Saline vs Silicone Breast Implants: Why Saline is Out, and Motiva is In

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Saline vs Silicone Breast Implants? Which do I recommend?

When it comes to which type of breast implant content to choose, saline vs silicone, I mention that saline breast implants are rarely in use today by most plastic surgeons operating in Australia. In fact, the latest breast implant trends preferred by the majority of Australian plastic surgeons are strongly in favour of quality silicone breast implants using moderate to small implant sizes, rather than very large or heavy implants (although there are exceptions and every patient has a different goal and physique for a surgeon to consider before making breast augmentation recommendations).


What type of breast implant I prefer and why – Dr Rubinstein’s recent interview for the Plastic Surgery Hub.

  • Saline breast implants are mostly “out” in terms of breast implant preference for plastic surgeons in Australia. Less than 8 Australian plastic surgeons favour saline implants.
  • Silicone breast implants are “in”. The latest technologies that employ soft, cohesive gel fillings, such as those supplied by Motiva and Mentor

Highlights of the interview discussion on the choice between Silicone vs Saline Breast Implants

As an aesthetically-minded specialist plastic surgeon, I prefer the stability of high-grade silicone-gel filled implants. I find I can get patients natural-looking breast augmentation results using round Motiva brand or Mentor brand breast implants, carefully selected in terms of size and projection, using:

  • careful measuring and planning.
  • precision insertion techniques.
  • small, skinny incision techniques in the breast crease, to better minimise your scars (sometimes only 3 cm) – read Small Scars after Breast Augmentation for details.
  • recommended patient-safety protocols and steps for reducing some of the breast implant surgery risks. This includes using the Keller Funnel and avoiding over-handling of implants.
  • extensive surgical skills and insertion expertise.
  • Rapid Recovery Packages with healing aids to assist with wound healing and surgery recovery.

Source: Dr Rubinstein excerpts from a recent interview with the Plastic Surgery Hub on Facebook in June 2018.

Which Breast Implant Brands Do I Consider Great Choices for Breast Augmentation Procedures?

I prefer silicone and here’s why. In terms of ‘silicone breast prosthesis, there are two high quality breast prosthesis brands available in Melbourne, Sydney, Adelaide, Perth, Queensland and Tasmania.

These are the modern-style Mentor range and the new Motiva breast implants.

Mentor brand implants and Motiva brand implants have helped me give patients natural-looking breast augmentation results that are also long-lasting. Read How Long Breast Implants Are Expected to Last.

  • Both implant brands are manufactured by reputable companies
  • They have excellent reputations for manufacturing standards including sterility protocols for making and packaging the prosthesis
  • Their high standards for making quality breast prosthesis include:
    • using very high grade silicone
    • focusing on sterility protocols during all aspects of manufacturing, packaging and shipping
  • They also insist on using high-grade, cohesive, quality gels and shells rather than cheap silicone
    • There are dangers in using cheap implants you’ll likely be aware of, especially if a cheap supplier uses non-high grade silicone

Their lifetime prosthesis warranties for breast implants is helpful to patients, and yet another positive reason I prefer these two brands.

Links to breast implant operation safety reports and discussions – and breast implant longevity including warranty information- are listed below this blog.

Next, you’ll learn more about my professional opinion about which breast implants – saline or silicone – can help you have a good surgery outcome in terms of a pleasing, natural-looking and long-lasting result with enhanced cleavage.

I’ll also share how you can choose the best implant size(s) for your augmentation. I do this using bra sizers and 3D breast imaging such as Crisalix or Vectra 3D technology.

  • Watch my video interview with the Plastic Surgery Hub (the interview link can be found below my photograph) for details of what I prefer in terms of breast augmentation surgery techniques, types of implants and which patient-safety protocols we use during breast augmentation operations.

Disclaimer: Remember, however, that all information on my website, and on breast implants, is general in nature. Please keep in mind that each and every breast surgery patient is different. Results can vary from patient to patient, and every surgeon has his or her own opinion.

Breast-Surgery-Mammoplasty-Implants Dr-Craig-Rubinstein

Review and Recommendation of Different Types of Breast Implants (My Professional Opinion)

Before we review different types of implants and whether I believe silicone or saline implants are best for most augmentation procedures, it’s important to consider that you may need more than breast implant surgery to get the breast improvements that you’re wanting.

  • For natural looking and long lasting breast surgery results, your may require just breast implants
  • Or you might actually benefit most from having a breast lift, a mastopexy-augmentation (an uplift with implants), or even a breast reduction or asymmetry correction procedure.
  • More complex procedures even allow for the resizing or reshaping of the areola (nipples)

It really all depends on what you’re wanting to achieve, as well as your health, the condition of your skin, and numerous other factors and body dimensions.

Breast Augmentation Choices: Silicone or Saline? Round or Anatomical?

In terms of your options for saline vs silicone breast implants, here’s what I keep in mind when I help my patients choose the type and size of implant for their augmentation surgery procedure (and I’ve helped thousands of women successfully enlarge their breasts or gain more cleavage).

I cover these in detail, in writing (below), and in my Youtube Interview Video on the Plastic Surgery Hub’s Facebook Live chat feature. Note this video is over 45 minutes long. So grab your favourite beverage, put your feet up and find out why silicone round implants, properly inserted, can help you get the surgery results you’re looking for.

My recent video interview on silicone vs saline implants and Mentor vs Motiva breast implant brands. Watch this Youtube video to better understand what I recommend, and why, in terms of breast augmentation procedure options.

Pro and Cons of Saline vs Silicone Implants

Why do I believe saline implants are not the best choice a patient can make for breast augmentation? Why do surgeons prefer silicone?

Saline implants may sound good in theory, as some people fear silicone. (Read recent ASAPS patient safety discussions/news updates on breast implants here). But saline isn’t always best – and not only that, the shell is silicone, so you’re not really getting away from silicone by using saline. But saline implants are not always the easiest to customise and get a good result; they can suddenly deflate if under-filled or they fold on themselves and cause leakage or a rupture.

Common Problems with Saline Breast Implants vs Silicone Breast Implants

  • Saline implants still have a silicone-based shell; so despite having a saline solution for volume, they are not silicone-free.
  • Saline implants don’t tend to feel as natural as silicone (according to patient reports after surgery)
  • Sizing: saline breast implants tend to be more difficult to insert properly or to fill precisely.
  • It’s trickier to adjust the actual projection and volume using a saline-filled implant than a stable silicone-filled implant of a specific size, shape or projection dimension.
    • Silicone breast implants come in a variety of volumes and projection profiles
    • It also offer different shapes, round or teardrop (formerly called anatomical)
    • Silicone implants are generally soft feeling, if a high quality gel is used; yet the are also considered mostly stable in terms of form and shape; this helps with cleavage design and breast projection aims during Surgery
  • They can collapse, fold on themselves or wrinkle – or even lead to sloshing sounds
    • Compare it to a plastic bag filled with a saline solution (or heavily salted water)
    • It doesn’t necessarily maintain the perfect breast shape
    • Folding of the implant shell often leads to skin rippling or misshapen breasts
    • They can sometimes lead to skin appearance concerns around the implant
    • Some patients also report they hear sloshing sounds when moving or exercising
  • When a saline breast implant folds on itself, not only does the breast become malformed in appearance,  a point of weakness is created in the shell casing at the area of the fold
  • This point of weakness in the shell casing can rupture at some stage, leading to immediately deflated breasts on one or both sides, requiring somewhat urgent re-operation to remove or replace the saline implant

If a silicone breast implant with cohesive gel ruptures, it’s an entirely different scenario to a saline implant.

  • MRI scans can better assess and check the silicone implant situation
  • The breasts often still looking natural-looking (versus deflated as with a saline implant) although a capsular contracture has a different appearance.
  • We can schedule the removal and/or replacement of the implant, although we must address any damage to an implant as soon as possible.

Other Breast Implant Option Questions: Teardrop vs Round Pros and Cons

  • Teardrop silicone implants – once a trend, because the logic behind them sounds good, given they have a more natural breast shape
  • But how they look outside the body isn’t necessarily how they’ll look once in the body, impacted by the muscles and other tissues around them
  • Also, they require a certain texture to help maintain stability (they call it ‘velcro-like’ textures), but this is not always the best of textures and some feature coarser are coarsely textured versus nano-textured.

So whilst anatomical implants sounded great in theory for attaining more ‘natural-looking’ breast augmentation results, these implants never became as popular as round implants. Here are some of the reasons why (and listen to my video interview on anatomical vs round implants for details).

Potential Problems with Anatomical Shaped ‘Teardop’ Silicone Implants

  • Potentially higher complication rates for some patients
  • May look great at first, but if they rotate, this causes unusual breast shapes or misshapen breasts
  • They don’t give as much upper pole fullness (cleavage at the top of the breasts), which many women seek from a breast augmentation procedure

So the main reasons round vs anatomical implants are better, in my professional opinion, is related to texture, shape, and the risk of higher complications including the tendency for anatomical breast implants to rotate, and the problems with certain textures. They can be used, and I have used them, but they are not typically my preference.

Round smooth implants (such as Mentor), or nano-textured round implants (such as Motiva), are typically a better option as far as I’m concerned.

What about Polyurethane Breast Implants?

A short-lived fad  – my video explains why polyurethane breast implants fell out of favour.

Benefits of Mentor Breast Implants?

  • Reputable brand
  • Smooth round
  • Lots of choices in sizes and projection profiles.
  • Offers customised projection results and volume enhancements.

Benefits of Motiva Brand Breast Implants?

I’m not an early adopter of new technology. I prefer to wait and be sure the data indicates it’s got a track record for patient-safety research and is actually effective. Something that takes time to accumulate in terms of patient-safety data and new procedure monitoring.

For example, remember the PIP implant scandal, when people were buying cheap breast implant surgeries that were using low silicone quality implants? These were manufactured in ways that caused many women to have to undergo urgent breast implant removal or replacement.

A reminder to patients about not falling for cheap augmentation or implant options. You get what you pay for and it’s just not worth the risk!

  • But Motiva implants have now been used in approximately 600,000 breast augmentation surgeries according to the manufacturer.
  • Some of the world’s best respected plastic surgeons now use Motiva brand implants, including Dr Dennis Hammond  and others across the globe
  • Users of Motiva report very positive patient outcomes and breast surgery experiences
  • They show good results and fewer complication rates – a positive in any type of medicine

I’ve recently started offering this brand to Melbourne breast surgery patients for augmentation and breast lift with breast implant surgery. Patients report they love the feeling of them as they are such a soft, natural feeling high-quality cohesive gel. Plus so many sizing options, just like with Mentor. I also still offer these implants as a long-term user of Mentor.

Benefits of Motiva implants

  • Safety manufacturing processes including novel nano-textures and high quality cohesive gel that feels very natural.
  • Shown to potentially prevent capsular contracture (when too much scar tissue forms around the implant).
  • The manufacturers claim these implants have an 80% lower risk of capsular contracture.
  • The shell is nearly impenetrable – I couldn’t break it if I tried (and being a Surgeon, I certainly DID try!).

Thanks for reading.

Be sure you do adequate research into these breast surgery procedures and understand that patient results can vary from patient to vary. Further, the cost of surgery can also vary according to what procedures you require and where the operation occurs. Finally, you should feel free and comfortable to ask your surgeon any and all questions about your procedure.

Read our popular blogs about plastic surgery including tummy tucks, abdominoplasty and breast procedures.

For further information about breast augmentation surgery and breast implant options by attending a confidential, no-obligation consultation at my clinic. I look forward to helping you get the breast enhancement surgery you’ve been contemplating for a very long time.

About Dr Craig Rubinstein

Dr Craig Rubinstein FRACS is one of Melbourne’s Best Specialist Plastic Surgeons for breast and tummy surgery.

He has been rated as a Top 3 Plastic Surgeon in Melbourne and rated a Top 5 Plastic Surgeon on the ‘Best in Australia’ website. 

Dr Rubinstein offers women personalised tummy surgery and all forms of cosmetic breast surgery.

He uses only the highest quality Motiva breast implants and is renowned for his natural-looking, long-lasting results.


Next Steps in Your Surgical Journey

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About Your First Consultation

  • Dr Rubinstein’s Consultation fee is $300.
  • A referral from your GP or your specialist is helpful but not essential.
  • You need a medicare referral in order to claim any medicare benefits or Health Insurance for plastic surgery,
  • Please contact the Patient Care Team at Coco Ruby Plastic Surgery today to book your consultation.

What to Bring to your Consultation

  • You are more than welcome to bring a friend or relative to help discuss the information and your choices.
  • Ensure you also take a lot of notes and thoroughly examine the documents provided.
  • Please be aware you may need to undress for a physical exam so wear simple clothes.

*Disclaimer: Individual results can vary significantly from patient to patient. The information we provide is general. For further information on what to expect for your preferred procedures, arrange to see one of our Specialist Plastic Surgeons for a full history and surgical consultation. Read further information about surgical outcome variability on our Disclaimer page.