Saline vs. Silicone: The Differences Between Saline and Silicone Breast Implants

Saline vs. Silicone Implants

Saline implants are filled with sterile saltwater, while silicone implants are filled with silicone gel. These breast implants have a few other core differences: how they feel and look on your body, how ruptures present, and what long-term monitoring may be recommended.

With board-certified surgeons across our West Coast centers and AAAHC-accredited surgical facilities, the Athēnix approach is grounded in safety, advanced technique, and informed decision-making. Below, we break down the differences between saline and silicone breast implants so you can walk into your consultation confident and prepared.

Basic Types of Breast Implants

• Saline implants have a silicone outer shell and are filled with sterile saltwater—usually filled during surgery (Mayo Clinic)
• Silicone gel implants have a silicone outer shell and are pre-filled with silicone gel in varying cohesiveness (including more form-stable “cohesive gel” styles)
• Gummy bear implants generally refer to more cohesive, form-stable silicone gel implants designed to hold their shape more firmly

Saline vs. Silicone (Side-by-Side)

“Gummy Bear Implants” Explained

The term "gummy bear" refers to cohesive silicone gel implants, which maintain their shape more effectively than previous gel styles. These implants can help you achieve your cosmetic goals—whether you're aiming for subtle fullness, upper pole structure, or a specific profile—while still prioritizing a natural appearance that complements your body.

Safety, Risks, and What We Monitor Long-Term

No implant is considered a “lifetime device.” Breast implants are medical devices with known potential complications that can include capsular contracture, rupture, pain, infection, and the need for reoperation.

Rupture surveillance and imaging

For silicone gel implants, the FDA has discussed rupture screening surveillance, commonly summarized as ultrasound or MRI, starting 5–6 years after placement and then every 2–3 years after that.

Systemic symptoms (“breast implant illness” reports)

The FDA has published information about medical device reports of systemic symptoms reported by some patients with breast implants. The science and terminology here require nuance—your symptoms deserve to be taken seriously, evaluated thoroughly, and managed with an individualized plan.

BIA-ALCL and textured implant awareness

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare lymphoma most strongly associated with textured implants. It typically presents in the tissue/fluid around the implant (BIA-ALCL Physician Resources | American Society of Plastic Surgeons).

How Long Do Implants Last?

Implants don’t have a guaranteed expiration date, but over time, the likelihood of needing a revision can increase due to natural aging, shifting preferences, or complications. Ongoing patient education and follow-up are part of implant care.

Cost Breakdown

• Surgeon expertise and credentials: At Athēnix, your procedure is performed by board-certified plastic surgeons with advanced fellowship training and thousands of successful procedures performed across our West Coast centers. This experience matters when anticipating and preventing complications.
• Facility safety standards: All Athēnix surgeries are performed in AAAHC-accredited surgical centers that meet rigorous national standards for patient safety, sterilization protocols, anesthesia administration, and emergency preparedness. Accredited facilities provide an added layer of protection that should never be overlooked.
• Implant type and features: The differences between saline and silicone breast implants—including cohesive gel or “gummy bear” options—can affect cost. Implant manufacturer warranties, technology advancements, and profile selections are also considered when building your surgical plan.
• Surgical complexity: An augmentation alone differs from an augmentation combined with a lift, revision surgery, implant exchange, or correction of asymmetry. Revision procedures, in particular, require elevated surgical precision and planning.
• Anesthesia and surgical team expertise: Board-certified anesthesia providers and experienced operating room staff are essential components of a safe surgical experience. At Athēnix, your care is delivered by a coordinated, highly trained team focused on safety from start to finish.
• Post-operative care and long-term planning: Follow-up visits, recovery guidance, imaging recommendations when appropriate, and ongoing communication are part of a responsible surgical approach. Breast implants are medical devices that require long-term monitoring; your care should reflect that.
• Comprehensive consultation process: Your initial consultation includes detailed measurements, discussion of implant placement options, incision strategies, and a review of potential risks and long-term considerations. This planning phase is one of the most critical components of achieving a safe and predictable outcome.

How to Choose: The Shortlist We Use in Consultation

When we guide implant selection, we focus on what actually determines your outcome:

• Your tissue thickness and chest dimensions
• Your desired shape (soft slope vs fuller upper pole)
• Your lifestyle and tolerance for trade-offs (rippling risk, monitoring preferences)
• Whether you may benefit from placement strategy changes
• Your long-term plan for follow-up, imaging, and revision planning when needed

FAQs: Differences Between Saline and Silicone Breast Implants

Which looks more natural?

It depends on your starting tissue, implant size, placement, and goals—but silicone gel implants are often chosen for a more natural feel, particularly in patients with thinner tissue.

Which is safer?

Both saline and silicone implants are FDA-regulated medical devices with known benefits and risks. “Safer” usually comes down to appropriate patient selection, meticulous technique, accredited facilities, and a strong follow-up plan.

Do silicone implants require MRIs forever?

FDA guidance commonly references ultrasound or MRI screening intervals for surveillance of silicone gel implant rupture. Your surgeon will personalize recommendations based on your history and clinical needs.

Are “gummy bear implants” always better?

Not automatically. Cohesive gel implants can be an excellent option—but “best” depends on your anatomy, desired look, and the surgical plan that supports long-term outcomes.

The Differences Between Saline and Silicone Breast Implants Go Beyond Saltwater vs. Gel

What ultimately determines your outcome is the combination of implant selection, surgical technique, tissue support, and thoughtful long-term follow-up. That’s why this decision should never be based on trends, online opinions, or a single feature comparison.

At Athēnix, your augmentation plan is developed by board-certified plastic surgeons who evaluate proportion, skin quality, structural support, and aesthetic balance before recommending a specific implant type. Every procedure is performed in AAAHC-accredited surgical centers with rigorous safety standards, experienced anesthesia providers, and coordinated surgical teams focused on precision and protection at every stage.

If you’re ready to move beyond general comparisons and receive guidance tailored to your body and goals, we invite you to book your consultation with Athēnix today.