Saline implants are filled to size during the procedure. As the name implies, they are filled with sterile saline fluid, which is simply salt water. Note that the outer shell of the saline implant is made with silicone, but this is similar to many medical devices. The difference is the filling, not the shell (which is solid and does not “leak”).
While Dr. Marwan Khalifeh personally believes that both saline and silicone implants are safe, he recommends saline implants if the patient is a “worrier” or is not convinced of the absolute safety of the silicone gel. “There are enough stresses in today’s life,” he says. “I would rather not implant a product that will cause my patients to worry more. I want my patients to be as stress-free and confident as possible.”
Because saline implants are filled during the procedure, they can be inserted into either a submuscular or subglandular pocket through a very small incision. In general, the saline implant will have a slightly smaller scar than the silicone implant. This becomes more of a difference with implants greater than 300 cc. They do not require monitoring. If a saline implant leaks, you will know it because the fluid will seep out over the next few days. This is not true of silicone. If a silicone implant shell ruptures, you may not know it until you have your breast examined. Saline implants are also less expensive than silicone. In general, they will be around $500 less than the silicone implants due to the different costs charged by the manufacturer.
The greatest relative disadvantage to saline implants is the feel. We use the word “relative” because it’s not that saline feels bad — it’s just that the majority of individuals believe silicone feels better. This becomes more of an issue the less native breast tissue the patient has and the bigger the size of the implant. It’s also more of an issue with the subglandular (over the muscle) placement of the implant.
Silicone implants have a silicone rubber shell that is filled with a fixed amount of silicone gel. It’s been decades since the first silicone implant models were invented, and they have come a very long way. Silicone breast implants are now safer, more refined, more advanced, and better than ever before.
To Dr. Marwan Khalifeh, saline implants feel fine. However, silicone simply feels better. This is more of an issue with larger implants and implants being used over the muscle.
A slightly larger incision is required with silicone implants because they come pre-filled. This is only an issue if you are planning to go big, i.e., 300 cc or more. Overall, this is a minor issue. The scar will still be small (only slightly bigger than the saline implant). As far as monitoring goes, the FDA recommends you get an implant check-up every three years via MRI. This is because you would not necessarily know if the implant were to rupture. Silicone implants are slightly more expensive than saline. Their size typically comes in 25 cc intervals.