Saline Vs. Silicone Part III

Part 3 of 3: Dr. Loftus Ties it all Together and Offers Her Advice

Prior to reading Part 3 of this 3-Part Blog, please read both Part 1 and Part 2 which will make Part 3 even more helpful to you.

The question of saline versus silicone breast implants is critical. It is second only to that of size when making decisions prior to breast augmentation surgery. For some women, the decision is simple; for others it is difficult. Many women seek my advice on this issue…and here it is.


Tying it all together:

So, now that you have read Parts 1 & 2 of this Blog, you know all the factors. You are ready to make a decision. Here is my advice…take it or leave it.….

  • If you have almost no breast tissue (as in Example 1 in Part 1 of this blog) with no breast crease beneath the breasts), then you should strongly lean toward silicone, as the difference between silicone and saline with regard to the cosmetic result will be profound.
  • If you have significant breast tissue (as in Example 2 in Part 1 of this blog), then unless you are choosing a large implant, you should feel comfortable leaning toward saline, as the cosmetic benefit of silicone may be nominal.
  • If you are somewhere in-between (as most women are), then…
    • If you can identify which of the issues raised in Parts 1 and 2 of this blog are the most important, then I can tell you whether you should choose saline or silicone. The only problem is that for many women, more than one issue is important. Still, if there is a single issue which prevails, then you will answer this question for yourself.
    • Unfortunately, you simply must ”pick your poison.” Neither saline nor silicone is perfect – just decide which disadvantages you can and cannot tolerate, and make your decision based on that.
    • Do not look upon this decision as a life and death decision. I can (and often do) have two women with nearly identical breasts: one will choose saline, and one will choose silicone, and both will ultimately be happy with her choice. As long as you are aware of the pros and cons and willing to accept them, you will most likely be satisfied with your choice. Keep in mind that prior to November of 2006, only saline implants were available in this country, and even women with nominal breast tissue were pleased with their results.
    • If you are going to lay awake at night worrying about silent rupture of silicone implants, then do not bring this burden upon yourself. No matter how many studies are done, and no matter what the science says, if it will cause you anxiety, then just go with saline.
    • If you still can’t tell whether you want saline or silicone, then look at the issue of feel and how important this is to you. Clearly, all women would prefer to have implants that can not be felt through the skin when the breasts are touched. However, this issue is not as critical to some as to others. If this is a make or break issue for you, then go with silicone. If you are one of the women who says, “Yeah, it would be nice not to be able to feel them through the skin, but if I do, I can handle it,” then the benefits of saline may outweigh the benefits of silicone breast implants, and you should choose saline.

Hopefully this 3-part blog has helped to tie things together for you. If you have any remaining questions about thus topic, PLEASE do not hesitate to post below, and don’t forget to view some Breast Augmentation Before and After Images.

Jean M. Loftus, MD

19,450 thoughts on “Saline Vs. Silicone Part III

  1. Thank you so very much for posting this blog it has helped me tremendously, but now I’m a bit discouraged. I was planning on saline however, I now realize that saline implants will not suit me the way I thought they would. I was able to accept all of the disadvantages of saline until you mentioned downward displacing and which women it tends to happen more in, That’s the only problem I have with saline since that is what I am trying to fix now with my natural breast on top of the fact that I never really developed a normal amount of tissue below my breasts. Now I see that silicone’s disadvantages are more tolerable than saline. And This is where my discouragement comes in, I was planning on having my surgery sometime next year; I’ll be 19. It is my understanding that silicone is only approved for people 22 and older.

  2. Dr. L,
    Your site has been more than helpful, as well are your you-tube video. Thank you for all the info. Wish you were in Dallas. Any recommendations?

  3. Reading your blog has been very helpful – thank you! I am an American currently living outside the US (Brazil) and am thinking about breast augmentation following significant weight loss which has resulted in a great loss of breast volume, particularly above the nipple. I am not drooping but my breasts are now pretty small. I met with a surgeon,who recommended the cohesive (gummy bear)implants. He showed me the difference between that type and a regular silicone -he had cut into one of each and while the regular oozes a sticky viscous sap, the gummy bear doesn’t ooze at all. They have been used for years here with great success (only downside is they are the most expensive type. I actually liked the teardrop shape as I am looking for natural, undetectable results. Now that I’ve learned from you about the risk of these types shifting, I am less inclined.

  4. I feel so comfortable in making my decision after reading this blog. This was extremely helpful. My biggest concern was that my breasts look and feel real. I have almost no breast tissue so reading this blog and considering other review confirms that gummy bear silicone is the way to go for me! Thanks so much!

  5. This is an awesome blog which ties everything together from the previous two blogs: Saline vs. Silicone Part I & II. I’m not planning on getting a breast augmention but reading these blogs give me such amazing information that if I was to decide to get implants without a doubt I would choose saline. I feel that I would be making the correct choice for me based on the information within these three blogs that were filled with amazing advice from Dr. Loftus

  6. Just wanted to say I really enjoyed your blog very informative!! I’m still a tad on the fence over which ones i want…I want to look natural but do not want to worry about ruptures or MRI etc, can’t I have cake and eat it to lol thanks again for this info

  7. I’m torn between going silicone or saline. I have little breast tissue and my doctor said I was a better candidate for silicone but I’m so nerveous that I’m going to have a silent rupture. The nurse has tried to reassure me that a rupture will happen during high impact actions (like a car wreck or bad fall) but I’ve been reading too much on the saline versus silicone….my surgery is in 4 days and I’m still torn on what to do. At first I was saline and then after the doctor sugggested silicone I changed my mind and now I’m thinking about saline again. This was a very informative site and I appreciate your helpful tips.

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