Saline breast implants were originally designed by plastic surgeon Henry Jenny because of his concerns about the safety of silicone gel breast. In addition, they can be implanted through a smaller incision (2.5-3 cm) than that required for a silicone implant. After the FDA silicone gel moratorioum in the early 1990’s, saline implants became the dominant type placed in the United States.

The complications for saline breastimplants are similar to those for silicone gel implants, including infection, malposition, rupture, and capsular contracture. Case reports of bacteria and fungal contamination have been reported. Advantages of saline implants include intraoperative adjustability, ease of removal, decreased capsular contracture rates,and cost (several hundred dollars less per implant than silicone).

As compared to silicone gel however, saline implants are more likely to cause rippling, wrinkling, and be noticably palpable. Many surgeons also feel that they are more likely to cause an attenuated “bottoming out” appearance of the lower breast pole tissue from the dependent weight of the saline filler. Some of these characteristics can be improved with newer designs, submuscular or partial submuscular placement (the “dual-plane” technique) of the implant and proper implant sizing.

In patients with more breast tissue, it can be difficult to discern an advantage in feel or appearance to silicone. However, with thin breast tissue coverage, and particularly in the setting of post-mastecomy reconstruction, silicone is felt to be the superior device by most Plastic Surgeons.