In my cosmetic plastic surgery practice, the most common questions asked during a breast augmentation consultation are, “What will my implants feel like?” and “Will my implants feel real?” This is a very understandable concern. Though I wish our patients could experience exactly how implants will feel inside their body prior to surgery, in real life it is not possible for them to experience that until the breast enhancement is completed. We do offer our patient implant sizers to try on. Though this process does not provide an answer to how the implants will feel inside the body, it does offer a good visual as to how they will look in clothing and how the patient’s body proportions will be improved.
In general, I tell women who are contemplating breast augmentation in my Champaign, IL or Bloomington, IL practices that, yes, both silicone and saline implants will feel real.
The easiest way to describe the difference between saline and silicone is to make the analogy that silicone implants generally tend to feel like the breasts of females who have had babies – that is, quite soft. In fact, sometimes they feel similar to fatty tissue. In contrast, saline implants feel more like the breasts of very young women, particularly those who have not had babies and whose breasts feel a little more substantial. In general, remember what your breasts felt like in your mid to late teens, and that is very much the type of feel that saline implants tend to have.
I think that most plastic surgeons would agree that typically silicone implants feel softer and appear more similar to a natural breast shape than saline implants. However, the degree of difference in the look and feel between saline and silicone implants varies when considering a few factors.
One consideration is that many thinner patients do not have a lot of breast tissue prior to breast augmentation. (They may wear an A cup and have thin chest tissue, for example.) In this situation, it is usually best to select silicone implants, as thinner patients have less tissue to conceal the implant. However, if there is sufficient breast tissue before the surgery, saline implants can feel quite natural and are easily camouflaged by the existing tissue. During saline breast augmentation surgery, I prefer to place the implants under the pectoral muscle, which makes them less palpable and provides further camouflage. The placement of implants beneath the muscle tends to lead to fewer problems, very likely because there is not any contact between the implant and the breast tissue itself.
Another consideration in achieving a natural look and feel is the size of the implant being used. In most cases, excessive volume will result in a firmer breast. If the patient desires natural looking breasts, then selecting less volume may be a factor to consider. Nearly 100% of patients are very satisfied with the look and feel of their implants, whether they are saline or silicone implants, as long as they have selected an experienced, knowledgeable surgeon.
Note: National statistics show that silicone prostheses have a higher capsular contracture rate, which can result in a revision surgery if this develops. For this reason, while I use both saline or silicone implants in my practice, I tend to use saline implants for the most part. I find saline to be reliable, satisfying, very well accepted and nearly free of post-operative revisions and/or complications.