Dr. Adam Tattelbaum Reviews Silicone vs Saline Breast Implants
Rather than comparing and contrasting silicone implants Maryland and saline implants Maryland, which has already been done many times, I thought it would be more helpful to give my opinion on the subject. At this stage, about five years after the FDA allowed silicone gel implants back on the market and hundreds of implants later, here is my opinion- I like silicone gel implants.
As I strive to give my patients the most natural results, silicone wins hands down. Silicone implants have a softer and more natural feel. The gel in the implants gravitates toward the bottom of the breast giving a more gentle transition from the chest wall. For women with little natural breast tissue to camouflage an implant, silicone is the best tool we have. While we still continue to study longevity and contracture rates, in my opinion these implants are lasting longer and behaving better in terms of contracture compared to the last generation of silicone gel implants.
Even so, silicone is not always right for each patient and not always my first choice.
So when might saline be a better option? Here are a few examples:
1) The asymmetric patient: Silicone gel implants cannot have their volume adjusted. In a woman with asymmetric breasts I will sometimes use two different implants. This leads to subtle tradeoffs in the projection and diameter of the implant. The volume of saline implants can be adjusted in surgery, offering more flexibility in a woman with asymmetric breasts.
2) The patient trying to avoid a lift: Some patients have enough drooping of the breast that they may be candidates for a breast lift. Saline implants, particularly high profile, have more projection and fullness in the top of the breast. This upper pole saline fullness, while less natural looking, elevates more loose skin and can sometimes minimize or avoid the need for an additional breast lift.
3) The patient who likes that “implanty look”: While most of my patients want to look as natural as possible, some patients like that “implanty” look. While less natural, some consider it more sexy.
4) The apprehensive patient: Despite the safety studies that have been done, and approval of the new generation of these implants by the FDA, some patients continue to be anxious about silicone gel filled implants. It is important to me that I educate my patients about both options, but ultimately I want my patients to have the implant they are comfortable with.
5) Cost: On average, silicone gel implants cost about $1,000 more than saline implants. FDA guidelines recommend an MRI 3 years after surgery and every 2 years after that to evaluate the integrity of the silicone implant. While both silicone and saline implants will eventually require maintenance, for some patients the less expensive saline route is most appealing.