The short answer to this question is very “muddy”- personal preference plays a large role in deciding which type of implant looks and feels more natural. However, we do have information from past patients as to the type of implant that more patients choose when considering Breast augmentation Nashville, and that is the silicone implant.
In fact, a 2013 study by the ASPS shows that 72% of patients chose silicone implants for their breast augmentation surgeries last year. Why would over two thirds of patients choose silicone implants? The major factors that patients consider when deciding between saline and silicone breast implants are look, feel, safety, and cost.
Silicone implants look and feel much more natural than saline implants. During your personal consultation, Dr. Burgdorf will let you feel the difference between the saline and silicone breast implants. Once patients are able to feel each type of implant, we find that patients desiring a natural result typically gravitate toward the silicone implant.
The reason that the saline implant feels less like natural breast tissue is because of the material used for the filling. Imagine the feeling of a water balloon filled almost to bursting. It feels hard and structured. This is the feeling of a saline implant. Saline implants are filled with salt water, and to reduce the appearance of rippling, the shell is overfilled with saline. This overfilling technique gives the implant a very round appearance which tends to look less like the natural breast shape (Note: some patients desire a very round or more augmented look, and may prefer the less natural appearing result).
Silicone implants are filled with a highly cohesive gel that is very soft and feels very much like natural breast tissue. The round gel implant gel redistributes as you move and the implants move with you like natural breast tissue. They will maintain a natural appearance when you change positions; from standing to lying down, leaning over, etc. and move similarly to natural breasts.
The newest implant to receive FDA approval is the shaped gel or “gummy bear” implant. These implants have a firmer, form stable silicone gel filling and have the most natural appearing contour when compared to natural breast tissue due to their teardrop shape and gradual slope. The literature reports that the “gummy bear” implants feel slightly more firm than the round silicone gel, but it is very difficult for me to appreciate on exam. They feel just as soft as the round gel implants after surgery to me.
Placing the implants under the chest muscle (subpectoral or submuscular placement) typically helps to hide the implant better and can diminish any rippling that may show (especially in very thin individuals). This may also be better for mammograms in the future. The breast tissue is not as hidden or distorted by the implant when it is placed under the muscle as it is when the implant is placed above the muscle. Most plastic surgeons choose the incision under the breast fold for precise placement of the implant. This placement may also decrease the risk of capsular contracture because it avoids involvement with the ducts of the breast.
Breast Augmentation is a very highly customized procedure and relies heavily on patient preference. No two breast augmentations are exactly the same. We believe in patient education and allowing our patients to make the most informed decision possible when choosing between saline and silicone breast implants.