Saline and silicone breast implants have different characteristics of filler material, and this explains the difference in surgical incision length. Saline implants need a smaller incision for placement of the implants, whereas silicone implants need a slightly longer incision to put the breast implants into the breast pocket. The difference is quite small, and I will discuss the advantages and disadvantages of both implants and incision size.
Saline implants are placed into the surgical breast implant pocket empty. This allows the plastic surgeon to roll up the empty saline implant, and then place it into the pocket, filling it with saline solution through a fill tube. The incision to put in a rolled up saline breast implant is usually about 2.5-3.5 cms, or about an 1-1.5 inches long.
Silicone implants are already filled with material before insertion. You can’t add or subtract any silicone filler material into the implant, so this is why they are inserted completely filled. This larger volume requires a slightly longer surgical incision to accommodate a silicone breast implant. The incision is typically about 4-5 cms, or 1.5-2 inches in length.
The difference in the length of the incision needs to be weighed to the different feel and look of a saline or silicone breast implant. It is my opinion that a silicone implant has a slightly better appearance, since there should be less rippling and wrinkling with a silicone gel breast implant versus a saline breast implant. Also, it is my opinion that silicone breast implant has a better overall filler material, and moves and feels much more like a natural breast than a saline breast implant.
Any surgical approach will have a longer incision with a silicone breast implant, including an areolar incision, breast fold/ inframammary fold incision, or underarm/ axillary incision.
In the end, the choice is yours, but a slightly longer incision is a small trade-off to get a better appearance and a more natural feeling breast long after surgery is done.
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