Saline vs. Silicone Implants: What's the Difference?

A breast augmentation, one of the most popular cosmetic surgery procedures every year, can be used to increase the size and shape of existing breasts or reconstruct breast tissue that has been removed due to cancer. According to the American Society of Plastic Surgeons' Plastic Surgery Statistics Report for 2022, breast augmentation was the second most commonly performed cosmetic procedure in the United States.¹

While a breast augmentation may occur along with a breast lift, they are different cosmetic procedures. Patients considering a breast lift or augmentation should consult with a certified plastic surgeon to determine the best procedure or combination of procedures for their desired results.

The focus of a breast lift is to get the best breast shape and nipple position possible and works to achieve these goals by tightening surrounding tissue and removing excess skin. These patients are looking to change their drooping breasts with a more youthful, perky shape that they had prior to childbirth, aging or weight loss.

A breast augmentation, on the other hand, aims to increase the breast size. This can be performed by transferring fat from another part of the body, or more commonly, by inserting a breast implant.

Breast implants are filled with either saline or silicone. For individuals considering undergoing breast augmentation, one of the biggest decisions can be the choice between these two types of implants. Here's information that can help you to make the right decision for your procedure.

Saline vs. Silicone Breast Implants

Breast implants are offered in two different FDA-approved materials—saline and silicone. Both types of implants have a silicone shell.

• Saline breast implants are a combination of a medical-grade silicone shell filled to the desired volume with saline, a sterile solution of saltwater.
• Silicone breast implants have a silicone shell prefilled with medical-grade silicone gel.

Both saline and silicone implants can come in either smooth or textured shells. Smooth shells can move within the implant pocket, which may provide the appearance of more natural breast movement. A textured shell is designed to prevent the implant from moving out of place, but can increase the risk of a rare lymphoma.

Features of Saline and Silicone Breast Implants

Saline and silicone breast implants offer different benefits and features. Both saline and silicone implants have a variety of options that impact the overall look of the breast augmentation:

• Fill volumes: The volume of an implant is measured in cubic centimeters or cc's. Implants between 130 to 150 cc's equate to roughly an increase of one bra cup size.
• Shape: Breast implants are available in both round and teardrop shapes. Round implants are more common and provide a more spherical appearance to the breast. Teardrop-shaped implants are fuller at the bottom than the top and can provide a more tapered look.
• Base widths: The base width is the measurement from side to side and from top to bottom of the implant. Those with narrow or wider frames should look to ensure the base width of their implant matches their body type.
• Profile height: From low to moderate, full to extra-full, the profile of an implant impacts the projection and overall appearance of the breast implant.

Saline-filled implants have their volume adjusted by adding or removing saline during the operation. Some saline implants can even be adjusted postoperatively by a remote port to revise the desired volume over the first few months of recovery.

The ability to fill saline implants after they have been surgically inserted means that the incision can often be smaller and therefore more discrete.

Since saline is a liquid, saline implants often have a firmer feeling. However, for those with thinner skin the edges or folds of a saline-filled implant can sometimes be seen under thin skin and can cause rippling.

Silicone implants cannot be adjusted like saline implants, but do come in a variety of fill volumes, base widths and profiles. Due to the viscosity of the gel, silicone implants can create a more natural breast-like feel and appearance.

Safety and Risks of Saline and Silicone Breast Implants

While the majority of individuals who have breast augmentations do not have major issues, there are potential risks and complications that should be considered.

Both saline and silicone breast implants have been FDA-approved; saline implants in 2000 and silicone in 2006. Although there are no legal age limits for breast implants, most plastic surgeons follow FDA recommendations that endorse saline implants for individuals 18 years and older and silicone implants for patients 22 years and older.

• Surgery: Breast augmentation, like any surgery, poses the possible risk of complications due to the surgical procedure itself. There may be issues from anesthesia, infection, bleeding or difficulties during the healing process such as scar tissue or pain. There can also be complications with the implant itself such as rotating, rippling or capsular contracture.
• Breast implant rupture: Both saline and silicone implants have a potential risk of rupturing. If a saline implant ruptures, there will be visible deflation, and the fluid will be absorbed by the body and removed. Silicone implant ruptures are sometimes called “silent ruptures" since it may not be physically obvious that the implant has broken. Often an MRI is needed to detect or confirm a suspected silicone implant rupture. The silicone gel does not absorb into the body and may cause tenderness, swelling or even migrate to other parts of the body.
• Other risks: Other rare complications can come from textured breast implants which the FDA warned have been found to have an association with a rare form of lymphoma called Breast Implant Associated Lymphoma (BIA-ALCL), as well as a condition labeled as breast implant illness (BII) in which patients experience a variety of symptoms including joint pain, fatigue and brain fog. Some research dismisses the symptoms as unrelated to implants while other research suggests that the condition is worthy of additional study.

How Long Do Breast Implants Last?

Breast implants are not lifetime products. Both saline and silicone implants are estimated to last an average of 10 years, but may be able to maintain their condition for up to 20 years and beyond.

The longer you have implants, the larger the risk that they will rupture or have issues. Additional surgeries may be required to replace an implant or remove the implants and/or the capsule, the scar tissue that is created around the implant.

How Much Do Saline and Silicone Breast Implants Cost?

The cost for a breast augmentation varies based on the type of procedure, if there is a fat transfer, geographic location, the cost of the surgeon and any added procedures such a breast lift, liposuction or mommy makeover.

According to CareCredit's 2023 Average Procedural Cost Study for Cosmetic Practices Across the United States, the average cost* of a breast augmentation is $7,149, though it can range from $5,100 to $18,465.²

It is important to note that this does not include other commonly required costs, such as initial consultations, anesthesia, prescriptions, as well as surgeon and facility costs.

Here are the average costs for a breast augmentation by state or region:²

Whether you decide that saline implants or silicone implants are the best fit for your breast augmentation, be sure to understand your options and what is right for you.

Financing Breast Implants With the CareCredit Credit Card

Ready to revitalize your appearance and boost your confidence? The CareCredit credit card makes it easy to pay for breast implants and related expenses not covered by health insurance.** Use our Acceptance Locator to find a doctor or cosmetic surgeon near you that accepts CareCredit so you can stop dreaming and start living your best life. Continue your wellness journey by downloading the CareCredit Mobile App to manage your CareCredit account, find a provider on the go and easily access the Well U blog for more great articles, podcasts and videos.

In addition to cosmetic procedures, you can also use your CareCredit credit card for dentistry, pet care, vision, hearing, health systems, dermatology, pharmacy purchases, spa treatments and so much more within the CareCredit network. How will you invest in your health and wellness next?

Expert Reviewer

Dr. Justin West, M.D., F.A.C.S.

Dr. Justin West is a board-certified plastic surgeon practicing at Finesse Plastic Surgery in Orange, California, focusing on aesthetic surgery of the face, breasts and body. He creates results that enhance his patients' natural beauty, and has been recognized throughout his career with awards that include Top Surgeon in Newport Beach, RealSelf Top Contributor and Top Doctor and Patients' Choice.

Author Bio

Kate Bayless is a health and wellness freelance writer with 15 years of experience. Her work has appeared in Parents, Women's Health, Beachbody, and OpenFit.