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Purely from an aesthetic point of view, silicone implants are superior to saline filled ones. Silicone implants are softer and less likely to leave the patient with palpable implants or visible ripples. Over time, saline filled implants lose a little water and slowly decrease in size, creating visible ripples and palpable edges. In our practice we definitely prefer extra high profile, highly cohesive (“gummy bear”), silicone gel filled implants and normally use Allergan SRX implants or Mentor Ultra High Profile Memory Gel implants.

One drawback of the gels is that ruptures are difficult to detect. With a saline implant, the water gets absorbed by the scar tissue surrounding the implants and the problem is immediately evident as the breast deflates. With ruptured gel implants, the breasts will look and feel the same and the only way to confirm that a rupture has taken place is with annual mammograms or an MRI. We now know that the presence of a ruptured implant cannot cause any diseases, but why would someone elect a gel if a rupture is more difficult to detect? The answer is quite simple – gel implants are far superior to saline filled bags in feel and appearance. Patients with saline implants have a higher likelihood of a firm or unnatural feeling breast. Also, surface ripples and wrinkling, or a palpable implant, are far more likely with saline implants. Many patients who were implanted with saline implants in the past are now coming in to have their breasts evaluated with the thought of replacing their implants with the new gels. But are gel implants for everyone? Dr. Dennis C. Hammond of Grand Rapids, MI, a recognized expert in the plastic surgery community, recently stated, “There is a whole generation of surgeons out there who trained after silicone implants were removed from the market in 1992 and they have had a satisfactory experience with saline implants. Many of these surgeons will continue to use saline implants”. In my opinion, the proper thing to do at this time is to provide each patient with the pros and cons of all available implants types and to let them participate in the implant choice. But once my patients have had a full consultation, including an opportunity to see or feel both types of implants, most today choose a gel implant for themselves.

If you have any specific questions about cosmetic procedures, your best bet would be to see a qualified plastic surgeon to review your options. Please feel free to contact our office at 949-888-9700 to set up an appointment with Dr. Bunkis; you may also check out our web site at to see further examples of similar patients. You may also wish to come to our ALL ABOUT BREASTS SEMINAR on March 22nd – one lucky person will win a free pair of breast implants!