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How To Choose The Right Breast Implant Type

Once you’ve decided to undergo a breast augmentation, you will need to decide on the type of breast implant you want. But what types of implants are available?

There are basically two choices: saline or silicone implants. The filling inside each is different, giving different results, although they both have an outer silicone shell. There are also different options for manufacturer, texture, and shape.

It’s enough to make your head spin, so on this page, we’ll do our best to explain all the options. Then, hopefully, you’ll have all the information to need to choose the right type of implant for your goals.

Filling – Saline vs Silicone

Saline implants are filled with sterile salt water. That’s the same fluid found in IV bags. The implant is inserted empty and filled once they’re in place. 

If a saline implant happens to rupture, it will deflate, but your body will safely absorb the saline solution. Saline breast implants are available to women age 18 and older, or at any age for breast reconstruction.

The main pros of a saline implant is that the incision is smaller for saline implants (so less scarring), and they also cost less than silicone breast implants. 

One downside, though, is that thinner patients might notice folds of the implant underneath very thin skin (visible wrinkling if you will). Plus, the resulting shape and feel is somewhat less natural than their silcone counterparts.

Silicone implants come pre-filled with silicone gel, which is similar to the feel of human fat. If there’s a leak, which is very rare, the gel will likely stay within the implant shell or leak just outside of the shell. Patients must be 22 years of age or older to get a silicone breast implant, although age doesn’t matter for breast reconstruction.

Silicone or gel-filled implants tend to look and feel more natural, which is why I prefer them. They’re also softer than saline implants.

However, like any procedure I perform, everything is based on the individual. For example, silicone works well on a woman with little or no breast tissue, simply because it’s much harder to hide saline implants in a patient with minimal breast tissue.

Yet, if a patient wants a bigger bulge up top to look more “implanty” (and some do), saline will accomplish this.


There are multiple manufacturers of breast implants but for our purposes on this page, I will focus on the four that are FDA approved in the US.

Mentor and Allergan are the oldest and most competitive. Both make good implants, including saline and silicone, and have been doing it for decades. Sientra is a newer company that only makes silicone. 

The Ideal implant is also a newer implant, which is only saline. I might consider the “Ideal” implant in a patient who is very slender with little natural breast tissue who wants saline. The “Ideal” implant is a “structured saline.” It has internal layers called baffles to help minimize rippling. Because of how it is constructed, it costs more than most implants.

All of these companies go through rigorous safety testing in order to achieve FDA certification, so you can be confident, whichever your choice. In my practice, we mainly use Mentor, but all are good.


All implants can have a smooth surface or a rough surface known as “textured.” Some doctors feel that textured implants may break up the scar tissue around the implant leading to a lower risk of scar tissue tightening (capsular contracture). 

There is good evidence that this may be the case when implants are placed above the chest wall muscles (sub-glandular) but does not seem to make a big difference when implants are placed below the muscle (sub-muscular), which I prefer due to the more natural appearance.

There is a concern that textured implants may lead to a low-grade tumor (ALCL). Fortunately it is rarely seen, but nonetheless it is a mark against them.


Breast implants can be a round or teardrop shape. 

All teardrop implants must have a texture so that the implants sticks internally in the correct position. As a result, if a teardrop implant turns, as sometimes they do, they will look funny. If a round implant turns, no one will know the difference.

I prefer smooth-round implants at my practice. They do not stick on the inside and they move within the breast. I feel this provides a more natural appearance.

Furthermore, round silicone implants take on a teardrop shape anyway, but even if they rotate internally, the teardrop will always be in the right direction.

How To Decide

With so many choices, it can be hard for patients to choose between the different types of breast implants. 

Hopefully you’re now familiar with the options available, and this will help you with your decision. But if not, don’t worry – that’s where your surgeon comes in! 

At my practice, we will help to guide you through the maze of implant options based on your specific goals, body, and starting situation. We even have examples of each type of breast implant that you can touch and feel, which can really help when weighing up the options. Get in touch today to get started.

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