Complication Rates of Saline Versus Silicone Breast Implants in 1250 Augmented Breasts: a 16-Year Experience

Background: The use of saline versus silicone gel filled implants for breast augmentation surgery is still largely debated in the plastic surgery community. Many argue that differences in complication rates can play a decisive role in the type of prosthesis used.

Methods: We reviewed one surgeon's 16-year experience: 1993 to 2009. 1250 breast implants in 625 patients were used for breast augmentation surgery. The mean age of patients was 33.4 ± 9.54 years. 882 (70.56%) saline filled implants and 368 (29.44%) silicone gel implants were used. The mean follow up time was 96.12±78.24months.

Statsitics: Chi-square test with multivariate regression analysis. p<0.05 was considered significant. Results: Complication rate for saline in comparison to silicone implants included abnormal scar (n=32,4.25% vs. n=15, 5.14%; likelihood ratio=0.85, P=>0.05) capsular contracture (n=42, 4.75% vs. n=8, 2.65%; likelihood ratio=1.79, P>0.05), infection (n=14, 1.9% vs. n=1, 0.34%; likelihood ratio=5.56, P>0.05), hematoma (n=13, 1.76% vs. n=3, 1.03%; likelihood ratio=1.72, P>0.05), seroma (n=0) nipple-areolar complex sensation change (n=6, 0.82% vs. n=1, 0.34%; likelihood ratio=2.39, P>0.05), minimal malposition (n=52, 7.06% vs. n=23, 7.87%; likelihood ratio=0.90, P>0.05) and major or minor revisions (n=19, 7.3% vs. n=25, 8.9%; likelihood ratio of 2.5 and P>0.05). The average implant size for the saline filled implants was 318±66.28 cc as compared to the silicone gel implants 315±61.03cc (P>0.05).

Conclusion: We found no differences in complications rates between saline and silicone filled implants. We recommend that an informed decision be made by the surgeon and the patient in light of cost, incisions, implant type, shape, feel, and size, when deciding for the primary breast augmentation.