Saline Breast Implants: Your Top 8 Questions Answered

Silicone or saline? This is one of the many decisions you’ll make along your breast augmentation journey. While saline implants are the most frequently used in the United States, that doesn't mean they're the right choice for you. Below we discuss the nature and design of saline breast implants to make the decision easier and clearer for you.

1. What is a saline breast implant?

Saline implants consist of an elastic silicone shell filled with a saline (salt water) solution. Saline is similar to fluid found naturally in the human body, and therefore will feel firmer to you than a silicone gel-filled implant.

The shell surface of saline implants is either smooth or textured, and the implant itself can vary in volume, shell thickness, profile, and shape. They are also expandable. Most saline implants are single lumen, filled with a fixed volume of saline at the time of surgery. There are pre-filled saline implants filled by the manufacturer; however, none have FDA approval at this time.

2. What is the size range for saline implants?

Saline breast implant sizes range from 120cc to 960cc. If you want implants larger than 850cc, you will need custom implants. Currently, the only implants available for use in the United States are those manufactured by Mentor Corp. and Allergan.

3. How much do saline implants cost?

On average, the procedure for saline implants is about $2,000 cheaper than silicone implants. This is because of the production cost of the materials.

4. Will there be visible rippling?

Rippling is more common in saline breast implants than silicone because the saline tends to move more with the body’s position. Rippling is most common on the outer edge of the implant near the armpit, but is more often felt than actually seen. Folds are likely to occur in the shell of an implant if it happens to be underfilled. Filling an implant to capacity and placing it below the chest muscle will hide any potential rippling.

5. What happens if the implant shell ruptures?

The shell of a saline implant consists of a strong silicone elastomer, filled with a sterile saline solution at the time of surgery. Should these implants rupture, the body will absorb the saline, much like it does when you drink a glass of water. The sterile saline solution, used as the implant filler, should conform to the United States Pharmacopeia of normal physiological saline (injection grade), which has a concentration of 0.15M and a pH of 7.2-7.4.

6. Is the Ideal saline implant FDA approved?

In 2014, the FDA approved a new breast implant design, the Ideal Implant. This design has a series of shells layered together that hold the saline. The purpose behind the new implant is to diminish the chance of rupture and deflation by way of controlling the saline movement. Also, the exterior edges of the breast implant are lower than standard implants to contour more closely to the chest wall.

7. Why do saline breast implants have valves?

All inflatable implants have valves located on the anterior or front of the implant. There are a few types of valves: the leaf valve, the kink valve, and the diaphragm valve.

Mentor and McGhan no longer use the leaf valve, which is a flat sleeve about 1.5 inches long that allows for a stylet (metal catheter) to thread through. When the stylet is removed, the sleeve goes flat, sealing the valve. The leaf valve has had a high degree of user trauma. If the stylet was forced hastily into the sleeve, damage could occur to the valve, thus causing leakage.

The diaphragm valve is like a snap closure you’d find on clothing. The male portion at the end of the tubing snaps into the female receptor hole, which are incorporated into the implant shell.

8. What are Spectrum expandable saline breast implants used for?

The Spectrum Expandable saline implant can be used as a permanent expander, or as a "regular" breast implant for general breast augmentation. This implant has the Becker valve, fill tube, and reservoir system. For use as a "regular" implant, the fill port and tube is removed at the time of surgery, sealing the valve. Once the fill tube is removed, you can no longer add or remove saline from this implant, as you can from most other saline implants.

For use as an expandable implant, the fill tube is left in place. A special fill port is attached to the tube, through which saline can be added or removed. Saline is usually added in 50cc increments. Once the desired size has been achieved, a minor surgical procedure is performed in your surgeon's office, during which the fill port and tube are removed. This closes the valve, sealing the implant. In the event of a redo, the incision will need to be a little longer, because the implant will have to be removed in tact, since the valve cannot be reopened.

The Spectrum Expandables come in smooth round, textured round, and contour profile, with the valve located on the posterior surface of the implant. The Spectrum valve has three sealing mechanisms. As the fill tube is removed, the kink valve, leaf valve and the plug offer triple protection against valve failure.

Updated August 2016

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