Which is Right for You? Saline Implants, Gel Implants, or Fat Transfer
Understanding Your Breast Augmentation Options
When it comes to breast augmentation, there are three main approaches: saline implants, gel (silicone) implants, and fat transfer. Let's break down the differences so you can make the most informed decision for your body and goals.
Gel (Silicone) Implants: The Most Popular Choice
Most of my patients end up choosing gel implants because they look and feel more natural. But what exactly is inside a gel implant?
When I tell my patients that the inside of a gel implant is like a gummy bear, what do I mean? I mean the gel is cohesive—it's sticky and holds together. Cohesivity isn't a spectrum; it's a "yes or no." If a gel is cohesive, it does NOT leak, which also means that if your implant were to rupture, the silicone stays put inside the breast implant pocket/capsule. However, there are different amounts of "stretch" to the gel.
People often worry about the risk of gel implants rupturing, but it's important to note that the material inside is very sticky and will stay in place. Our gel implants today are considered 5th and 6th generation—they're more cohesive than the original silicone implants on the market and far less likely to cause issues if there's a rupture. The technology has gotten SO much better over the years, which makes the actual risk of rupture very low.
For some perspective, a 30-year-old implant would have gel that is much runnier, so it could potentially escape the capsule and cause little masses of silicone in the body. This really rarely happens with modern implants. We now have a lower risk of rupture, and the gel stays put even if a rupture occurs.
For example, Motiva offers two types of gel, both cohesive but one is a bit stretchier than the other.
Saline Implants: A Less Common But Valid Option
Only about 2% of my patients choose saline implants, but there are some specific situations where they make sense:
If you have asymmetry between your breasts, saline allows for precise volume adjustments
If you'd like to know immediately if there's a rupture (the implant will deflate and you'll notice right away)
If you have a lot of natural breast tissue on top of the implant and aren't worried about feeling ripples
If you're under 22 years old (silicone implants aren't FDA-approved for patients under 22)
If you like the idea of a quick and easy procedure to drain the implants (done with a small puncture while you are awake). Silicone implants typically require a surgery to remove.
One advantage worth mentioning: let's say you get saline implants at age 30 and you're tired of them at age 60. Saline implants can be drained right in the office which is actually very easy. You can even safely leave the shell in if you want!
Fat Transfer: Not Always the Magic Solution
Yes, I do perform fat transfer, but I'll be honest, I don't love it as much as some people may think given the popularity in mainstream media. Why? It's not as powerful an option as many people believe it to be.
If you're hoping for upper pole fullness (that nice fullness at the top of the breast), there's only so much you can achieve with fat transfer. I've found that upper pole fullness is generally what most people are wanting, and this is not accomplished with fat transfer. Also, if you're super thin, there's not a lot of fat to work with so this isn’t an option for you. TLDR - a transfer really won't give you that upper pole fullness that implants can provide.
Finding the Right Option for You
Every patient is different, and the best choice depends on your unique anatomy, goals, and lifestyle. While most of my patients choose gel implants for their natural look and feel, there are advantages to the other options that might make sense for your specific situation.
I'd love to have you come in for a consultation so we can chat about what's right for you. You can actually feel the different implant options in person, and together we'll determine the best approach for achieving your goals!
