In the United States and Canada, women, generally, only have one option when it comes to choosing a breast augmentation implant: saline. Generally, a gel implant is only available on a limited basis, usually medical necessity. In European and other countries, however, women are free to choose whether they would prefer a saline or silicone breast implant. There are pretty significant differences between the two, and any woman making a choice should be aware of them.

Look

Many plastic surgeons believe that a breast augmentation implant filled with saline does not look as natural as a silicone-filled implant. Silicone allows the augmented breast to settle and sag a little more naturally than saline does, meaning the augmentation can look a little more natural. Sometimes, a saline breast augmentation implant can actually be seen beneath the skin. Nothing makes a breast look more fake than the sight of an implant rubbing against skin. However, advances are being made that allow saline implants to look more real.

Feel

Surgeons also believe that a saline implant feels less real than a gel implant. Silicone gel has a texture similar to that of natural breast tissue. A saline breast augmentation implant does not feel as soft. Advances are being made that allow saline implants to feel more real.

Size

A woman can get a silicone breast augmentation implant in any size she wants; saline only comes in sizes up to 850cc. Beyond that, the silicone implant will have to be custom-made. However, saline implants have the advantage of being adjustable during surgery or after surgery.

Maintenance

Both types of breast augmentation implant will need to be replaced within seven to ten years if not sooner. Women with gel implants may have to undergo regular MRI screening to detect leaks and ruptures.

Safety

Generally, saline implants are thought to be safer than silicone implants. This is because when saline implants rupture, it is immediately obvious as the implants rapidly deflate, and the saline is simply absorbed into the body like water. Silicone, on the other hand, has to be removed from the body and may cause several autoimmune and rheumatological diseases. This is complicated by the fact that women won’t always know that silicone breasts have ruptured since there will not necessarily be a noticeable physical change. Neither type of breast augmentation implant has been shown to have any causal link to cancer. Regardless of whether the implant is filled with saline or silicone, it has the potential to interfere with mammograms and digital breast examinations. Women should always alert their physicians if they have breast implants prior to any type of breast exam.

Complications

Both a saline breast augmentation implant and a silicone gel implant will rupture. Saline implants seem to rupture more often than gel implants, but the rupture is easier to detect and remedy and is less likely to cause health problems. Capsular contraction is also a concern for both types of implants, and, again, saline implants seem more likely to harden than silicone. Further, saline implants are more likely to calcify (develop calcium deposits that can resemble cancerous lumps), but textured saline implants have decreased the likelihood of calcification.

There are many decisions to be made when undergoing breast augmentation surgery, and for some women choosing an implant is one of them. When deciding on a type of a breast augmentation implant or making any other surgical decisions, women should always do some independent research and consult with their physicians.

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