Dr. David Stoker board-certified plastic surgeon in Los Angeles. A question our practice frequently receives is, “Are silicone gel breast implants better than saline?” The answer is it depends but usually yes. I certainly prefer the feel of silicone gel implants. We use the latest generation, highly cohesive model we nicknamed the Gummy Bear breast implant. They’re very popular, and probably 95 percent of patients in my practice will choose silicone gel implants based on their feel and longevity. However, saline implants are also useful. I’ve done thousands of them, and they are a good product. They don’t feel quite as natural as silicone gel implants. They are also more predisposed to rippling and deflating more often, which can result in more surgery. Some patients are anxious about silicone in the general concept. Saline implants are filled with the same type of fluid; it’s a component of every cell in our bodies. There’s little concern about the safety of those implants, but I might add that since 1962 so many breast implants have been performed. We have so many generations of implants out there. We’re still seeking more and more knowledge about breast implants; they’re more popular than ever.
Silicone Breast Implants
The main advantage of silicone implants is that they feel more natural than saline implants. Gel implants are less prone to rippling than saline, which makes them particularly advantageous for thin patients. The current generation of silicone implants is cohesive, meaning that the gel is viscous enough that even if the implant ruptures, the gel tends to remain in the same place. The cohesive gel implants are an important advance in implant technology.
Saline Breast Implants
Saline implants have a long record of safety and are less expensive than silicone gel implants. Because they are placed when they are empty and filled once they are inside the breast pocket, the access incisions may be even smaller. When a saline implant leaks, most of the saline from the implant is rapidly and harmlessly absorbed by the body. The deflation is usually obvious, and the patient returns for removal and replacement of the saline implant. This may be done under local anesthesia if the patient is an appropriate candidate. The primary disadvantage of saline implants is that they don’t look or feel as natural as silicone gel implants. This is a particularly important issue for women who are thin or have decreased elasticity of their skin.
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