The choice between saline and silicone breast implants is one of the first—and most important—decisions a woman makes when planning breast augmentation. Both have been in clinical use for decades, both are FDA-approved, and both have produced millions of successful outcomes. But they differ in meaningful ways that affect feel, appearance, safety profile, and the right candidacy for each. At E. Kim Plastic Surgery in Beverly Hills, double board-certified plastic surgeon Dr. Eugene Kim discusses implant options in detail during every consultation, ensuring patients understand the nuances before making their decision.
Saline Implants: What They Are and How They Work
Saline implants have a silicone outer shell that is filled with sterile saltwater (saline) after the shell is placed in the breast pocket. Because they are filled post-placement, saline implants can be inserted through smaller incisions than prefilled silicone implants. They also allow for minor volume adjustments during surgery—a useful feature for patients with slight breast asymmetry.
Advantages of Saline Implants
- Smaller incision size at placement
- Easy detection of rupture—when a saline implant ruptures, the saline is harmlessly absorbed by the body and the breast visibly deflates, making the rupture immediately apparent
- Lower initial acquisition cost than silicone
- FDA-approved for patients 18 and older (silicone is approved for 22 and older)
Disadvantages of Saline Implants
- Less natural feel than silicone—particularly in thin patients with limited breast tissue coverage
- Higher rate of visible or palpable rippling, especially in the upper and lateral breast
- The sloshing sensation of liquid can occasionally be noticed by the patient
Silicone Implants: What They Are and How They Work
Modern silicone implants are filled with a cohesive silicone gel that mimics the natural consistency of breast tissue far more closely than saline. Highly cohesive (gummy bear) implants maintain their shape even if the shell is compromised. Silicone implants are prefilled and require a slightly larger incision for placement.
Advantages of Silicone Implants
- More natural feel—the most commonly cited reason patients choose silicone
- Lower rate of visible rippling
- Better aesthetic results in thin patients with limited breast tissue
- Maintain shape well over time
Disadvantages of Silicone Implants
- Silent rupture—when a silicone implant ruptures, the cohesive gel tends to remain contained and the breast may not change noticeably; routine MRI screening is recommended to detect rupture
- Slightly larger incision required for placement
- FDA-approved for patients 22 and older for elective augmentation (though used in younger patients for reconstructive purposes)
Which Is Right for You?
For the majority of patients—particularly those with limited existing breast tissue or who prioritize a natural look and feel—silicone gel implants are the preferred choice. The significant improvement in natural feel and the lower rippling rate make silicone the more widely recommended option in modern breast augmentation practice.
Saline implants remain an excellent option for certain patients—those who are younger than 22, those who want the immediate rupture detection that saline provides, or those who have sufficient breast tissue to provide adequate coverage over the implant.
What About Structured Saline and Gummy Bear Implants?
Between traditional saline and cohesive silicone, newer options have expanded the choice further. Structured saline implants (such as the IDEAL IMPLANT) use an internal structure to reduce the rippling and sloshing of traditional saline while maintaining the safe rupture detection advantage. Highly cohesive form-stable silicone (gummy bear) implants provide the greatest shape retention and lowest rupture risk among silicone options. Dr. Kim will discuss the full range of options during the consultation based on your anatomy and goals.
To compare implant options in the context of your specific anatomy and goals, schedule a consultation at ekimplasticsurgery.com.
Dr. Kim provides breast augmentation to patients in Beverly Hills, Los Angeles, Santa Monica, and greater Southern California. Contact E. Kim Plastic Surgery to schedule your consultation.
Contact the Office of Beverly Hills Plastic Surgeon Dr. Eugene Kim
Click here see more plastic surgery procedures and treatments performed by Board Certified Plastic Surgeon, Dr. Eugene Kim on patients in Beverly Hills, Los Angeles, West Hollywood, Santa Monica, CA and surrounding areas or call 310-271-6996 to schedule a consultation.