Silicone Or Saline Breast Implants – Which Is Better?

Some surgeons recommend silicone breast implants because they feel that they are “more modern”.  However, in the case of breast implants, “more modern” does not mean better.  In fact many of the latest, most modern, silicone breast implants have been associated with Anaplastic Large Cell Lymphoma (ALCL) and Breast Implant Associated Illness due to silicone and heavy metal allergy or toxicity.  Some of the “more modern” silicone implants have been banned and all silicone gel implants are currently under review because of silicone and heavy metal allergy or toxicity.

Even though saline implants do have a silicone shell, they are filled with normal saline (salt water) and have not been associated with any of the above problems.  Saline breast implants are extremely robust and rarely rupture.  However, when they do rupture, it is only salt water that leaks into the body and so no harm is done.  The implant is usually easily removed and replaced.

On the other hand, when a silicone gel implant ruptures the silicone is often not contained within the fibrous capsule and migrates to the lymph nodes and other areas of the body.  In many cases it is impossible to remove all of the silicone gel after an implant has ruptured.

So there is no question that saline implants are far safer than silicone gel implants.

But what about the way they feel inside your body?

The answer is that, when breast implants are placed behind the pectoral muscle, for many women it is almost impossible to tell the difference between a silicone gel and a saline implant.  Just recently, I treated 2 women with leaking silicone gel implants.  In both cases the implants were removed and replaced with saline implants.   At their 6 week review I asked the women whether they noticed any difference between their old silicone gel and their new saline implants.  Both replied that there was no difference in the feel of their breast implants.

So why then do so many surgeons in Australia recommend silicone gel implants?

The answer is that these implants have been very heavily marketed by their manufacturers and distributors as being something “new” and therefore “better”.  In addition, many surgeons in Australia have had no experience of saline implants.  It is interesting that in the USA many surgeons who insert a large number of breast implants every year prefer to use saline implants.  Their reasoning is simple:

When the implants are placed under the muscle, they feel the same and saline implants are much much safer.