Breast Implants: Silicone or Saline?
By George John Bitar, M.D., Bitar Cosmetic Surgery Institute

The FDA has recently approved the cohesive gel silicone breast implants. I have experience with both silicone and saline breast implant operations, and have written a research article on silicone breast implant rupture clean-up. I prefer saline to silicone implants for many reasons.

Silicone breast implants may feel more natural than saline when a woman has had many breast procedures and has very little breast tissue or muscle remaining in the breast. Silicone implants may be preferable also when a woman is very skinny, in which case, silicone implants may feel more natural. In these two situations, I will offer my patients silicone breast augmentations. That is where the advantages of silicone implants end, in my opinion.

If a woman’s breasts are a small “B cup” and the saline implants are placed behind the muscle, as I place them routinely, the feel of the breast is very natural, making the argument that “silicone implants feel more natural” not a valid reason for having silicone implants.

Other reasons why I believe saline implants are better:

1. Saline implants are safer, in my opinion. If they rupture, saline- or salt water- is spilled as opposed to silicone, which can cause local scarring and hardening of the breast.

2. They are more easily inserted from an armpit incision approach than silicone implants, thus having a minimal scar, and the ability to be inserted completely behind the muscle. In this approach, the muscle and breast tissue are not cut, unlike other approaches, resulting in less trauma and scarring, less pain, less bruising, and a shorter recovery time with minimal complications.

3. No need for MRI scans biannually to determine if there is a silicone rupture, as the FDA recommends with silicone implants. MRI costs $2,000- $3,000.

4. The scar is about 2 cm (less than an inch) vs. a silicone implant scar, which is about 5cm.

5. Saline implants are about 60% the price of silicone implants.


The good news is that there is a choice now, so consult with a board-certified plastic surgeon who is experienced with both silicone and saline implants to determine what is appropriate for you.