Perhaps no other cosmetic surgery has been in the news more this year than breast implants.

Earlier in 2017, the FDA released a statement about a “rare T-cell lymphoma that can develop following breast implants,” a condition that is more associated with textured than smooth implants. While uncommon, they advised that people continue their “routine medical care and follow-up.”

There has also been a lot of talk about the safety of silicone–but not inside breast implants. The FDA also issued a statement against using injectable silicone in the body for contouring, stating that “injectable silicone is different from the silicone contained within approved breast implants, because the breast implant shell keeps the silicone from migrating within the body.”

Despite all this, breast augmentation with implants continues to be an incredibly safe procedure for most people. To dispel some of the myths, we talked to top breast implant surgeons to find out what you need to consider when choosing between saline and silicone breast implants.

 

Safety

“There has been no device more extensively studied than breast implants,” says Dr. Franklin Richards, a plastic surgeon in Bethesda, Maryland. “Saline and silicone implants are equally safe.”

While both are safe, finding a leak in a silicone implant does require extra tests.

“You will know when a saline implant ruptures without having to do any tests because your implant will deflate, and it’ll be obvious,” says Dr. Robert M. Grenley, a Seattle plastic surgeon. “With silicone gel implants, implant rupture cannot be diagnosed by physical examination and usually does not show up on mammograms. An ultrasound or MRI exam is usually required to detect a ruptured silicone gel implant.”

Silicone gel isn’t thought to cause systemic or long-term health problems, including breast cancer, reproductive problems, or rheumatoid arthritis. Still, a ruptured silicone breast implant might eventually cause breast pain or changes in the contour or shape of the breast.

Doctors on RealSelf recommend that women who have silicone gel-filled implants should get an MRI scan three years after the implant surgery and then scans about every two years.

 

Related: Read more in our Breast Implants Guide.

 

Cost

Silicone implants cost approximately $1,000 more than saline implants,” says Dr. David Finkle a plastic surgeon in Omaha, Nebraska, in a RealSelf Q&A. 

Beyond that initial implant cost from the manufacturer, the lifetime cost of silicone implants can be slightly higher than saline because of the ongoing maintenance of MRI costs.

According to RealSelf data, the average U.S. cost of breast implants is $6,325. Cost is affected by your location, doctor’s skill level, and the complexity of your individual surgery.

 

Feel

“All a patient usually needs to do is feel a saline implant and a silicone implant, and 99% will pick silicone,” says Dr. Frederic H. Corbin, a Los Angeles plastic surgeon. 

Why? Doctors on RealSelf say that silicone implants are made of a material that more closely mimics the weight and suppleness of a natural breast than liquid saline solution.

 

Look

Choosing your implant material can also depend on the shape and size of your natural breasts. For some patients with less breast tissue there’s a higher chance that “saline implants will also have a less natural appearance and a greater risk of visible implant wrinkling,” says Dr. Grenley.

But, some pre-op patients with asymmetrical breasts may choose saline because the volume of each implant can be adjusted with more saline solution to even out the breasts.

 

Age

The FDA requires that women must be at least 22 years old for silicone implants, but only 18 for saline implants.

Overall, most doctors on RealSelf say that silicone is the more popular choice. Of course, everybody is unique and your needs might be different than your sister’s, so talking to a board-certified plastic surgeon is the best way to determine what kind of implant is right for you.

And when you’re ready, make sure you know the 20 essential questions to ask at a breast implant consultation.