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Breast Implants

Saline vs Silicone breast implants explained by experienced Chicago breast surgeon Dr. John Q. Cook.





John Q. Cook, M.D.

Chicago 312-751-2112
Winnetka 847-446-7562

Breast Implants

Differences and Comparisons In Consideration of Your Goals

Many of the patients who come to me in consultation for breast augmentation surgery are confused about the advantages and disadvantages of the different types of breast implants.

I have put together this section of the website in order to help you obtain practical information about the advantages and disadvantages of saline implants and silicone gel breast implants.

Video: Implant Choices


Dr. John Q. Cook explains the breast implant choices available to his patients.

Many patients are surprised to learn that both saline breast implants and silicone gel implants have a silicone component. The outer shell of both types of implants is made of silastic, the solid form of the silicone polymer. The difference is what’s inside the implant.
Saline Breast Implant

Saline Breast Implant

Saline implants are filled with sterile salt water, the same solution that is delivered in an IV.
After the surgeon creates a space for the implant, he or she takes an empty implant, connects sterile tubing to a valve in the front surface of the implant, places the implant in its proper location, and fills the implant with salt water.

Because the saline implant is not filled until it is placed beneath the breast, it can be inserted through a smaller incision than would be required for a similar-sized silicone gel implant. Saline implants can also be filled to a range of volumes, which allows the surgeon to “fine tune” their size and firmness. These advantages ore offset by the distinct disadvantage the “feel” of the implant: it is not as natural as that of a silicone gel implant.

Silicone Breast Implant

Silicone Breast Implant

Silicone gel implants are filled with a gel-like version of the silicone polymer.
This feels much more like a natural breast. All implants currently available in the US market contain what is known as a cohesive gel. This means that the chains of silicone polymer are cross-linked so that they stick together even if the shell of the implant is broken.


Form Stable Implant

Form Stable Implant

The implants that are known as anatomical, form-stable (pictured left) or “gummy bear,” are more recently available in the United States. These implants have a distinct shape that puts more fullness in the lower part of the breast.


Advantages of Saline Breast Implants

  1. They can be inserted through a shorter incision.
  2. They can be adjusted to a specific volume by the surgeon, within a limited volume range.
  3. They are less expensive than silicone gel implants.
  4. If they develop a leak, it is easy to detect, since the breast goes “flat.”
  5. You do not have to worry about theoretical concerns about silicone gel and its effect on the body. The Internet is full of speculation, and if you are the type of person who is easily upset by such things, you may gain peace of mind by selecting saline implants.

Disadvantages of Saline Breast Implants

  1. The number one complaint about saline breast implants is that they do not feel as natural as silicone gel implants.
  2. Saline implants are prone to rippling, which may be visible in certain portions of the breast, especially if you bend forward.
  3. Some surgeons try to avoid this rippling by over-filling the implants, but this leads to another problem: an overly-firm implant with a ball-like shape.
  4. There have been reports of saline implants being colonized by bacteria or other microorganisms. I have never encountered this in a single one of my patients, but it is a theoretical concern.
  5. Some surgeons think that saline implants are less durable than silicone gel implants. It’s very hard to get good data on this.

Advantages of Silicone Gel Breast Implants

  1. Silicone gel implants have a more natural “feel” when compared to saline implants. This advantage is particularly important for patients with limited natural breast volume since there is less to camouflage the implants.
  2. Silicone gel implants are less likely to ripple than saline implants.
  3. For certain patients who could benefit from an anatomical-shaped breast implant, the form stable implant provides this possibility. I find these implants particularly helpful for my breast reconstruction patients and for trim athletic patients who want to minimize volume in the upper portion of the breast.

Disadvantages of Silicone Gel Breast Implants

  1. Silicone gel implants require a longer incision for insertion than do saline implants of the same size.
  2. Silicone gel implants are more expensive than saline breast implants.
  3. A break in the shell of a silicone gel implant is sometimes harder to detect than shell breakage of a saline implant.
  4. There will always be speculation about possible ill effects of silicone gel implants, even though a large number of studies have shown no connection between breast implants and health problems. If you are inclined to worry about this type of speculation, saline implants may be a better choice.

What I Have Learned From My Patients and The Choices They Make

Over 95 percent of my patients who undergo breast augmentation surgery or breast reconstruction surgery opt for silicone gel implants. My patients tend to place a premium on obtaining the most natural result possible. They are willing to tolerate the increased expense and longer incisions that come with silicone gel implants in return for a softer breast that is less likely to reveal rippling from the implant. The vast majority of my patients maintain a high degree of satisfaction with the surgical result, whether they choose saline or silicone gel breast implants.

Contact the Whole Beauty® Breast Center

Dr. John Q. Cook and his team at the Whole Beauty® Breast Center in Chicago and Winnetka have helped many women enhance their appearance and self-confidence through breast augmentation surgery. They understand, however, that there are many choices to be made when it comes to breast enhancement, and work with patients to help ensure they receive the very best treatment. If you have questions about breast augmentation in Chicago, or would like to schedule a consultation, call Dr. Cook’s practice today at 312-751-2112. Dr. Cook proudly treats patients from throughout North Side Chicago and Winnetka, IL.