath, MD says:

    Thanks for you email. Without seeing you I cannot really comment on how you will look after your operation. However, the approach your doctor is taking seems reasonable.
    Sincerely yours,
    David B. Reath, MD

  • marqueta says:

    I am 30 years old about 5″7 and 136lbs. I’ve had my consultation with my plastic surgeon to have breast implants. I’m super excited but nervous at the same time. I’ve never been put to sleep before so that part has my nerves rattled. I’m also concerned about my recovery I’m active duty military normally how many days would I be out of work? My doc told me I could go back with 72hours of my procedure but that seems so soon. Thanks

  • David B. Reath, MD says:

    Thanks for your comment. Without knowing what your plastic surgeon’s surgical plans are, I cannot comment on your recovery. However, when I am putting implants beneath the chest muscle, I tell people to take about a week off. It can be a bit less if you are going on top of the muscle.
    All the best,
    David B.

  • racheal says:

    Hello im 24 5’4 and inbetween weigh of 120 and 125 im looking into getting my breast done iv had 4 wonderful babies but before them i had a great C cu and was against boob jobs but sence 4 and after breast feeding im so unhappy with the way i look im probably smaller then an A cup they look so gross to me i dont ever let my husband see them i went to a consul 2 days ago and what they offered didnt seem so real it looked the same in every try on even thou they said it was bigger it just looked wider i want to be a DDD the lady said but its only in silicone and that is what i want i want them to feel and look so real not fake and hard my main question is how bad is the pain going to be i have 4 babies i was told 3 days is thee worst my smallest us only 7months im a very loving mom i dont want 2 not be able 2 hold my babies for a whole month and what is best silicone right??

  • David B. Reath, MD says:

    Dear Racheal,
    Thank for your email. Most of my patients take a week off from work and I restrict lifting to nothing over 25 lbs. for two weeks. This is more for comfort than anything else.
    There will be some pain but usually people are doing well within a few days. If you are using large implants placed under the muscle, there can be more pain.
    All the best,
    David B. Reath, MD

  • racheal says:

    I do want larger then what iam now but i was once as big as i want if that does make sence my son is 25lbs.. although iam with my husband hes not much of help am i not going to be able to lift my baby into my truck? Also iv had 4 all natural labors very painful but after rest for maybe 4hrs i was up walking around perfectly fine do you think im going to be in more pain then that? I dont want to do anything to make them pop or end up healing wrong or something

  • Jeanne says:

    I am 57, 133 lbs a runner and I consider myself in good shape. On Dec 1st I had a mastectomy on my right breast. I just finished my last expansion before surgery in May to insert the implant. I am very torn between Saline or Silicone. My wonderful plastic surgeon gave me a lot of info to read up on. He recommended Silicone…just more natural. I do not know of anyone who has implants. The thought of having MRI every 2 years sounds costly. Help…???

  • David B. Reath, MD says:

    Thanks for your question. In post-mastectomy reconstruction silicone implants are absolutely superior to saline. I would not have any hesitation in choosing silicone. The original recommendation of the FDA to have frequent MRI’s no longer applies. They agree with plastic surgeons that there is no reason for an MRI unless a problem is suspected.
    You will have a much better result with silicone even more so than if you were just having a breast enlargement.
    And, silicone is as safe as saline.
    All the best,
    David B.

  • Alyssa says:

    Hi I had saline implants under the muscle. The surgeon had some complications putting in the left breast implant. After the procedure that implant just didnt heal right and the right breast is so nice and firm. I chose the 600cc for saline. I have gone to my PS and advised him of my left hurting more and its smaller. The breast feels really loose like the implant deflated. Its about half a cup smaller than the other breast. The doctor said I had more fat on the right breast that is why its bigger. Do you think that is true? The left breast is smaller so if each implant is 600cc wouldnt the breast be fuller and even firmer on the smaller breast? What is your opinion? I am 2.5 months post up. I was flat chested before the surgery. I want silicone so bad but just dont know what to do. I stand 5’9 weight 200 pounds.

  • David B. Reath, MD says:

    Thank you for your comments. Without seeing you it is impossible for me to give you and idea of what may be going on.
    I hope you get a good resolution to your concerns.
    All the best,
    David B. Reath, MD

  • Sherry says:

    My saline implants look great but they are now 20 years old. I am concerned one is going to blow any day. Is it best to pursue a new set (possibly silicone) before the ultimate happens?

  • David B. Reath, MD says:

    Thanks for your question. There is no right answer to your question. However, if you are considering switching from saline to silicone, this may be something that you would want to pursue now. Your saline implants are probably getting close to the end of their lives, but they could also last for for one to several years. If you want to be proactive, it might well be a good idea to look into having them replaced.
    All the best,
    David B.

  • Joanna says:

    Hey there, I am a 32 year old mom of 3, 2 of them being twins I had 2 years ago. Over the last year I have lost almost 40 pounds. I am 5’6 and 145 lbs now, I have worked like mad to get to this weight but my poor breasts have taken a toll. I used to be a full 38 DD before weight loss but am now a 34 D-C, the main problem is how my breasts have completed deflated from weight loss, I still have a lot of my own breast tissue but excess skin, when I pull the skin up as if I were to get a lift, it looks like my breasts would only be maybe a B cup, so the volume has dramatically decreased, I dance a lot and lift weights. What would you recommend for me? Lift + Implants? Just implants to fill them out again? I am new to all this and want to head in the right direction.

  • David B. Reath, MD says:

    Thanks for your comments. Without seeing you I cannot give you specific advice. But if you have a lot of loose skin you will most likely need a lift and implants. Using implants alone will just give you larger, sagging breasts. So I would advise going with a lift.
    Best of luck,
    David B.

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