Breast augmentation surgery is one of the most common and popular elective surgeries. From reconstruction of the breast after mastectomy to giving the breasts more volume, implants are versatile. For those considering getting breast implants, one of the first choices is whether to use saline or silicone.

Saline VS Silicone: The Main Differences

Both saline and silicone implants feature a solid shell made of medical-grade silicone. That’s where the commonality ends.

Saline Implants: Saline implants are placed when they are empty. They are then filled with sterile saltwater to the predetermined volume.

Silicone Implants: Silicone implants are pre-filled with silicone gel that feels quite similar to human fat.  Most patients find that silicone gel gives a convincingly natural look and feel.

History of Implants

Patients have been getting both silicone and saline implants since the 1960s. There was a preference for silicone implants from the very beginning since patients felt they were more natural-looking.

1992 brought an FDA ban on silicone implants. The ban lasted from 1992 to 2006. The FDA had concerns that silicone implants may be associated with an increased prevalence of autoimmune disorders. After thorough investigation found that there was no difference in autoimmune disorders in people with silicone implants vs. no implants, the ban was lifted and silicone implants became an option again.

Aesthetic Properties

The biggest reason many women prefer silicone implants is because they look and feel more natural than saline in most cases, particularly in thin patients. The gel has a more convincing consistency that feels realistic. Silicone implants are also not as susceptible to rippling as saline and they work well for those who do not have much natural breast tissue.


Silicone implants come pre-filled, which may result in a longer incision than for augmentation using saline implants.  If the Keller funnel is used, the resultant scarring is very similar.  Silicone implants may be placed through an incision just over an inch long using this tool.  Both saline and silicone implants may be placed through incisions at the breast fold, lower border of the areola, and underarm.  While it is technically possible to insert saline implants through the navel, this is not a preferred approach.  It is difficult to precisely place the implants from a longer distance with limited visibility.


There is a risk of rupture with both types of implants, but ruptures can look different in each case.

Saline: Saline implants contain only salt water. If a saline implant ruptures, it will be immediately noticeable because the breast will lose volume and shape. The saline will be safely absorbed by your body.

Silicone: The latest generation of silicone implants is made of cohesive gel, the so-called “gummy bear” implant.  Rupture might be harder to detect for these implants, since silicone does not spill out from the implant.  If a small break in the implant shell develops, there may be no outward symptoms.  It may be detected as an incidental finding on breast imaging, whether mammogram, ultrasound, or MRI.  In some cases of silicone implant rupture, patients may develop discomfort or notice change in their appearance.  Routine imaging may detect ruptures, so your plastic surgeon will give you the best idea of what to expect.

Overall Cost

Silicone implants are generally more expensive than saline implants, but it’s important not to let cost guide your decision-making, especially if you have a certain outcome in mind. Your plastic surgeon can help you find the right implants for your goals during your consultation.

Schedule a Consultation

It can seem overwhelming to consider your options for breast implants, but your plastic surgeon can help. To meet with Dr. Power and learn more, we invite you to contact our Toronto area office by calling or filling out our online form.