Should I Replace Saline with Silicone Implants?

Choosing the Right Fit – Saline or Silicone Implants

Choosing the right type of breast implant is important not only for your aesthetic satisfaction but also for your overall well-being. Both saline and silicone implants have their unique benefits and drawbacks, which can significantly impact your experience and results.

Consultant Plastic Surgeon Anthony MacQuillan discusses the properties of saline and silicone implants, compares their advantages and challenges, and discusses the medical and aesthetic reasons why you might consider switching. All to help you answer the question “Should I replace Saline with Silicone Implants?”

What Are Breast Implants?

When considering breast augmentation or replacement of existing implants, understanding the fundamental differences between the two main types of implants—saline and silicone—is essential. Each type offers distinct advantages and challenges, which can influence your decision based on personal preferences, lifestyle, and health considerations.

Saline Implants

Saline implants consist of a silicone shell filled with sterile saltwater (saline). One of their primary advantages is that they can be inserted empty and filled once in place, allowing for smaller incisions and potentially easier placement. This feature is particularly advantageous for achieving symmetry, as Anthony can adjust the amount of saline to correct differences in breast size.

From a safety perspective, saline implants offer peace of mind in the event of a rupture. The saline solution is harmlessly absorbed by the body, making it easy to detect and address a leak, as the breast will visibly deflate. However, the downsides include a firmer feel and a higher likelihood of visible rippling, especially in patients with minimal natural breast tissue.

Silicone Implants

Silicone implants are filled with a viscous silicone gel that mimics the feel of natural breast tissue more closely than saline does. This gel feels softer and tends to provide a more natural appearance, making silicone implants a popular choice among patients seeking a realistic texture and contour.

The cohesiveness of the gel in modern silicone implants also helps maintain their shape and reduces the risk of rippling. This makes them an excellent option for thin-skinned patients or those with little breast tissue. However, if a silicone implant ruptures, the leak is not immediately apparent since the gel may remain within the implant shell or the surrounding tissue, a situation known as a “silent rupture.” Therefore, regular imaging tests, such as MRI scans, are recommended to monitor the integrity of silicone implants.

Both types of implants come with their own set of considerations regarding durability, aesthetics, and safety. Saline implants might be preferable for those who prioritise ease of monitoring and smaller surgical adjustments. On the other hand, silicone implants are often chosen for their superior natural feel and aesthetic appeal, despite requiring more rigorous follow-up.

As you contemplate the choice between saline and silicone, it is essential to weigh these factors in light of your personal health, body type, and aesthetic goals.

2013 - Breast Augmentation by Anthony MacQuillan 45 Left

Reasons for Breast Implant Replacement

The decision to replace breast implants—whether switching from saline to silicone or simply updating the existing implants—can arise from a variety of medical, aesthetic, and technological motivations. Here are some of the reasons:

Medical Reasons

Medical reasons for replacing breast implants are often at the forefront when considering this surgery. These can include:

  • Implant Rupture: While saline implant ruptures are easily detectable due to the deflation of the implant, silicone ruptures are less obvious and can go unnoticed without imaging tests. Known as ‘silent ruptures,’ these can occur without any symptoms, necessitating periodic MRI scans to ensure the integrity of silicone implants.
  • Capsular Contracture: This occurs when the scar tissue that naturally forms around the implant tightens and squeezes the implant, sometimes causing pain and distorting the shape of the breast. Replacement might be necessary to remove the scar tissue and replace the old implants with new ones.
  • Infection and Other Complications: Though rare, infections around an implant or complications such as displacement, where the implant moves from its original position, can necessitate replacement. Other issues like symmastia (merging of the breasts at the midline) or rippling (visible wrinkles of the implant) also prompt consideration of implant replacement.

Aesthetic Reasons

Aesthetic motivations are highly personal and vary widely among patients. Some common aesthetic reasons include:

  • Change in Size Preferences: Over time, personal preferences regarding breast size can change. A person might desire larger or smaller implants than they originally chose. Replacing implants to meet current aesthetic desires is a common practice.
  • Lifestyle Changes: Significant life events such as pregnancy, breastfeeding, or major weight fluctuations can alter breast tissue and the appearance of implants. Post these changes, women may seek implant replacement to restore or improve the appearance of their breasts.
  • Ageing Effects: As the body ages, natural changes in breast tissue can affect the appearance of implants. Older implants might be replaced with newer models that are better suited to the natural changes in the body’s contour and skin elasticity.

Advances in Implant Technology

Advancements in implant technology may also prompt consideration of replacement. Improved designs and materials offer better safety profiles and aesthetic outcomes, which can be compelling reasons to replace older models:

  • Cohesive Gel Implants: Known as ‘gummy bear’ implants, these are a newer type of silicone implant known for their ability to maintain shape even when cut in half. Their stability and reduced risk of leakage make them a popular choice for replacement.
  • Implant Shape and Texture Variations: Innovations in the shapes and textures of implants allow for a more customised fit and appearance. Options include anatomical (teardrop-shaped) implants that mimic the slope of the natural breast, and textured implants designed to reduce the movement of the implant within the breast pocket.
  • Safety Improvements: As the medical community gains more insight into the long-term outcomes of breast implants, improvements are made to enhance safety. For example, newer implants are designed to minimise the risk of BIA-ALCL (Breast Implant-Associated Anaplastic Large Cell Lymphoma), a rare cancer associated with certain types of implants.

Comparison of Saline and Silicone Breast Implants

When choosing between saline and silicone breast implants, it’s essential to consider how each type affects factors like feel, aesthetics, and health. Here’s a detailed comparison based on key attributes to help potential patients make an informed decision:

  • Feel and Texture: One of the most noticeable differences between saline and silicone implants is their feel. Silicone implants are generally preferred for their soft, more natural feel, closely mimicking natural breast tissue. This makes them particularly appealing to patients seeking a realistic touch. Saline implants, while safe and effective, tend to feel firmer and might not provide the same natural texture, which can be particularly noticeable in patients with less natural breast tissue.
  • Durability and Lifespan: Silicone implants are renowned for their durability. The cohesive nature of the silicone gel allows them to maintain shape and integrity even in the event of a shell breach. Saline implants, though structurally simpler and potentially easier to replace if ruptured, can be more prone to folding and rippling, which may lead to a shorter functional lifespan in some cases.
  • Risk Profiles: Both implant types are associated with specific risks. Saline implants offer the benefit of immediate rupture recognition, which can be crucial for timely intervention. Silicone implants, while less likely to rupture, require regular monitoring through MRI scans to detect silent ruptures. The introduction of highly cohesive silicone implants has mitigated some concerns by minimising the risks of gel migration.
  • Surgical Considerations: The choice of implant can affect the surgical procedure. Saline implants can be inserted empty and filled once in place, potentially allowing for smaller incisions and less invasive techniques. Silicone implants, being pre-filled, typically require slightly larger incisions, which might influence the decision for patients concerned about scarring.

Ultimately, the decision between saline and silicone implants involves balancing these factors with personal health, aesthetic goals, and lifestyle considerations.

FeatureSaline ImplantsSilicone Implants
MaterialSterile saltwater (saline)Silicone gel
Feel and TextureFirmer feel; more prone to ripplingSofter and more natural feel; less prone to rippling
Insertion MethodInserted empty and filled once in place, smaller incision possiblePre-filled; requires slightly larger incision for placement
Detection of RuptureImmediate detection due to deflationRequires MRI for detection of ‘silent ruptures’
DurabilityLower risk of gel bleed, but higher risk of shell ruptureHigher durability with less risk of rupture
Aesthetic OutcomeCan appear less natural especially in thin patients with little breast tissuePreferred for more natural appearance
MaintenanceEasier to replace or remove due to structureRegular monitoring recommended; more complex to replace
Safety ProfileLower risk of complications from material leakageModern implants have high safety profiles but require more diligent monitoring
CostGenerally less expensive than siliconeMore expensive, but preferred for feel and longevity
Ideal CandidateIndividuals prioritising safety and cost over natural feelIndividuals seeking a more natural look and feel

Considerations before Replacing Saline with Silicone Breast Implants

While there are many compelling reasons to consider replacing breast implants, it’s important to discuss the potential risks and benefits with a qualified plastic surgeon. Anthony, with his extensive experience in breast surgery, can provide personalised advice based on your medical history, body type, and aesthetic goals. The following are essential considerations to discuss during a consultation:

  • Health Status: Your current health can affect surgical outcomes. It’s important to evaluate any existing health issues and discuss how they might impact surgery and recovery.
  • Cost and Insurance: Understanding the financial implications is important as insurance might not cover elective cosmetic surgery. Discussing the costs involved in replacement surgery, including the surgeon’s fees, anaesthesia, and facility costs, is essential.
  • Expectations: Having realistic expectations about the outcomes of implant replacement is also important. While replacement can enhance appearance and comfort, every surgical procedure comes with limitations and risks.

FAQs about Saline and Silicone Implants

How long do breast implants last before they need to be replaced?

  • Breast implants are not lifetime devices, and replacing them is a consideration for most patients at some point. On average, implants can last between 10 to 20 years. However, the lifespan can vary based on the type of implant, individual lifestyle, and any complications that might occur.

Is the recovery time different when switching from saline to silicone implants?

  • The recovery period for any breast implant surgery generally depends on your health, the technique used, and personal healing speed, rather than the type of implant. However, patients might experience slightly different sensations as the body adjusts to the new silicone implants, which could potentially affect the perceived recovery time.

Can I switch from silicone to saline implants if I am not satisfied with silicone?

  • Yes, it’s possible to switch from silicone to saline implants. Some patients opt to switch due to personal preference or specific health concerns. The process involves a similar procedure to replacing any type of implant.

Are there any new types of implants other than saline and silicone?

  • While saline and silicone remain the most common types of breast implants, there are variations within these categories, such as the highly cohesive silicone gel implants (often referred to as “gummy bear” implants). Ongoing research and technological advancements continue to refine and potentially introduce new types of implants, but these remain the standard choices.

Will changing my implants have any impact on breast screening for cancer?

  • Breast implants can make mammography screening more challenging, but technicians are trained to work around them. It’s important to inform your radiologist about your implants before any breast imaging. Silicone implants, in particular, may require different imaging techniques such as ultrasound or MRI to ensure thorough breast cancer screening.

Further Reading about Breast Surgery with Consultant Plastic Surgeon Anthony MacQuillan

Medical References about Saline and Silicone Implants