Dex Code

Breast Implant Options

Difference between silicone and saline implants

Silicone gel

Silicone gel is an inert polymer with no known human allergies, sensitivities or reactions. Like a gummy bear candy, the molecules are stuck to one another in a cohesive matrix. Silicone is more viscous than saline. In contrast to saline, it flows differently within its shell and can often create a more natural look and feel to the breast, like breast tissue. Women must be 22 years of age or older to be offered silicone gel implants for breast augmentation, as per the FDA's regulations.

Saline (sterile salt water)

Saline-filled implants are available to all women for breast augmentation over the age of 18. A silicone shell is inserted into the body and then filled to its desired volume by a board-certified plastic surgeon with saline fluid. Saline has the consistency of water. Underneath very thin skin, folds of a saline implant might be seen or felt more often – this is known as implant "rippling" or "wrinkling."

Your breast health is important to us. We recommend that you call our office if you notice any significant changes in your breasts, such as swelling, significant pain, new asymmetry, or changes in the implants themselves.  The vast majority of the time, these types of issues do not represent anything serious, but any change warrants evaluation. In alignment with the American Cancer Society’s recommendations for mammograms and self-breast exams, we recommend monthly self-breast exams and a yearly physician-administered formal breast exam, with your primary care physician.

Variable cohesiveness of silicone implants

Different degrees of stiffness or "cohesiveness" (cross-linking of the silicone molecules) are now available in silicone gel breast implants. The most "liquid" ones are softest and flow most easily, and are most commonly used for routine breast augmentation. The most highly cohesive silicone implants are stiffest and tend to hold their shape most firmly, with potential advantages for post-mastectomy breast reconstruction. An intermediate stiffness implant is also available, which can be beneficial for breast augmentation patients who wishes to have silicone but have experienced rippling with the less cohesive devices.

At your consultation, Dr. Barnett will help you determine which projection, size and profile will work best with your body and desired outcome.


Another issue that Dr. Barnett feels is important to compare involves the results of implant leakage. A leaking saline implant will immediately deflate as water is rapidly absorbabed into your body, which will result in a second surgery. Silicone gel remains in the breast pocket instead of being absorbed into the body. A ruptured silicone gel implant can be impossible to detect by physical exam alone. Imaging studies such as an MRI may be the only way to detect implant leakage.

Textured Implants

As of July 24th, 2019, Dr. Barnett no longer offers textured implants.

FDA Recommendations If You Have Allergan BIOCELL Breast Implants

  • If you have no symptoms, we are not recommending the removal of these or other types of breast implants due to the low risk of developing BIA-ALCL. However, if you have any questions, talk to your health care provider.
  • Know the symptoms of BIA-ALCL - primarily persistent swelling or pain near the breast implant - and monitor the area around your breast implants for any changes.
  • If you experience any of these symptoms or other changes, talk to your health care provider regarding the need for further evaluation. Evaluation for BIA-ALCL typically involves a physical exam, imaging, and/or assessment of the fluid or tissue around the breast implant. It is important to undergo an evaluation to diagnose BIA-ALCL since a confirmed BIA-ALCL diagnosis may change the type of operation that should be performed.
  • Based on discussions with your health care provider, patients with confirmed BIA-ALCL should undergo implant removal and removal of the surrounding scar capsule, which is a more extensive operation than implant removal alone.
  • As with any implanted device, it is good to keep a record of the device manufacturer, unique device identifier, and implant model name. You may have received this information on a patient device card from your surgeon. If you would like to obtain any of this information, consider asking your surgeon or obtaining the record of your surgery (operative notes) from the facility where it was performed.
  • Understand that most cases of BIA-ALCL occur many years after breast implant placement. Talk to your surgeon about your risk of developing BIA-ALCL.
  • If you are considering breast implants, please see these important recommendations.


For additional information please see the Allergan website.
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