By Dr. Karen Singer
Breast augmentation is a highly personalized procedure — and one of the most important decisions patients make is choosing between saline and silicone implants. While both are safe, FDA-approved options with excellent outcomes, they differ in feel, appearance, and maintenance considerations. Understanding these differences helps patients make confident, informed decisions during consultation.
What All Breast Implants Have in Common
Both saline and silicone implants use an outer shell made of silicone and share similar potential risks such as capsular contracture, infection, pain, changes in sensation, or rupture — sometimes requiring revision surgery.
There is also a rare association with breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), particularly with textured shells.
Implants are not lifetime devices, meaning ongoing follow-up and possible replacement are part of long-term care planning.
Saline Implants
Saline implants are inserted as an empty silicone shell and filled with sterile saltwater after placement.
Advantages
- Smaller incision placement because they are filled after insertion
- Adjustable volume during surgery for symmetry and customization
- Easier rupture detection — the implant quickly deflates and is noticeable
- Generally lower cost than silicone options
- Leakage involves sterile saltwater that is absorbed by the body
Considerations
- May feel firmer or less natural than breast tissue
- More prone to visible rippling under the skin
- Some patients report movement or “sloshing” sensation
Saline implants are FDA-approved for augmentation in patients 18 and older.
Silicone Implants
Silicone implants come pre-filled with cohesive silicone gel designed to mimic natural breast tissue.
Advantages
- Typically look and feel more natural
- Less rippling and smoother contour
- Maintain shape if the shell ruptures due to cohesive gel structure
Considerations
- Require slightly longer incision placement
- Ruptures may be “silent,” without visible changes
- Imaging (MRI or ultrasound) is recommended to monitor integrity
Silicone implants are FDA-approved for augmentation in patients 22 and older.
Importantly, research has not found an association between silicone implants and breast cancer, connective tissue disease, or reproductive problems.
How Dr. Karen Singer Guides Patients
In my practice, implant selection is never one-size-fits-all. Each consultation focuses on aligning implant choice with:
- Body proportions and tissue characteristics
- Desired look and feel
- Lifestyle considerations
- Comfort with monitoring and maintenance
Some patients prioritize the natural feel of silicone, while others appreciate the adjustability and simplicity of saline. My role is to provide education, assess anatomy, and help each patient select the option that best fits their aesthetic goals and medical profile.
Breast augmentation today is about balance, proportion, and confidence — not simply volume. With modern implant technology and individualized surgical planning, both saline and silicone implants can deliver beautiful, safe, and satisfying results.
Final Thoughts
Choosing between saline and silicone implants is a personal decision rooted in priorities around feel, appearance, incision size, and follow-up requirements. With proper consultation and ongoing care, both options offer reliable, effective solutions for breast enhancement or reconstruction.
If you are considering breast augmentation, a thorough discussion with a board-certified plastic surgeon ensures you understand every aspect of your options — and feel empowered throughout your journey.
