Silicone vs. Saline: Which is Best for Your Breast Augmentation

Breast augmentation is the most popular cosmetic surgery in the United States. Hundreds of thousands of women are undergoing breast augmentation every year and that number continues to grow. With the procedure becoming safer, more accessible, and more advanced than after it is now an option to more than the rich and famous. Breast augmentation can be a solution for:

  • Restoring fullness after pregnancy, breastfeeding, or weight loss
  • Adding balance to match curvy hips
  • Enhancing small or asymmetrical breasts
  • General boost in confidence and self-image

What is Breast Augmentation?

Breast augmentation (commonly known as a boob job) is a cosmetic surgery that uses saline or silicone implants to improve the size, shape, symmetry, and/or fullness of the breasts. The procedure is tailored to meet woman’s individual goals but generally, the purpose is to create a more aesthetically pleasing breast profile.

Saline vs. Silicone

One of the many choices you will face when beginning your breast augmentation journey is the option of saline vs silicone implants. Saline implants are inserted as empty silicone shells and then filled with sterile salt water. Silicone implants are silicone shells filled with a plastic gel (silicone). Saline and silicone implants both come in different sizes and have either smooth or textured shells. Each has its own pros and cons so your decision should be based on your own personal goals and preferences. 

Look and Feel

As for feel, silicone implants have a reputation for feeling more natural due to the silicone gel filling. Gel filling matches the feeling and weight of natural breast tissue closer than liquid saline solution can. This is especially true for women with naturally small breast breasts because silicone is less likely to ripple, which can potentially be seen with saline implants if there is a small amount of surrounding breast tissue. On the other hand, saline may be better for women looking to achieve more symmetry between their breasts, because the volume of the solution can be adjusted during surgery.


Scarring will vary depending on the size of your breast implant and your anatomy. The incision can be made in one of four places:

  • The inframammary incision is suitable for both silicone and saline implants. The inframammary incision is made where the breast meets the torso. This is the most common incision and allows for the best mobility when inserting the implants. It can also be used again if there are any more surgeries in the future.
  • Another popular option for both silicone and saline is the periareolar incision. This incision is made on the outer edge of the areola, hiding the scar in the darker skin of your nipple. This can also be used again in future surgeries. However, there is risks due to the proximity with the milk ducts and can cause loss of sensation in the nipple and/or trouble breastfeeding.
  • The transaxillary incision is made underneath the armpit, aiming to hide the scar as a natural crease leaving the breast seemly untouched. This is most commonly used for saline implants because they are inserted into the chest empty. This is a good option for women planning on breastfeeding in the future because it is unlikely to affect the mammary gland. However, this incision can only be made once and a new surgery would require a new incision.
  • The transumbilical incision is the newest form of incision. It is made on the upper-inside edge of the belly button leaving you with little to no scar. However, it can only be used for saline implants and the incision can only be performed once.


While it is possible that you will never need to replace your implants, it is also possible that your implants may rupture. If your saline implant were to rupture, you should be able to tell within a matter of hours due to the deflation of the breast. The saline solution would leak out of the implant and your body would harmlessly absorb the solution. While this is harmless, it will require surgery to remove and replace the implant.

However, if your silicone implant were to rupture, you may not notice for months or even years. Because the silicone gel is so thick, it can remain trapped in the scar tissue that was formed after surgery. You may feel pain, discomfort or notice a change in your breast shape eventually. There has been no evidence of health issues due to a ruptured silicone implant. Again, you will need surgery to remove and replace the implant.


Because woman’s breasts continue to grow until their late 20s, the FDA requires women to be at least 18 years old to get saline implants and 22 years old to get silicone implants


The final consideration is cost. The bottom line is that saline implants are generally less expensive upfront and in the long-run. Breast implant manufacturers charge about $1,000 more for silicone implants than saline. Additionally, due to the risk that your silicone implant may rupture it is recommended that women get an MRI three years after surgery and every two years after that. This is not covered by health insurance plans.

Learn more

Our team of experts would love to talk with you about which type of implant is best for you and how breast augmentation can help you look and feel your very best. Please schedule an appointment or give us a call at 615-454-2271 to learn more!

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2201 Murphy Avenue, Suite 301,
Nashville, TN 37203

At Nashville Plastic Surgery, we have a deep understanding of the important role that physical image plays in life, yet we never lose sight of emotional well being. Our approach to plastic and reconstructive surgery integrates these fundamental principles to promote overall health.