About three-quarters of breast augmentation patients today are choosing silicone implants over saline implants because the former can deliver better cosmetic results even in patients with little “coverage.”
While both breast implants are made of an outer silicone shell, their main difference is the filler material that moves and “behaves” distinctly from each other.
Saline implants are inflated at the time of surgery with a predetermined amount of sterile saltwater solution, while silicone implants are always prefilled with a viscous type of medical-grade silicone gel.
The main appeal of saline implants is that they do not pose any risk of gel leak and its side-effects such as pain and tissue inflammation (in the event of rupture) because the saltwater solution is easily and quickly absorbed by the surrounding tissue.
Because asymptomatic or “silent” leak is not a concern with saline implants, regular MRI exam—which might be too expensive for some patients—is not a requirement, unlike with the use of silicone implants in which the procedure is part of their “maintenance.”
To compensate for the “sloshing effect” of saline implants, certain techniques and appropriate implant design and size are used to deliver more natural results.
The first step to deliver natural results with breast implants, no matter what kind of filler material they are using, is to choose a conservative size based on the patient’s chest/breast measurement (vertically and horizontally) and the amount of her existing soft tissue.
By going conservative, the soft tissue is more palpable than the implants, leading to a softer and more natural result.
Smaller saline implants, or at least not larger than 350 cc, can also reduce the likelihood of visible rippling.
Patients who are opting for saline implants also fare better with a submuscular technique wherein the prostheses are placed underneath the thick layer of pec muscle, which provides additional coverage. While it results in more post-op pain and longer recovery, the “cosmetic” benefits still far outweigh the “temporary” drawbacks.
Using the right implant profile or forward projection can also help saline implants deliver results that look and feel more natural. The rule of thumb is that women with a narrower chest are best suited for implants whose base is equally small, while patients with a wider frame need a design that complements their anatomy.
And for patients whose breast tissue is saggy, while their upper cleavage looks deflated, breast implant with mastopexy (or more commonly referred to as breast lift) is the only surgical approach that could provide them good aesthetic results.