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Silicone versus Saline Implants for Breast Augmentation

One of the many decisions a patient must make when they are considering breast augmentation surgery is the type of device they will have implanted. As outlined on our Breast Augmentation page, there are two main choices: saline and silicone.

There are several differences between the two types of implants:

  • Saline
      • Filled with saline liquid
      • Require a smaller skin incision (scar) to place because they are filled with saline after they are implanted
      • May loose volume or deflate if they fail, making one breast suddenly smaller than the other
      • May also be more prone to ripple along the edges, creating visible ripples on the breast
      • Tend to be firmer than silicone implants
  • Silicone
    • Filled with cohesive silicone gel
    • Require a larger skin incision (scar) to insert under the breast because they come pre-filled
    • Can have rupture of the device that is not noticeable on the outside of the breast, therefore imaging with MRI for screening has been recommended by the FDA
    • Less likely to ripple compared to saline devices, but may be more likely to have thickening of the scar tissue that the body naturally forms around the implant (capsular contracture)


Some patients ask if there is a difference between breast size and/or shape when one implant type is used compared to another. Until recently, Plastic Surgeons guessed that there was not difference. I had the pleasure of working on a project which focused on answering this question and was recently published in the European Journal of Plastic Surgery. The paper, titled “Comparison of long-term changes in breast surface measurements after augmentation mammoplasty: silicone versus saline implants,” tested the short and long-term changes in breast measurements after breast augmentation with both saline and silicone implants. Interestingly, we found that at early time points (one week and one month after surgery), the silicone implants tended to have an increased effect on the outer measurements of the breast. However, by four months and one year, this difference was not present and both saline and silicone devices of similar volumes produced similar long-term increases in the size and shape of the breast.

So, whether you’re leaning toward saline or silicone for your augmentation, rest assured, they have a similar effect on the overall size of the breast. This is only one of the many factors that need to be considered when choosing an implant. So be sure to spend plenty of time researching the options and discussing them with your Plastic Surgeon who specializes in breast procedures and breast augmentation.

About the Author

Ergun Kocak

Dr. Ergun Kocak, MD, MS, is a board-certified plastic surgeon who specializes in plastic and reconstructive surgery of the breast using DIEP, SIEA GAP, TUG, PAP, and direct-to-implant, in Columbus and Cincinnati, OH.
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