Saline Breast Implants

Among the many choices that need to be made when planning a Breast Augmentation, choosing between a saline-filled breast implant or a silicone-filled implant is one of the more difficult decisions. Both types of implant have specific advantages and any number of these factors may influence which option could be more beneficial for you:

  1. Your existing breast anatomy
  2. The look and feel you desire
  3. The placement of the implant above or below the chest muscle
  4. The size of the implant
  5. The incision used to insert the implant under your breast

The information given below is intended to give you an overview of your saline implant options, thereby allowing you to make a more informed decision. To further assist you in the decision making process, during your Breast Augmentation consultation with Dr. Jugenburg, you will look at and feel various pre-filled implant samples, and try on a range of sizers. At the Toronto Cosmetic Surgery Institute we offer all sizes and shapes of breast implants so that every woman can rest assured that we will be able to create just the look and feel she desires.

The most important benefit of saline implants is that they are adjustable (their volume can be adjusted during surgery to give you best possibly symmetry between the two sides) and since they contain saline, should a leak or rupture occur, saline is 100% natural and gets absorbed by your body without any harm.

For information on silicone breast implants, please refer here.

What Are Saline Breast Implants?


A saline breast implant has a highly durable, elastic silicone shell. This shell is filled with a sterile saline (salt-water) solution that is similar to the fluid that naturally exists in the human body and gives a slightly firmer feel than silicone gel.

Saline implants are available in a wide variety of shapes, sizes, profiles and surface textures to fit the body, preference and individual needs of every woman.

  1. Base width (or diameter) – width on the chest wall; women with narrower chest walls require smaller diameter implants for a proportionate appearance.
  2. Size (or projection) – protrusion from the chest wall; a suitable size for any given women will depend on her existing breast anatomy and body proportions.
  3. Shape: Round or Shaped (Teardrop or Anatomic) – Round implants can give a natural or fake looking appearance depending on their placement. Teardrop implants are designed to mimic the gentle contours of a natural breast (for Breast Reconstruction).
  4. Shell surface: Smooth or Textured – a textured surface for greater tissue adherence, while the smooth surface is less prone to rippling/wrinkling.

Further information on your breast implant choices is given here.

b2Insertion of Saline Implants

The silicone shell of each saline implant is inserted into its placement under the breast without fluid (i.e., without being inflated), and filled during surgery through a fill-tube to the predetermined size.  The benefit of this is that saline implants can be inserted through a smaller incision than silicone breast implants.

The size of a saline implant therefore does not influence the type of incision that is used to perform the surgery. Unlike silicone implants, any size of saline implant can be inserted using an incision made in the armpit (Trans-Axillary), thereby completely removing scarring in the breast area.  A self-sealing valve then allows the implant to automatically seal itself once the fill-tube has been removed.

Saline Implant Fill Volume

Every implant has an optimal volume of saline fill that gives the best balance between either rippling/wrinkling (caused by not enough saline) or becoming too firm (caused by too much saline). The difference between an inadequate volume and the optimal volume is small and as little as 10% of the maximum volume for any given implant. All saline implants therefore come with an optimal range of fill volumes that have been defined by Vthe manufacturer.

The Mentor SPECTRUM® saline breast implant is an innovative design that also allows Dr. Jugenburg to make further adjustments to the saline fill volume post operatively. A small, removable fill tube is left temporarily attached to the implant after surgery. The tube is accessible to Dr. Jugenburg by injection through the skin. In a simple procedure, the implant size can therefore be adjusted until the desired effect is achieved. Dr. Jugenburg then removes the fill-tube through another routine procedure and a self-sealing valve immediately closes and seals the implant.

Is Visible Rippling a Problem With Saline Breast Implants?

To some extent, rippling/wrinkling occurs with every breast implant. Breast implants are soft and natural folds therefore commonly occur in the shell of an implant. This effect only becomes a problem if visible, but is more often felt and not seen (typically along the outer edge of the implant, below the armpit), especially when a woman leans forward. A similar pattern of skin folding occurs in women with naturally larger breasts (i.e., without implants).


Saline breast implants are more prone to rippling because the liquid saline fill shifts with changes in a woman’s body position, but is more common when saline implants are under-filled. Since under-filling a saline implant also leads to a higher incidence of implant rupture and deflation, it is not normally done.

Most Plastic Surgeons will fill a saline implant to the upper range of the implant. Rippling is most objectionable when it is visible at the top of the breast. For that reason, placing a saline implant below the chest muscle (pectoralis muscle) can be advantageous, as the thickness of the muscle disguises any folds on the implant’s surface.

Studies have shown that bringing a saline implant to its optimal fill volume, thereby reducing rippling, also helps to extend the lifespan of an implant. Rippling leads to premature failure by causing increased stress at the folds and wrinkles. Filling to the maximum volume is not over-filling; however, some Plastic Surgeons still use the term in this situation, although it refers to older saline implants that came labeled with a single, set fill volume.

Over-filling current generation saline implants is not recommended by breast implant manufacturers, and may violate an implant’s warranty. Furthermore, if an implant is filled beyond the recommended range, scalloping of the edges of the implant may occur. Scalloping is puckering around the edges of an implant and may cause visible folds on the surface of the implant that have the appearance of rippling, but are a separate issue.

What Happens if Saline Breast Implant Leaks or Ruptures?

Saline breast implants are capable of rupturing and deflating, which is one of the more notable risks of saline implants. Should a hole or tear develop in the shell of a saline implant, the liquid saline solution will be released and the implant will deflate. The speed at which deflation occurs will depend on the size of the defect. When the saline solution is released, it will leak into the body where it will be harmless and absorbed over a period of days; it will not cause any irritation, illness or other unwanted effects. The patient (or Dr. Jugenburg) will be able to identify a leaking or ruptured implant due to the loss of size and shape in the affected breast.


Saline breast implant leaks are not common, and for any given patient, having it happen once does not mean that patient will have a higher risk of it happening again.  Rupture and deflation can be caused by a number of different factors, such as physical trauma, general wear and tear, Capsular Contracture (implant hardening), or complications from medical procedures. If a patient believes that her breast may be losing volume, she should arrange to see Dr. Jugenburg as soon as possible.

All patients not in Toronto can contact the clinic by email and send photos of the affected breast to allow Dr. Jugenburg to make an assessment. Should Dr. Jugenburg determine that a breast implant leak or rupture has occurred, he will discuss treatment options with the patient and try to schedule a quick replacement.

Although there is no health risk from the deflation of a saline implant, it is preferable to replace the defective implant before the implant has completely deflated and the breast pocket in which the implant is positioned has collapsed. If caught early, the implant capsule, which is the scar tissue that forms around an implant, will still be in its original shape and size.

However, if the breast pocket is allowed to collapse after an implant has deflated, the implant capsule will shrink and tighten. If this happens, a new space for the replacement implant will need to be created.

Saline Breast Implant Costs

Saline implant Breast Augmentation procedures are typically $2000 cheaper than silicone implant procedures due to the differing manufacturing costs of the two types of implants. Women who receive silicone implants are also advised to have annual MRI scans after the third year to detect implant ruptures (silent ruptures), which adds further costs. Since saline is harmless and a saline implant ruptures immediately apparent, regular MRI scans are not necessary for women receiving saline implants.

A Comparison of Silicone and Saline Breast Implants

Benefits of Cohesive (Silicone) Gel Breast Implants:

  1. All Cohesive Gel implants are FDA and Health Canada approved.
  2. Each implant is filled with a thick, cohesive silicone gel formula that holds together uniformly and retains a natural pliability that closely resembles breast tissue.
  3. Cohesive Gel implants suffer from less rippling/wrinkling than saline implants and older liquid silicone implants.
  4. Ideal for women with very little natural breast tissue or fat.
  5. If a Cohesive Gel implant leaks or ruptures, the silicone gel will not be released.
  6. Each implant has a set fill volume for predictable results.
  7. To ensure best long-term results for all patients, all Cohesive Gel implants are covered (free of charge) by a generous manufacturer warranty and lifetime replacement policy: AllerganConfidencePlusPremier®Warranty and Mentor Premier Advantage Limited Warranty.

Benefits of Saline Breast Implants:

  1. Saline implants have been FDA and Health Canada approved for many years.
  2. Each implant is filled with a sterile salt-water solution similar to the fluid that makes up most of the human body (i.e., it is harmless and compatible with the human body).
  3. Saline implants generally have a slightly firmer feel than silicone-filled implants.
  4. All saline implants have a flexible fill volume that can be precisely adjusted by Dr. Jugenburg during surgery to meet the needs of each patient and give the best result.
  5. Ideal for women with slight breast asymmetries.
  6. If a saline implant leaks or ruptures it will be harmless, and since the breast size and shape will noticeably change, it will also be immediately apparent.
  7. The insertion of any given saline implant during surgery requires a smaller incision than that required for a similar size of Cohesive Gel implant.
  8. Saline implants are cheaper than Cohesive Gel implants, which means the total procedure cost for saline implant augmentation is cheaper for the patient.
  9. To ensure best long-term results for all patients, all saline breast implants are covered (free of charge) by a manufacturer warranty and lifetime replacement policy: AllerganConfidencePlus®Warranty and Mentor Standard Advantage Limited Warranty.

A variety of similar options are available for both saline and silicone gel implants to meet the individual needs of each woman:

  1. An extensive range of base widths (diameters) to suit the body size and shape of each woman.
  2. Different implant projection options from low to high profile and an extensive range of sizes to give each woman the look she wants.
  3. Two shape options: Round implants or more expensive Shaped implants (Anatomic or Teardrop).
  4. Two shell surface options: smooth implants or textured implants.

Every woman should also know that whether receiving saline or silicone implants, both types of implants have similar highly durable, elastic and resilient silicone shells that are designed to be highly resistant to rupturing or tearing, and have been thoroughly tested.

Your Breast Augmentation Consultation

Dr. Jugenburg is a highly experienced plastic surgeon who always takes the time to get to know his patients and their needs before committing to any kind of surgery. At your consultation, you will have the opportunity to meet with Dr. Jugenburg, and let him know about the look you want to achieve. The doctor will guide you through the whole breast augmentation process: from the preparations you will need to make, through to the surgical procedure and aftercare. You will have the opportunity to ask any questions and raise any concerns you might have with Dr. Jugenburg and his team of highly qualified and friendly healthcare professionals.

Meet Your Doctor, Dr. Martin Jugenburg

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