When it comes to breast augmentation, which involves breast implants, there are actually two types to choose from: saline and silicone.

While they achieve a similar look and are both approved by the Food and Drug Administration, there are pros and cons of both types of implant materials.

This article will discuss the similarities and differences between saline and silicone breast implants to help you decide which type is right for you.

Saline implants have been used since the 1960s. They have an outer shell made of silicone, but the shell is inserted empty. It’s then filled with sterile salt water, which means the incision site is often smaller and less noticeable. Saline implants are typically a bit less expensive than silicone.

A drawback of saline is that some report that they’re more easily seen under the skin (often causing rippling) and you may feel water sloshing.

Some people say that the saline implants feel more firm than natural breast tissue, and they can sometimes be overfilled to avoid rippling or wrinkling of the implant.

Baffled saline implants have water dispersed in separate chambers, which makes the water move less quickly and may reduce some of the sloshing and the rippling. Saline implants are available to those age 18 and older.

Silicone implants are made fully of silicone, a synthetic material that feels similar to human fat. The implants have a silicone case filled with a silicone gel.

They come in a variety of sizes and shapes. Some silicone implants are more cohesive, or firmer, than others. These are sometimes referred to as “gummy bear” implants.

You and your surgeon can work together to pick the right option for your desired shape and size.

Many people think that silicone implants look and feel more natural, however, they do pose more of a risk if they rupture.

Manufacturers recommend checking for ruptures every few years through MRI. If you choose to have silicone implants, talk with your doctor about scheduling these screenings and how often you should have them.

You have to be at least 22 years old to get silicone implants, except in special circumstances like breast reconstruction. It’s important to note that while it’s actually legal to get silicone implants under the age of 22, many implant manufacturers will not honor warranties in younger patients.

Both saline and silicone implants are generally considered safe if your breast augmentation surgery is performed by a reputable, board certified surgeon.

Some believe that saline implants are safer because if the implant ruptures, most of the salt water will reabsorb into the body. Plus, with saline implants, you’ll know right away if it bursts and you can immediately take precautions.

While the research on this is mixed, some studies have seen a correlation between silicone implants and autoimmune diseases, such as rheumatoid arthritis and lupus. Both saline and silicone implants have silicone shells, so if you have an autoimmune disorder, you may want to avoid implants entirely.

Some experience a range of medical problems collectively called breast implant illness (BII). The symptoms range from fatigue to chronic headaches and brain fog, aches, pains, and gastrointestinal symptoms.

While there’s no definitive evidence that breast implants cause BII, many patients anecdotally report that removal of their implants makes them feel better.

There’s some correlation between a blood cell cancer called anaplastic large cell lymphoma (ALCL) and certain types of breast implants, primarily textured or rough surface implants. Breast implant-associated ALCL is typically detected 8 to 10 years after the implant is placed.

Both saline and silicone implants can rupture or cause complications. Here’s what to look out for with each implant type if you suspect it has ruptured.

Saline

  • You’ll likely notice a saline rupture right away because the breast will look and feel deflated.
  • Saline is sterile and will be reabsorbed by the body.
  • You’ll likely need surgery to remove the silicone shell. During the removal surgery, the doctor can add a new implant.

Silicone

  • Silicone ruptures are more difficult to detect, as the silicone can get trapped in the fibrous capsule that forms around the implant after surgery.
  • This is sometimes known as a silent leak, but you may notice a slight change in breast size or feel a hardness.
  • If left alone, leaking silicone can cause breast pain or cause the breasts to change shapes.
  • You’ll need surgery to remove ruptured implants, during which a new implant can be inserted if you’d like.
  • On average, breast implants last about 15 years before rupture.

In most cases, breast implants are considered elective cosmetic surgery and aren’t covered by insurance. Implants are also not always permanent, and many people need to get them replaced or removed.

Silicone implants are more expensive than saline

Breast implant surgery can cost as much as $12,000, and silicone implants are around $1,000 more expensive than saline. You also have to consider the cost of follow-up MRIs, which are recommended every few years to make sure silicone is not leaking into the body.

Neither are guaranteed permanent options

Neither saline nor silicone are guaranteed permanent options. Up to 20 percent of people have their breast implants removed or replaced within 8 to 10 years, either because of ruptures or for aesthetic reasons. In most cases, removal surgery won’t be covered by insurance.

It’s always important to find a reputable, board certified plastic surgeon to perform your surgery. You can use this tool from the American Society of Plastic Surgeons to find a reputable doctor near you.

During your initial consultation, it’s a good idea to ask to see before-and-after photos of the surgeon’s previous patients. You and your doctor can work together to find the type of implant that’s best for your body and specific needs.

Saline and silicone implants are generally considered safe, though both have the potential to rupture which requires additional surgery to correct or remove.

Many find that silicone looks and feels more like a natural breast, however saline may result in a smaller scar since the implant casing is inserted empty, and then filled.

Always look for a reputable, board certified plastic surgeon who can help you decide whether saline or silicone implants are right for you.