Making a Case for Saline Implants

Chicago plastic surgeon makes a case for saline implants versus silicone implants.

Across the country, silicone breast implants are experiencing a surge in popularity. But the story is a bit different among my breast augmentation patients in Chicago.

Silicone implants can create beautiful results, to be sure — and patients are taking notice. A statistical survey from the American Society of Plastic Surgeons® revealed that 72% of breast implants placed last year were silicone. At my practice, though, the overwhelming majority of my patients buck the trend and choose saline. Why?

Many people argue that silicone gel implants feel and look more natural. While this may be true in some cases, it’s not an absolute. The appearance of breasts with implants is no different in all but the most exceptional cases, such as that with very thin patients who have little breast tissue and large implants. The change in feel of the implant between silicone and saline is often very subtle. Much of the success of breast augmentation depends on the surgical technique and the individual surgeon’s skills in addition to the type of implant used. For instance, I often use a dual-plane approach, which combines the benefits of both over- and under-the-muscle placement for a lasting result that looks and feels quite natural with either saline or silicone implants. What is less well recognized is that the gel inside a silicone gel implant breaks down over time, much like the material in a tire. The body often reacts to the silicone breakdown with inflammation and scar tissue (capsular contracture), and the removal and replacement of a silicone gel implant is much more involved than replacing a saline implant. I give patients a choice after they fully understand the pros and cons of each implant. Silicone implants are the best choice for some patients, but in my experience, I have had high patient satisfaction with both saline and silicone.

I also take an active role in each patient’s decision-making process, which further helps improve results. By choosing a saline implant that is the correct size, shape, and projection for the patient’s body, complications such as rippling are kept to a minimum. Many patients also appreciate that saline implants tend to require shorter scars because they are filled after insertion.

I’m quick to tell each patient that, in the world of plastic surgery, there is no one approach that works for everyone. Patients are individuals, and approaching each surgery as a unique event is ultimately what leads to a beautiful outcome — with saline or silicone.

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