Women's health (7)
- Women's health: Preventing top 10 threats
- Cosmetic surgery: What to know beforehand
- Kegel exercises: How to strengthen pelvic floor muscles
- see all in Women's health
Breast health (11)
- Breast cancer prevention: Lifestyle factors that can reduce risk
- Is it breast cancer? Procedures to evaluate breast lumps
- Breast implants: A choice between saline and silicone
- see all in Breast health
Women's sexual health (52)
- Birth control pill FAQ: Benefits, risks and choices
- Women's sexual health: How to reach sexual fulfillment
- Emergency birth control
- see all in Women's sexual health
Women's life stages (12)
- Belly fat in women: How to keep it off
- Fitness tips for menopause: Why physical activity matters
- Delaying your period through oral contraceptives
- see all in Women's life stages
Mayo Clinic Health Manager
Get free personalized health guidance for you and your family.
Get Started
Mayo Clinic Housecall
Stay up to date on the latest health information.
What you get
- Free weekly e-newsletter
- Mayo Clinic expertise
- Recipes, tools and other helpful information
- We do not share your e-mail address
Breast implants: A choice between saline and silicone
Thinking about breast implants? Read a Mayo Clinic specialist's answers to questions about saline-filled and silicone gel-filled implants.
By Mayo Clinic staff
In 1992, responding to claims that silicone gel-filled breast implants had harmed tens of thousands of women, the Food and Drug Administration (FDA) banned the marketing of the devices for breast augmentation.
Fourteen years and mountains of safety data later, the FDA relaxed its stance, approving two manufacturers' applications to market silicone gel-filled implants for breast augmentation once again. The implants had remained available for breast reconstruction following mastectomy, as well as for women enrolled in certain clinical trials, throughout the ban. Saline-filled implants stayed on the market all along, used with FDA approval for either breast augmentation or breast reconstruction.
Not surprisingly, the rise and fall of the ban on silicone gel-filled breast implants left many women with unanswered questions. What are the risks of breast-augmentation surgery, and are those risks increased with either type of implant? How do you choose between silicone gel-filled and saline-filled implants? Here Molly Walsh, D.O., a plastic surgeon at Mayo Clinic in Rochester, Minn., explains some of the differences between these two types of breast implants.
Who can get silicone gel-filled breast implants?
Silicone gel-filled breast implants are available to women age 22 and older for breast augmentation, or women of any age for breast reconstruction. This includes primary surgery to put breast implants into place and also revision surgery to correct or improve prior implant placement.
Why the age restriction on silicone gel-filled implants for breast augmentation? One reason is because a woman's breast tissue continues to develop into her early 20s. But the age restriction is a bit arbitrary. FDA officials felt that at age 22, most women could make a fully informed decision about getting breast implants — including the risks and ongoing costs associated with the procedure.
Who can get saline-filled breast implants?
Like their silicone gel-filled counterparts, saline-filled breast implants carry an age restriction for use in breast augmentation. But in this case, you have to be at least age 18 to get saline-filled breast implants for breast augmentation. Saline-filled breast implants are available for women of any age for breast reconstruction.
FDA officials say the age restrictions for saline-filled and silicone gel-filled breast implants differ because the two types of breast implants carry different risks.
What's the difference between the two types of breast implants?
The two types of breast implants differ in material and consistency. Saline-filled breast implants consist of a silicone shell that's filled with saline during implant surgery, after the shell has been inserted and is in place. Silicone gel implants also consist of a silicone outer shell, but they're pre-filled with a silicone gel rather than saline.
Silicone gel has a viscosity — a thick, sticky fluid consistency — that closely mimics human fat, which is a large component of female breast tissue. Saline, on the other hand, isn't compressible and gives a more firm impression.
Some women claim that silicone gel-filled breast implants look and feel more like natural breast tissue. Saline-filled implants have been criticized for feeling hard or unnatural, although improved surgical techniques — such as placing the implant behind the chest muscle and slightly overfilling it — have lessened these complaints.
What factors should you consider before getting saline-filled or silicone gel-filled breast implants?
If you're thinking about having breast augmentation, it's important to become fully informed about what it means to have breast implants. Before you make your decision, consider the following:
- Breast implants aren't lifelong devices. Odds are you'll eventually need additional surgery to replace or remove your breast implants. Every woman's experience is different, but on average, breast implants last about 10 years before they need removal or replacement due to leakage or cosmetic issues. The operation to exchange old implants for new ones is relatively straightforward and requires less recovery time than does the initial surgery.
- Breast implants change more than just the size of your breasts. Over time, the presence of implants may alter the shape and feel of your breast, sometimes requiring additional surgery, which may include implant replacement. In addition, if you decide one day to have your implants removed, your breasts won't go back to their pre-implant appearance.
- Breast implants may interfere with breast cancer screening. Although implants can make physical detection of lumps easier, they also may complicate routine mammography to screen for breast cancer. Additional images offering special views of your breast are often necessary. The images may also be harder to interpret because cancers can be obscured by the implant itself. You might have to visit a specialized facility experienced in mammography for women with breast implants. Your doctor might also recommend additional imaging tests — such as ultrasound or magnetic resonance imaging (MRI) — to check for signs of breast cancer, and insurance may not cover these additional tests.
- Breast implants may hamper breast-feeding. You may experience decreased milk production, or you may not produce any milk at all.
How does the plastic surgeon decide whether the implant will be placed behind the chest muscle (subpectoral) or with the breast tissue (subglandular)?
A combination of factors is considered when determining implant placement, including:
- Anatomy of your breasts, including amount of breast tissue
- Type of implant: saline or silicone gel
- Size of the implant
What are the risks of breast implants?
Both saline-filled and silicone gel-filled breast implants have risks, including:
- Implant rupture
- Need for additional breast surgery
- Scar tissue that hardens around and distorts the breast implant (capsular contracture)
- Breast pain
- Decreased nipple or breast sensation
- Infection
If you have saline-filled implants, implant deflation may be a concern. If you have silicone gel-filled implants, a rupture could mean that silicone gel leaks outside of the implant's silicone shell. However, there's no evidence that free gel poses any risks beyond those of an intact silicone shell — and neither one leads to autoimmune disease. That's why the FDA re-approved the use of silicone gel-filled implants.
Next page(1 of 2)
