The Great Debate: Saline vs. Silicone

You have made the choice to undergo a breast augmentation. Now, you must decide, saline or silicone? Often a difficult decision, there are a number of factors to consider. We are here to help! The following are commonly asked questions as to the great debate: saline or silicone.

The Basics

Saline and silicone implants are both encased by an outer silicone shell. Implants differ in material and consistency. Similar to the fluid that makes up 60% of our bodies, saline implants consist of a salt water solution. Silicone implants are made up of a cohesive gel-like substance.


Both implants can be inserted through an incision made under the breast (inframammary), just below the nipple (periareolar) or, in the armpit (transaxillary). Dr. Benien will carefully and discreetly place the incision—however, filled post insertion, saline implants allow for a smaller incision.

Saline implants look more natural when placed under the muscle (submuscular) not above (subglandular). With silicone, the implant can be placed under or above the muscle. Submuscular placement is usually the better option for larger implants. For both, when placed under the muscle, the chance of capsular contraction (hardening of the implant) is less likely.

Character: Look, Shape, & Feel

Many patients feel that silicone implants offer a more natural look and feel as they more closely mimic the feel of human breast tissue. Silicone implants are ideal for patients who have a smaller frame and naturally small breasts. Patients with a decent amount of natural breast tissue can provide better coverage, camouflaging a saline implant.

Women often feel that silicone implants look slightly less obvious than saline implants. Saline implants can look more round, especially visible in the upper portion of the breast. Being cohesive, silicone creates a tissue-like uniformity, giving the implants a more natural looking slope and contour.

Some patients like the predictability that silicone has—as the implant is prefilled, a set volume allows for predetermined results. In comparison, saline implants give Dr. Benien the ability to adjust your implant size during sugery to specially meet your augmentation goals.


Saline and silicone implants have proven to be equally safe and durable. We are often asked, “What happens if my implant ruptures?”. As per a rupture, no health risks have been associated in either saline or silicone implants.

Saline: Available to women 18 and older (for both augmentation and reconstruction) Silicone: Available to women 22 and older for augmentation, 18 for reconstruction.

A rupture in a saline implant will be more apparent as the rupture will cause the implant to deflate—changing in size and shape. With silicone implants, a rupture is not always as obvious. Known as a “silent rupture”, the shape and form of the implant does not always change. With silicone implants, the FDA recommends getting an MRI every two years to ensure proper implant health. In the rare case of a rupture, it is advised to have the implant removed.

It is worth noting: if you are concerned with breast disease, submuscular placement allows for easier and more accurate mammogram interpretation.

Augmentation with Dr. Benien

As you can see, there are pros and cons to both types of implants. As a board certified cosmetic surgeon, Dr. Benien can offer expert advice as to which implant is best suited for you and your body’s needs. Considering Implants? Schedule a consultation at Cosmetic Surgery Center.