Both silicone and saline implants have a silicone outer shell; the difference is the filling. In the UK, the great majority of breast augmentations use cohesive silicone gel implants because they generally feel more natural and are less prone to visible rippling. Saline implants, filled with sterile salt water, are rarely used in the UK today but remain more common in some other countries.
What is the difference?
- Silicone gel implants: filled with a cohesive silicone gel that holds its shape, often described as ‘form-stable’ in firmer versions. They come pre-filled in a range of shapes, sizes and profiles.
- Saline implants: an empty silicone shell that is filled with sterile salt water during surgery, which allows the volume to be adjusted and a slightly smaller incision to be used.
Why silicone is the usual choice in the UK
Modern cohesive silicone gel implants feel closer to natural breast tissue, and they are less likely to show visible rippling or wrinkling, especially in slim women with little natural breast tissue. They also keep their shape if the shell is damaged, because the gel does not flow away. For these reasons, silicone gel implants from established manufacturers are the most commonly used type in the UK. With your consent, implants can be recorded on the Breast and Cosmetic Implant Registry, which helps trace implants if a safety concern arises.
Feel and appearance
Saline can feel firmer and more ‘watery’, and is more prone to rippling that can be seen or felt, particularly at the sides and bottom of the breast. Silicone gel tends to move and feel more like breast tissue. The final look depends on many other factors, too: your anatomy, implant size and profile, whether the implant is placed above or below the muscle, and your skin quality.
What happens if an implant ruptures?
- Saline: if the shell fails, the salt water leaks and is absorbed by the body. The breast deflates noticeably, usually over days, so it is obvious.
- Silicone: cohesive gel usually stays within the implant pocket, so rupture may cause no symptoms (‘silent rupture’). It may be picked up on ultrasound or MRI, or may cause a change in shape, firmness or discomfort.
In either case, a ruptured implant is usually removed or replaced. If you notice a change in shape, a new lump, swelling or pain in a breast with an implant, see your GP or contact your surgeon.
Safety considerations
Breast implants are not lifetime devices, and further surgery may be needed at some point, whether for rupture, capsular contracture (hardening of scar tissue around the implant), changes with age or pregnancy, or a wish to change size. Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare cancer of the immune system that has been linked mainly to textured implants; symptoms include late swelling of the breast months or years after surgery, and it should be checked promptly. Some women report a range of symptoms they attribute to their implants, sometimes called breast implant illness; this is not fully understood and is discussed openly at consultation.
Choosing your implant
Mr Nassab will examine you, take measurements and talk through your goals, lifestyle and body shape to recommend an implant type, size, shape and position. Minimally invasive awake breast augmentation using the Motiva Preserve technique may suit some patients, and Mr Nassab can explain whether it is an option for you. Breast augmentation is for adults aged 18 and over.
Recovery and cost
Most people return to desk-based work within one to two weeks, avoid heavy lifting and upper body exercise for around six weeks and wear a supportive bra as advised. Swelling settles over a few months. Risks include bleeding, infection, capsular contracture, changes in nipple sensation, asymmetry, rippling and the need for further surgery. Breast augmentation with Mr Nassab is £8,500, plus a £150 consultation fee.
Frequently Asked Questions
Are saline implants safer than silicone?
Both types have a silicone shell and similar risks of surgery. Silicone gel is the standard choice in the UK and is regarded as safe, but all implants carry risks and may need replacing.
Which feels more natural, silicone or saline?
Silicone gel generally feels more like natural breast tissue and is less prone to visible rippling.
How long do breast implants last?
Implants are not lifetime devices. Many last for years, but further surgery may be needed at some point.
Can I switch from saline to silicone?
Yes. Saline implants can be exchanged for silicone implants in a revision operation.
Do I need scans to check my silicone implants?
Routine scanning is not always needed, but ultrasound or MRI is used if rupture or another problem is suspected.
