**Dr. Jim’s blog posts focus on many of the often asked questions that are made during plastic surgery consultation and follow-up visits by his patients. These posts may be representative of a particular patient, and individual diagnosis may vary.

Dr. Jim,

My friend was gasping when she heard I was getting saline breast implants! What is the difference between Saline and Silicone Breast Implants?



Dear Betty,

Yes, there are differences between saline and silicone for cosmetic breast augmentation. Silicone implants were removed from the market about 15 years ago for any new cosmetic usage because of a fear of causing systemic lupus or arthritis. Since that fear has yet to be actually proven so the implants are now available only to 21 year olds and older. Personally I never felt silicone caused illnesses but that fight is still on in some sectors. The FDA recommends MRI exams every 3 to 4 years to evaluate silicone implant stability, but we doubt that is complied with by most patients. Companies also want continues data retrieval from the silicone implanted patients about any possible problems with silicone implants. But the silicone is definitely available; about 10 %o of my practice uses silicone implants.

The saline implant is a water balloon which you may feel rippling under your skin, but if it breaks the salt water is absorbed which is easily identifiable and new implants are then placed.

The silicone implants are jelly-like balloons of the gelatinous silicone material all implants have the same outer shell. Silicone has less chance of rippling, but if it breaks the silicone sits there and an MRI scan or a mammogram is required to diagnose if it is broken. Over the years the silicone has a proven higher chance of causing a capsule of fibrous scar tissue (15 to 25 % for silicone) for or saline capsule formation is less (7 to 10 % for saline). If this implant ruptures the silicone is never 100 % removed. We have an album of implant complications you can look at also.

I have had 30 years of experience with problems using all breasts implant types for cosmetic purposes, cancer reconstruction, and then silicone gel removal after rupture. There are few doctors with as many years of clinical observation and knowledge. My opinion is to use saline. But I placed silicone breast implants last week at a patient’s request and I am doing silicone next month again. So I will put silicone in you if you desire, the cost is $1000.00 more because of the higher cost from the company because of the past litigations against silicone implants

There are plastic surgeons who do advocate silicone partly because they receive a kickback from the manufacturer.

If a better silicone was available of if the statistics about rupture and capsule formation change then I will feel better about recommending silicone.

Is your friend a plastic surgeon? What is the basis of her ‘gasping’??


[this is an informative letter, it took over an hour to compile, I do discuss the silicone-saline issue with patients when it arises, I am glad you brought it up, call us if you want silicone so I can reexamine you and order them]