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The Latest Buzz About Breast Implants, Part 2

In researching breast augmentation, some women come to a screeching halt when investigating implants, their thoughts punctuated by questions like: What type of implant should I get, silicone gel or saline? Which one is better? Which is safer?

Both types of implants have their advantages, and some patients are better candidates for one type than the other, depending on their anatomy and their personal choices. The main reason women opt for silicone gels is the feel. If you’re interested in doing a low-tech experiment, fill a plastic bag with thick molasses. Then hold the filled bag in your hands to give you an idea of what a silicone gel implant feels like (more or less). Next, fill another plastic bag with water to represent a saline implant. Now feel the difference between the two.

In addition to a more natural feel, silicone gel implants are much less likely to have visible wrinkling. For this reason, 80% of our patients choose silicone gel implants. But salines have their advantages as well. In fact, both types of implants have their advantages and their disadvantages. Below is a list of the plusses and minuses of each:


+ More natural look, with low rate of wrinkling

+ More natural feel

+ Lower reoperation rate than salines in our practice

+ Greater satisfaction in our practice by patients who switched from salines to silicone gels

Not FDA-approved for women younger than 22.

More expensive than salines

The FDA recommends an MRI at three years and every two years after to look for leakage.

In some cases a longer incision is necessary than with salines, though in our practice this is not common.


+ Less expensive than silicone gels

+ Available for breast augmentation in women 18 and older

+ Can fit into a smaller incision (though our silicone gel incisions are usually just as small through the use of advanced surgical techniques)

Less natural feel, especially in women with little breast tissue.

Wrinkling is common and is sometimes visible, especially along the sides and underneath.

Can leak, with loss of volume (The saline is harmless, but the volume loss can be distressing.)

Higher Reoperation rate than silicone gels in our practice, due to loss of volume and wrinkling. Reoperation is generally an out-of-pocket cost, except what may be covered by the implant company in the case of leakage.

If you are considering a breast augmentation, do your homework before surgery so you can rest assured that you have chosen the right surgeon, the right type of implant, and the right size for you. Whatever their decision, women who have had their breasts augmented have a very high satisfaction rate.

What’s the main complaint our patients voice after breast augmentation surgery? They should have done it sooner!


Dr. Heather Furnas

About Dr. Heather Furnas

Inspired by watching her plastic surgeon father operate in African bush hospitals, Dr. Heather Furnas followed in his footsteps, training at Stanford and serving on the Harvard clinical faculty. She and her husband, Dr. Paco Canales, practice together in Santa Rosa, California, where they raised their two children. (To learn more about their practice, visit She believes an informed patient is more likely to be a happy patient and is committed to providing that education. If you have any suggestions for topics you'd like to learn more about, she would love to hear from you!

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