Silicone vs Saline Breast Implants: What You Need to Know Before Your Consultation

Breast augmentation is a procedure that uses implants to adjust the size and shape of the breasts. For patients considering this surgery, one of the first questions to come up at consultation is which implant type to choose. The silicone vs saline breast implants question is among the most common, and it’s a decision that involves more than just personal preference.

In this blog, we’ll explain the differences between silicone and saline breast implants, including how they feel, how they’re monitored, and what a Specialist Plastic Surgeon will consider when discussing options with you. The information below is general in nature and is not a substitute for personalised advice. A consultation with Dr Fraser-Kirk will be the most useful next step in understanding what may be suitable for your individual circumstances.

What are silicone breast implants?

A silicone breast implant has a silicone outer shell that is filled with cohesive silicone gel. The gel is sometimes described as having a “gummy bear” consistency, meaning it tends to hold its shape while still moving in a way that can feel similar to natural breast tissue. The current generation of silicone implants is very different to the liquid silicone implants used decades ago, with improvements in shell construction and gel cohesion.

Silicone implants are available in a range of options, including round and teardrop (anatomical) shapes, as well as different widths, heights, and projections. They come pre-filled at a set size, which means the volume is selected before the procedure rather than during surgery.

In Australia, silicone gel implants are currently the most commonly used type for breast augmentation. This is generally because patients and surgeons often prefer the softer feel and lower visibility of rippling that silicone tends to provide, particularly for patients who have less natural breast tissue.

What are saline breast implants?

A saline breast implant uses a similar silicone outer shell, but it is inserted empty and filled with sterile salt water during surgery. Because the shell is filled in theatre, the incision required can sometimes be slightly smaller, and the fill volume can be adjusted on the table. This may be useful in certain breast reconstruction cases or where there is a noticeable difference in size between the two breasts.

Saline implants are typically only available in a round shape, and they tend to feel firmer than silicone. Rippling can be more visible, particularly in patients with less breast tissue covering the implant. If a saline implant ruptures, the deflation tends to be obvious within days, and the salt water is generally absorbed by the body without harm.

Key differences between silicone and saline implants

The table below sets out some of the practical differences between the two implant types. Your surgeon will go through these in more detail at your consultation, as the right approach can vary from patient to patient.

How do I know which is right for me?

There isn’t a single “best” implant type. The right choice will depend on your anatomy, your goals, and a thorough conversation with a Specialist Plastic Surgeon. When discussing options, your surgeon will generally consider a number of factors, including:

• Your existing breast tissue, including its volume and thickness, as patients with less tissue may benefit from the softer feel of silicone.
• Your body frame and chest wall anatomy, including chest width, skin quality, and nipple position.
• The kind of appearance you’re hoping for, whether that’s more natural or more augmented.
• Lifestyle factors such as athletic activity and any plans for breastfeeding in the future.
• Your personal preference after handling implant samples at consultation, as you can hold both silicone and saline implants and feel the difference.
• Future considerations, including mammography, breast cancer screening, and possible revision surgery.

Dr Grant Fraser-Kirk and Dr David Sparks both take a patient-focused approach during consultations, spending time explaining the trade-offs of each option clearly. The final decision is always made together with you, after a thorough discussion of the relevant factors.

Silicone implant rupture: what you need to know

One important difference between the two implant types is how a rupture may present. A silicone implant rupture can sometimes be what is referred to as a “silent” rupture. Because the gel is cohesive, it tends to stay trapped within the fibrous capsule that the body naturally forms around the implant. This means a rupture may not produce an obvious change in shape, feel, or symptoms.

Based on currently available evidence, leaking cohesive gel is not generally associated with long-term systemic health issues. However, because rupture can go unnoticed, periodic imaging is recommended for silicone implants. This typically involves an MRI, which is considered the gold standard, supplemented by ultrasound where appropriate. If a rupture is detected, the implant will usually need to be removed or replaced through revision surgery.

Attending all post-operative and follow-up appointments is an important part of safe long-term care after breast augmentation. Your surgeon will outline a clear surveillance plan for you and explain when and how often imaging may be recommended.

How long do breast implants last?

Breast implants are not considered lifetime devices. While many patients keep their implants for 10 to 15 years or longer without complications, revision surgery may be needed at some point. This can be due to rupture, capsular contracture (where the scar capsule around the implant tightens), or changes in breast shape from ageing, pregnancy, or weight fluctuations.

Some patients also choose to change implant size or have implants removed entirely later in life. It’s realistic to plan for the possibility of further surgery in the future, and this is something Dr Fraser-Kirk will discuss openly at your consultation.

What about breastfeeding and mammograms?

Breast implants may affect the ability to breastfeed for some patients, and this can vary depending on the surgical approach and the location of the incision used. If breastfeeding is a priority for you, it’s helpful to raise this at consultation so it can be considered when planning the procedure.

Implants of any type can also affect breast cancer screening. Patients with implants should always inform their radiographer before a mammogram, as additional imaging views (often referred to as Eklund views) are generally required. Submuscular placement, where the implant sits underneath the chest muscle, tends to interfere less with mammography than subglandular placement, where the implant sits in front of the muscle. Your surgeon will discuss placement options with you, including how each may affect future screening.

Regulation and safety in Australia

All breast implants used in Australia must comply with Therapeutic Goods Administration (TGA) standards. In 2019, the TGA suspended and recalled certain textured breast implants due to the recognised but rare risk of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). The TGA continues to monitor implant safety and updates its information regularly.

A separate condition known as breast implant illness (BII) is also part of the standard pre-operative discussion in Australia. BII is used to describe a range of symptoms that some patients with implants have reported, including fatigue, joint pain, and cognitive issues. The current scientific picture is still evolving, and a Specialist Plastic Surgeon will discuss what is currently known and what remains uncertain so you can make a fully informed decision.

Choosing a FRACS-qualified Specialist Plastic Surgeon, rather than a cosmetic surgeon, can give you an additional layer of training, accreditation, and oversight. For more on this, you may find our article on why choose a Specialist Plastic Surgeon over a cosmetic surgeon for your breast surgery helpful.

Schedule a consultation with Dr Grant Fraser-Kirk and Dr David Sparks on the Sunshine Coast

Dr Grant Fraser-Kirk FRACS is a Specialist Plastic Surgeon and Reconstructive Surgeon with an interest in breast surgery and reconstruction. Dr David Sparks MBBS (Hons), MS (Plast), PhD, FRACS (Plast) is an Australian-trained Specialist Plastic Surgeon who works alongside Dr Fraser-Kirk at the Maroochydore practice.

At your consultation, you’ll have the opportunity to discuss your goals, your medical history, and any concerns you may have about implant types, recovery, or long-term planning. You can also handle implant samples, ask questions about the surgical process, and review the relevant risks and complications. There’s no obligation to proceed, and many patients attend more than one consultation before making a decision about surgery.

When you’re ready to book your consultation, please contact our team. We’re happy to answer any questions you may have about the procedures offered at Fraser-Kirk Plastic Surgery.

Fraser-Kirk Plastic Surgery

Level 3, 37 The Esplanade, Maroochydore QLD 4558
Phone: (07) 5438 3588

This article is general educational information only and does not replace individual medical advice. Any surgical procedure carries risks. The right course of action for you can only be determined at a personalised consultation with a qualified Specialist Plastic Surgeon.

Further Reading:
https://fraserkirkplasticsurgery.com.au/breast/breast-augmentation/
https://fraserkirkplasticsurgery.com.au/breast/
https://fraserkirkplasticsurgery.com.au/breast-augmentation-recovery/
https://fraserkirkplasticsurgery.com.au/breast-lift-with-or-without-breast-implants/
https://fraserkirkplasticsurgery.com.au/why-choose-a-specialist-plastic-surgeon-over-a-cosmetic-surgeon-for-my-breast-surgery/