Saline implants are a common option for patients seeking breast augmentation surgery. They have been used in the United States since the 1980s with varying levels of success. As with silicone implants, the newer models of saline breast implants have lower failure rates than the earlier versions of these devices. Although silicone has become the most frequently selected implant type, saline still has a strong following.

Saline Implant Design Details

The saline implants used in the United States are filled after insertion (pre-filled versions are only available in other countries). The implant has a valve located on the front of the device that closes automatically once the tube that delivers the filler is removed. A small plug is placed over the valve to prevent tissue from growing into the area and potentially interfering with the integrity of the seal.

The shell of a saline implant is made of room-temperature vulcanized (RTV) silicone elastomer. This is a strong, slightly stretchy substance which is fairly resistant to rupturing. However, a rip or tear can occasionally occur due to:

  • Improper handling during insertion
  • Overfilling (this practice can actually void the warranty)
  • Rough handling after placement (during a mammogram or when aggressive massage is used to break up scar tissue)
  • Under-filling (this allows the implant to fold and rub against itself)
  • Valve failure (this type of problem is rare with today‚Äôs improved implant designs)
  • Degradation of the elastomer material over time

What Happens if a Saline Implant Breaks?

When rupture occurs, the saline usually drains out fairly rapidly and is absorbed into the surrounding tissue. The breast will look flattened or deflated as it loses volume. The implant can usually be removed and a new one placed through the original incision. This may be easiest with a smooth-surfaced implant that did not adhere significantly to the surrounding tissue. Barring unforeseen side effects, the recovery period for saline breast implant replacement should be shorter than the recovery from the original augmentation surgery because the pocket to hold the implant has already been created. However, there may be additional risks associated with implant revision including a higher risk of certain complications.

What Do Saline Breast Implants Look Like?

The shape of the shell can be a flattened sphere or a teardrop shape with most of the volume in the lower half of the implant. Large, round saline implants placed over the muscle tend to create a perky look with a curve along the upper surface of the breast and all the way around the perimeter of the breast. Teardrop shaped implants create a smoothly sloping upper surface along the chest with a rounded lower surface above the breast crease (mimicking the natural breast shape). Saline breast implants, particularly those with a textured surface, may cause a rippling effect in the overlying breast tissue.

With both shapes, placing the implant under the pectoral muscle generally offers the most coverage to camouflage the edges of the implant and conceal rippling. Some plastic surgeons have found that overfilling a saline implant and placing it under the chest muscle offers a very satisfactory aesthetic result comparable to silicone. Caution should be used since filling an implant with saline past the range recommended by the manufacturer can put more stress on the device. This may lead to premature failure.

Round saline implants with a smooth shell can move a little in the surrounding pocket. This allows the whole implant to shift slightly making breast movement look more authentic. For example, when you lie on your back the breast implant might move a little toward your armpit rather than just sitting immobile on top of your chest.

What Do Saline Breast Implants Feel Like?

Saline implants tend to feel much firmer to the touch than either silicone or natural breast tissue. Patients (and their intimate partners) may describe the implant as feeling like a plastic bag filled with water. In other words, it feels like what it is. Some patients remark that they can feel the implants sloshing slightly when they engage in vigorous activities. Most women get used to the feel of saline implants over time, just like you might get used to having pierced ears or other common body modifications.