Are you interested in breast augmentation surgery but don’t know where to start?

Once you have decided on surgery, you want to be informed about the process and the choices available to you! One of the biggest choices is deciding which type of implant you need, silicone or saline implants. They each have their own unique pros and cons based on durability, look, and feel.

When choosing breast augmentation surgeons, experience and technique are vital to your outcome. Dr. Steven Goldman is a triple-board-certified plastic surgeon located in Ohio. During your initial consultation, Dr. Goldman will discuss the best breast implant options for your individual needs based on breast size and body type.

Saline vs. silicone implants

Saline and silicone implants have important differences in look and feel. Saline implants are more densely filled, giving them a firm, full look and feel. Whereas silicone implants are more pliable, yielding a softer, more natural look.

Before we dive deeper into their differences, there are several things that saline and silicone implants have in common.

Similarities between saline and silicone implants

Silicone and saline implants share several similarities. Neither are lifetime devices. Implants can last for many years, but the lifespan of any individual device is unpredictable. It is a myth that implants have to be replaced every ten years. The 10-year leak rate is less than 15% in most studies. Saline implants do have a higher leak rate but are easier to follow for leaks. Both types of implants are encased with a silicone shell.

Additional commonalities include:

  • FDA approved – Both silicone and saline implants have received FDA approval, but the age guidelines differ (more on this in the next section).
  • Customization –Customization options are available for both types of implants, allowing patients to choose the size, profile, and shape that best suits their needs.
  • Durability – Both implant types feature an outer shell made from silicone that offers a lifespan of many years. A small percentage of patients have had implants that last 30 years or more, but accurate data regarding long term leak rates is lacking.

Saline Implants

Saline breast implants are made with a silicone outer shell and are filled with a sterile saline solution. Think of them like water balloons. Saline implants are filled by the surgeon during surgery. Although saline implants do have a recommended fill range, they should generally be filled to the top of this range.

Advantages of Saline Breast Implants

  • Easy to detect a rupture.

Implants are not lifetime devices. All implants will eventually leak if they do not require replacement for other reasons, like a desired size change, for instance. Most leaks occur through tiny pinholes that develop at stress points on the implant shell that form over time.

If a saline implant leaks, the body simply absorbs the salt water, and the patient notices deflation (generally within hours), as the breast volume decreases. When you notice this, call Dr. Goldman for a replacement.

  • Smaller incision

Unlike silicone implants that come pre-filled from the manufacturer, saline implants come as empty shells. The surgeon inserts the shell in the breast and then fills it with saline. As such, saline implants don’t require a large incision size.

Note: We should point out that scar sizes also depend on other factors. For instance, if you want a breast augmentation and a breast lift, the scar will be the same regardless of the type of implants you choose.

  • A rupture has fewer risks

The sterile salt water or saline used to fill the saline implant is a neutral fluid. So, in the event of a saline implant rupture, the body will absorb and remove the saline safely. With silicone gel breast implants, the body cannot absorb the silicone in case of a leak.

Although there is no evidence of silicone toxicity in scientific studies, patients who have leaking silicone implants left in place over time will likely develop capsular contracture (thickening of the scar tissue envelope that surrounds any implant).

  • Available at younger ages

Breast implants have age restrictions. For silicone gel implants, the FDA only approves patients above 21 years of age, but the age limit for saline-filled implants is 18.

Disadvantages of Saline Implants

  • Higher risk of rippling

All implants have some rippling, or gentle repetitive waviness, to their outer shells. This is not always noticeable from the outside but is more likely to be felt or seen in patients who have thin tissues or a small volume of tissue. Importantly, rippling is more noticeable in saline implants. Rippling is far more noticeable when implants are placed on top of the pectoralis major muscle.

  • May not be suitable for women with little natural breast tissue

In general, women, with a small amount of breast tissue, with thin, inelastic tissue, and women who want very large implants are less likely to be good candidates for saline implants. This is because the implants will tend to be more visible, potentially have more rippling, and potentially look more fake than a softer silicone implant.

Conversely, patients who have a significant amount of dense tissue, and want to look at augmented or small implants, may actually benefit more from saline implants.

  • Higher risk of downward displacement

Gravity affects breast implants causing downward displacement, especially over the long term. This can lead to bottoming out when the implant pushes below the natural inframammary fold. When severe, this can cause a double bubble deformity, in which the implant causes a visible bulge under the fold

Silicone implants

Advantages of Silicone Breast Implants

  • A more natural look

This is the main reason patients often prefer a silicone implant. They blend with the breasts’ natural shape, creating a more natural look.

Saline implants create a rounder look, while natural breasts have a teardrop shape. As such, saline implants are often more noticeable. Some patients do prefer the more augmented look of saline, but more do choose silicone for a softer, more natural look.

  • A natural feel

Silicone implants both look and feel more natural than saline. They also are less likely to show rippling. They maintain in a more teardrop-like shape, even when rounding plants are used. So, patients who want to look and feel more natural will often choose silicone.

  • Asymptomatic leak

Breast implants are not lifetime, permanent devices. Leaks are inevitable if patients do not replace their implants because of the desire for size change or other reasons. Although silicone does appear to have a slightly lower leak rate than saline implants do, leaks are easier to detect in a saline implant because of deflation.

However, for most patients with silicone implants, initial leakage is asymptomatic. As such, the FDA recommends MRIs to follow for leaks periodically, starting a few years after surgery for patients with silicone implants.

There is no evidence that silicone is toxic, but because silicone cannot be absorbed by the body, leaking silicone implants should be replaced.

Gummy Bear implants

Advantages of Gummy Bear Implants

  • Silicone gel implants

Newer silicone implants contain silicone gel that is more cohesive, meaning it tends to stick to itself. This produces a denser silicone that is similar to a Gummy Bear texture. Older implants were more similar to a loose, Jell-O-like texture.

Gummy bear implants ripple less, feel firmer, and may have a lower leak rate long-term


  • Silent ruptures

When you come for a consultation, Dr. Goldman will help you choose the best implant size. The sizes are based on filling volume and are measured in cubic centimeters. They come filled and sealed by the manufacturer hence little flexibility compared to saline implants.

The choice of silicone versus saline implants is just one aspect of choosing the ideal breast implant treatment plan for you. What specific implant is used, to some degree, matters less than how the implant is placed.

To help you get the best possible results from your breast augmentation, Dr. Goldman will help you decide which implant is best for you and whether any additional procedures, like a breast lift, may be needed. There are also important aspects regarding how the subpectoral pocket is best designed that he will clarify and explain to you.

Which will work for you?

Ultimately, the best way for a patient to choose the ideal implant for you is to consult with Dr. Goldman.

Patients seeking breast augmentation surgery in Ohio should schedule a consultation with Triple board-certified Plastic Surgeon – Dr. Steven Goldman to discuss the types of implants available and the surgical procedure that best suits the patient.

Dr. Goldman will discuss your specific aesthetic goals and evaluate your individual physical characteristics to help you choose not just the best implant for you, but also the ideal overall surgical plan to obtain the best results. He will also discuss long-term concerns, possible revisions, risks, and benefits of breast augmentation.

There is no better way to evaluate a doctor than to meet them in person, in consultation. But before this, reviewing their credentials and their work is essential. Reviewing before and after pictures has become essential in researching plastic surgeons. The photos on our site show that Dr. Goldman’s results are second to none, which is why patients come from all over the Midwest, and nationally to see him.

Call to schedule a consultation today at 216-514-8899.