Many patients want to know, “What’s better – silicone or saline?” The answer is that it depends. Both silicone and saline implants have pros and cons. It’s important that the educated patient understands these differences before making an informed decision. Before delving into these differences, though, it’s important to state unequivocally that currently utilized silicone breast implants are safe. Over the past 15 years, many large and rigorous studies have been performed investigating whether silicone breast implants are associated with autoimmune diseases or any types of cancer. All studies performed reached the same conclusion; there is no conclusive data supporting any link between silicone implants and these diseases. Only after carefully considering these scientific studies did the U.S. Food and Drug Administration approve the use of silicone breast implants in all women for breast reconstruction and in women over the age of 22 years for cosmetic breast augmentation.
Some good things about silicone breast implants; breast implants filled with silicone gel look and feel more like natural breast tissue. Also, particularly in thin patients, silicone breast implants tend to have fewer problems with visible rippling than saline breast implants.
Some bad things about silicone breast implants; breast implants filled with silicone are more expensive. Silicone breast implants are approximately twice the cost of saline breast implants, which is factored into the price of surgery. Also, a breast implant rupture is easy to detect when the implant is filled with saline; the breast tends to deflate rapidly, in the span of a few days. A silicone breast implant ruptures is much more subtle to detect. For that reason, the Food and Drug Administration recommends an MRI to monitor for rupture, the first one 3 years after surgery, and then every 2 years thereafter. This test is expensive and most likely will not be covered by third-party insurers. Lastly, capsular contracture rates, or pathologic scarring around the implant, traditionally were much higher with the older generation of silicone breast implants. This does not seem to be the case with the newer generation of silicone breast implants used, which is largely attributable to a thicker implant shell and thicker, more viscous silicone gel within the implant.
So, what’s better? To repeat, silicone breast implants look and feel much more natural, but it comes at a higher financial cost, the recommendation for MRI monitoring to detect for rupture, and a larger incision. Despite this, with each passing year, more and more patients are opting for silicone breast implants.