Saline vs. Silicone vs. Structured
Breast augmentation patients have a choice between breast implants filled with saline (salt water) or silicone gel. Silicone breast implants have become the implant of choice in the U.S. because they provide results that are more natural looking and feeling than saline. In fact, in the majority of breast augmentation procedures Dr. Sorokin performs, patients choose silicone breast implants. A third type of implant is the “Structured” breast implant. This is a specific type of saline breast implant that is designed to have more of the feel of silicone gel even those it is composed of saline. It has an internal structure of individual shells and baffles that slow saline movement from compartment to compartment and these individual lumens allow the “Ideal Implant” to perform more like a silicone implant. To get more detailed information please refer to my blog post about the Ideal Implant. While Dr. Sorokin does not feel that the Ideal Implant is quite the same as silicone it certainly has some nice qualities to consider over traditional saline breast implants.
In New Jersey, women trust Dr. Sorokin to provide pleasing results without compromise to their safety. He uses strictly FDA-approved silicone implants made by reputable manufacturers.
After a long and troubled history, silicone breast implants returned to the U.S. market as FDA-approved medical devices in 2006. Dr. Sorokin was delighted because his New Jersey and Philadelphia breast augmentation patients had more choices when it came to implant type. The FDA has declared that silicone gel implants from Allergan, Mentor, and Sientra are safe and effective medical devices.
Breast implant manufacturers continue to refine their products to improve safety and enhance quality. The silicone breast implants that Dr. Sorokin uses today are safe and provide high quality results. Patients can choose from:
- Cohesive silicone gel is soft, thick and gooey. These implants, which include Mentor MemoryGel® and Allergan Natrelle®, have an elastic silicone outer shell that is resistant to ruptures or tears. These are 4th generation implants which many surgeons still use extensively. The newer, more highly cohesive implants known as “Gummy Bears” are 5th generation. Dr. Sorokin no longer uses 4th generation devices and suggests that you ask your surgeon specifically what type of implant will be used. As far as Dr. Sorokin is concerned, there are newer better options and not all “cohesive gel” is “gummy.”
- Form stable silicone gel is also soft, but not gooey. These implants, often called “gummy bear” implants, retain their shape when cut, much like the namesake candy. FDA-approved options include Sientra® Silimed-brand implants, which have been available in Europe since 1995, Allergan Natrelle® shaped 410 implants were removed from the market in 2019 due to a rare potential association with lymphoma. There are textured shaped implants still available from Mentor and Sientra but Dr. Sorokin will not use textured implants due to the ALCL lymphoma association. Dr. Sorokin will only use smooth shelled devices. These “Gummy Bear Implants” have different pros and cons and Dr. Sorokin will discuss specific advantages based on your starting breasts and desired goals. These implants are more durable, offer better shape retention, and in the event of a rupture the gel is less likely to migrate.
- Saline breast implants continue to be available as well, and can be an appropriate choice in certain instances. In the saline category there are traditional saline implants as well as the newer structured breast implant, the “Ideal Implant.” While the structured implant is more expensive than traditional saline, it feels a little better than traditional saline.
- Structured Saline Implants known as the Ideal Implant. Using cleverly designed internal lumens and chambers, the saline in the Ideal Implant holds more of a shape than a traditional saline implant. The Ideal Implant is actually filled from two separate fill ports and the multiple chambers are isolated from each other. This complex geometry allows for an implant that feels more like a silicone gel implant. While Dr. Sorokin does not believe it feels the same as silicone, it is a little bit nicer of a feel than plain saline. For the lady who is afraid of silicone and willing to spend a premium for this implant, it is certainly a device to consider! Unfortunately Dr. Sorokin has seen these ladies back months down the road and often the Ideal Implant still has more rippling and feels more saline than patient’s desire. So, despite Ideal Implant’s advertising it is still saline, and while an upgrade, it certainly doesn’t feel like silicone.
At your consultation, Dr. Sorokin will evaluate your individualized needs and help you to make the most satisfying implant choice.
Silicone vs. Saline Comparison
There’s no right option when it comes to choosing silicone or saline breast implants. Each type option offers its own advantages and disadvantages which include:
- Advantages: Provide a natural look and feel; provide good results for patients with little natural breast tissue; hold their shape better.
- Disadvantages: Make ruptures difficult to detect; more expensive than saline; For cosmetic use must be age 22 or older, for reconstruction can be 18 years old.
- Disadvantages: Can ripple, wrinkle and slosh; feel firmer than silicone
- Advantages: Less expensive than silicone; leaks are immediately noticeable