Breast Implant Types - Saline and Silicone

Choosing to have breast implants involves many different decisions. What size should the implant be? Where should the incision be made? Where should the implant be placed? What surgeon should I choose? These are all important decisions that every breast augmentation patient must make. However, the type of implant chosen is also an important decision to be made.

Breast implants vary in several different ways. Their shape, what they are filled with, and their texture are all qualities that must be chosen prior to the breast augmentation surgery. “I have patients bring in pictures of what they would like their breasts to look like, and pictures of breasts they do not like. This allows me to help them decide what type of implant is best for the results they want,” says Dr. Mandell-Brown in Cincinnati, Ohio.

Round vs. Contoured
Breast implants can be either round or contoured. Round implants are more common, they are shaped like a globe, and once they have been placed, they can rotate within the breast implant pocket and not distort the shape of the breast. Depending on the healing process and existing tissue, a round implant will look the same as a contoured implant.

Contoured implants, or anatomical implants, were originally developed for women who needed breast reconstruction. However, many women find having implants that are shaped like a teardrop, to better mimic the natural shape of the breast, more appealing.

Contoured implants are textured and the shell of the implant is thicker, to compensate for the textured surface. If they rotate or shift in the breast implant pocket, contoured implants may distort the appearance of the breast; to prevent this, the pocket created must be more precise.

Saline vs. Silicone
All breast implants are created out of a shell and a filling material. The shells on breast implants are all made out of a silicone elastomer, with the exception of polypropylene implants, which are silicone free.

Silicone implants are pre-filled with a silicone gel so that there is no chance of having the silicone leak into the body while filling the breast implant. Since they are pre-filled, however, the incision made for the breast implant surgery must be larger to compensate for the size of the implant.

Silicone implants are now being filled with a cohesive gel that will hold its integrity and not leak out of the shell in the unlikely event that the implant ruptures. Old silicone implants had liquid silicone and were more challenging to remove. The beauty of the new cohesive gel implants, is that it is like JELL-O, and if there is shell rupture it won’t run and would be easy to remove.

Saline and Silicone implants are completely safe. Saline implants are filled with a sterile saltwater solution. If there is a leak, the solution is absorbed by your body. Silicone, because they are a gummy bear type of silicone, do not leak like the older generation Silicone Implants.

Textured vs. Smooth
The silicone shell of the breast implant can be selected to be either textured or smooth. Smooth implants are designed to move more freely in the breast implant pocket and they are the most common type of breast implant shell. Textured implants are intentionally marred and feel similar to sand paper. Textured breast implants were developed to decrease the risk of capsular contracture.

At the moment, studies on whether textured implants actually lessen capsular contractures in breast implant patients are inconclusive. Because of this, neither implant is considered to be better than the other.

Due to the intentional marring of the textured implants, the textured implant shell is thicker than the smooth implant shell. The firmness of the breast implant also depends on how thick the breast implant shell is.

“At the Mandell-Brown Plastic Surgery Center, we determine the best type of implants based on what the patients wants, and what their tissue will allow. The key to having a satisfied patient is having good communication between the patient and the plastic surgeon.” – Dr. Mandell-Brown, Cincinnati, Ohio.

The silicone implant incision is slightly longer than the saline incision.


Smaller Incision
Leaks are absorbed
Size can be added or subtracted
Less Expensive


Longer incision
Leaks stay cohesive
Implants are sealed at factory so replacement is needed
Costs more.

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