Silicone vs. Saline
Breast implants are silicone shells filled with either saline, which is a sterile salt water solution, or silicone gel. Both implant types are very safe, and each offers its own advantages. Your doctor will help you decide which kind is right for you. During surgery, the implants will be placed within each breast, underneath either the breast tissue or the chest wall muscle.
Differences in Texture
Silicone gel-filled breast implants may provide a more natural feel and are therefore the implant choice of many patients. The United States Food and Drug Administration (FDA) approved silicone breast implants for breast augmentation surgery after rigorously testing their safety. The texture of silicone gel-filled breast implants is much closer to that of actually breast tissue than saline implants.
Silicone is also beneficial because it helps to create and maintain a full, well-rounded shape for the breasts. It is generally the preferred type of implant for women who are thin and may not have a lot of natural breast tissue and those opting for an implant that is situated above the muscle of the chest wall. Silicone implants are frequently the best option for women undergoing a breast reconstruction procedure as well.
Saline implants may appear somewhat less natural than silicone as they can produce a rippling effect at the surface of the skin. This is typically not a problem for women who have a larger quantity of breast tissue or for those having the implant placed below the pectoral muscle where any creases will not be visible.
The choice of a silicone implant will necessitate the surgeon making a slightly larger incision than what is necessary for a saline implant. That is due to the techniques used for the implant placement. Silicone implants are measured and filled prior to surgery, so the implant is placed at its full size. In contrast, saline implants are placed as empty shells that are filled by the surgeon once they are in position, so the incision used is smaller. However, with both types of implants, the incision will be made as inconspicuously as possible and any resultant scars will fade over time.
Leaking and Ruptures
Another factor to consider when deciding between silicone and saline is the possibility of a rupture. Both types of implants can rupture and begin to leak eventually. The saline or silicone gel implant filling may leak out through a damaged valve or through a rupture in the implant shell. A leakage may drain the implant immediately or over a longer period of time.
An advantage of saline breast implants is that, if ruptured, the leaked saline is harmlessly absorbed by the body. Leaked silicone gel typically remains within the capsule around the breast implant but is not absorbed into the body. Because the filling is thicker, silicone gel implants are prone to "silent rupture," during which the patient may not realize her implant is leaking. For these reasons, it is important to undergo regular follow-up exams with a physician to check that the implants are intact. If an implant of either type ruptures, surgery is required for the removal and optional replacement of the implant.