As a Specialist Plastic Surgeon I often get asked if saline implants ripple.
Saline breast implants have once again become more popular. This is because of concerns about implants filled with silicone gel. Many of these silicone gel implants have now been removed from the market and a cloud hangs over those that are still available in the form of Breast Implant Associated Illness. This refers to a constellational of symptoms that some women develop following silicone breast implants. Symptoms such as fatigue, foggy thinking, night sweats, difficulty sleeping and skin rashes. Whatever the cause of these symptoms, it is a fact that about 90% of women feel much better following removal of their silicone gel implants.
In addition, the Chief Medical Officer has advised women that,
“All silicone gel breast implants are considered high risk medical devices”.
So if you require a breast augmentation and are not a suitable candidate for breast augmentation using your own fat (which is often the preferred option) it is wise to consider the saline breast implant alternative.
In the USA, 50% of all implants used are saline implants. Many US surgeons who are “large users” of breast implants (in other words perform hundreds every year) prefer to use saline filled implants. In Australia however, it is true that most surgeons have no or little experience with saline breast implants. This is probably because silicone implants have been heavily marketed in Australia (especially textured silicone implants). A consequence of this is that we lead the world in the number of cases of Anaplastic Large Cell Lymphoma related to these implants.
When a woman enquires about saline implants she is often provided with incorrect information. To say that saline breast implants cause “rippling” or “can leak” or that they “don’t feel as natural” is misleading and plainly wrong.
The reality is that, so long as the implant is placed behind the muscle (and it should always be placed behind the muscle so that it does not interfere with mammograms later on in life) then it is often impossible to tell the difference between a saline filled implant and a silicone gel filled implant. This is because the muscle provides a thick layer of tissue above the implant so that the implant itself is neither visible nor palpable. Certainly rippling does not occur and a saline implant, provided it is positioned accurately and filled to an appropriate volume, will feel as soft, or softer, than most silicone gel implants. As for the question of leaking, my own experience having inserted over 5000 saline implants is that most saline implants will indeed last a lifetime. I say this on the basis that I have seen fewer than 20 leaking saline implants. Of course when a saline implant leaks it only salt water and is immediately noticeable as the implant will deflate. This is actually a major advantage compared to a silicone gel implant in which a leak can be undetected for many years allowing the silicone time to spread to the lymph nodes and other parts of the body.
So if you are considering breast augmentation using implants make sure you have an honest discussion with your surgeon regarding the possibility of saline implants – which are certainly the safer alternative.
Below are some cases to illustrate this.
This images above demonstrate a case of severe rippling with Textured Implants placed in front of the muscle.
Corrected by removing implants and replacing with smooth wall saline implants behind the muscle.
And here is a patient that went from a AA cup to C cup using smooth wall saline implants under the muscle.
Breast implants should always be placed under the muscle to allow mammography and prevent rippling.