In the United States, each woman over the age of 22 can make the decision on what type of breast implant they would like used in their primary breast enhancement or breast augmentation surgery. The difference between the two types of implants is what they are filled with, as the shells around the implants are nearly identical. Both saline and silicone breast implants look the same when placed in the same implant pocket in the breast. The difference mainly is the feel of the implant when it is in the breast: silicone implants feel more natural as compared to saline which feel somewhat artificial especially when they are placed above the muscle and/or have minimal breast coverage over the implant. This is accentuated in the thin female with small breasts who requests large size implants because the tissue overlying the implants can thin over time. Breast implant rippling can occur in both saline and silicone implants, and is not related to what is inside the implant, but more related to the amount of scarring around the implant (capsular contracture) and/or the amount of breast tissue covering the implant and its surrounding capsule. Rippling is common in the thin female with sub-glandular implants because of the limited amount of coverage around the implant. Both implants have relatively similar amounts of scarring around the implants over time and equivalent rupture rates. They do not need to be changed out after ten years, but the breast implants should be monitored by the plastic surgeon for any change in the look and feel of the breast implants. A saline breast implant rupture or deflation is relatively easy to identify as there will be a loss of volume over a short period of time. A silicone implant rupture can be very quiescent and sometimes only identified on an MRI.
Saline breast implants are relatively cheaper than silicone implants with a one thousand dollar difference in implant price for a pair, as well saline breast implants can be placed through a smaller incision because it is inflated inside the body.
The decision regarding breast implant type and size is an individual process that should be discussed and agreed upon between you and your plastic surgeon. Dr. Trussler will spend the time to ensure that an individual decision is made regarding your breast implant and breast augmentation surgery.