When considering breast augmentation, the earliest decision you will face is saline or silicone implants. And what is right for you may not be the best choice for someone else. To make the most informed decision, you should understand the pros and cons of each implant and carefully discuss with your plastic surgeon the best option.

Common factors breast augmentation patients should consider in their decision:
• Natural look and feel
• Incision location
• Scarring
• Recovery
• Possible risks
• Amount of breast tissue present

To better understand which option will work for you, let’s examine each implant type.

Saline Breast Implants
Saline breast implants are primarily made out of a solid silicone shell that is inserted inside the body under the breast muscle. Once positioned appropriately, the surgeon then inflates the implant with saline to the desired size. The patient must be 18 or older for this option.

Advantages:
• Silicone shell filled with a salt-water solution that is similar to the fluids naturally found in the human body
• Smaller incision
• Can be placed transaxillary (under the armpit), inframammary (under the breast fold) or Areolar (nipple incision)
• Rupture is easily detected
• Typically costs less than silicone implants

Disadvantages:
• Firmer feel than natural breasts especially in patients with less breast tissue
• Rounder appearance than natural breasts
• Rippling is more common

Overview
Patients generally choose saline breast implants because they feel that it is the safer option if in a rare situation a rupture occurs. After all, it is easy to detect a rupture as the breast will immediately deflate. However, the main drawback is that saline generally lacks the natural look and feel of natural breasts and patients with less breast tissue can ripple significantly which may show in clothes and bathing suits.

Silicone
Silicone implants are pre-filled shells that contain a cohesive silicone gel. The silicone implant feels more like natural breast tissue. Recommended age is 22 years old for this option – discuss with your surgeon if you can have silicone under 22.

Advantages
• Look and feel more like natural breasts
• Lower risk of rippling or being able to feel the implant through the skin
• Patients with less breast tissue may still have a natural look and feel to their breast
• Skilled surgeons are able to place implant transaxillary (under the armpit), inframammary (under the breast fold) or Areolar (nipple incision)

Disadvantages
• Usually costs more than saline implants
• Larger incision in some patients
• Some surgeons may limit incision site choices (example: unable to do under the arm incision)
• Silent rupture, harder to detect without an MRI

Overview
Many patients view silicone as the more “natural” feel and look they are trying to achieve with breast augmentation. Since their is no true liquid inside the implant to leak out, an MRI is recommended to detect any sign of rupture as it may not be obvious by an exam.

Making the Decision
As you can see, there is no such thing as a perfect implant choice but rather the best option for you and your lifestyle. From our experience, the vast majority of women are choosing silicone now as it is much softer and more natural than saline. Dr Ennis and the doctors at BECA specialize in the transaxillary incision allowing them to place even large silicone implants through the under-arm which does not leave a scar on the breast.

It is important to discuss your options thoroughly with your surgeon so that you have a clear understanding and can make an informed decision. The key to satisfaction is to be realistic in your expectations and being acutely aware of the advantages and disadvantages of each option.