Advice from Dr. Loftus

On Whether You Should Get Saline or Silicone

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

• If you have almost no breast tissue (as in Example 1) 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), 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 the pages on saline and silicone 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, neither saline nor silicone is perfect, and if you are having a hard time deciding, then you should consider the Ideal Saline Implant, which combines the advantage of saline with the advantages of silicone. The only disadvantage is that it costs a few hundred dollars more.


• 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 patient 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. Again, the Ideal Saline Implant may be best for you.

Hopefully this this has helped to tie things together for you. If you have any remaining questions about this topic, PLEASE do not hesitate to see me in person.

Jean M. Loftus, MD