Breast Implants

Saline, Silicone, or the IDEAL IMPLANT – How to Choose?

When preparing for a breast augmentation or breast reconstruction procedure, one of the most central decisions to be made concerns breast implant type. It can be a controversial question – saline versus silicone – but ultimately the choice comes down to patient preference and body type. 

What’s the difference? 

Saline implants consist of an outer silicone shell and sterile saltwater filler. The implant is inserted into the body empty and inflated with the water solution once in place. Filling the implant during the operation provides the physician with a greater ability to achieve symmetry, for both single and bilateral implant procedures. However, a common criticism of saline implants is their water-balloon like feel. Should the implant rupture, the water solution is absorbed safely into the body. The rupture will also be immediately apparent, prompting either removal or replacement of the implant in question. 

Silicone implants are made of both a silicone outer shell and inner filling. The silicone gel filling is a thick substance intended to provide the breast a more natural look and feel. Silicone implants are pre-filled and therefore require a larger incision than most saline implants. In the event of an implant rupture, the gel is typically caught in the surrounding tissue. For this reason, silicone implant ruptures are not always obvious and are known as silent ruptures. However, silicone gel is not known to be harmful or cause any long-lasting health problems. Nonetheless, the Food and Drug Administration recommends that women with silicone breast implants undergo MRI scans every two years, beginning the third year after surgery. 

A new implant on the market, the FDA approved IDEAL IMPLANT, sought to combine the natural feel of silicone with the rupture awareness of saline. The IDEAL IMPLANT is composed of a series of shells and chambers, which are filled with saline solution. Like other saline implants, the IDEAL IMPLANT is inflated during surgery. Thanks to its complex structure, the IDEAL IMPLANT looks and feels more like a more traditional silicone implant. 

Risks Associated with Breast Augmentation or Reconstructive Surgery

As with any surgery, risks are present when undergoing either breast augmentation or breast reconstruction procedures. Some of the most common risks or complications include, breast pain, infection, changes to nipple and breast sensitivity, implant leakage, implant rupture, or capsular contracture. Capsular contracture refers to an accumulation of scar tissue around the implant, which can affect the look and feel of the implant as well as cause breast pain. 

How to decide? 

Ultimately, the decision must be based upon personal preference and the physician’s recommendation based upon body type.  For example, silicone implants are favored for patients with limited fat and soft tissue in the breast, a typical characteristic of post-mastectomy individuals. In contrast, for women who begin with C cups, saline, silicone, and the IDEAL IMPLANT will yield good results. 

Finally, cost can be a factor as saline implants are typically less expensive than their silicone or IDEAL IMPLANT counterparts.  

Whichever option is ultimately chosen, it is most important that the patient has realistic expectations for her new body contour.  Understanding the risks as well as the final results is paramount before beginning any surgery. The main goals, as always, are patient safety and satisfaction.