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09/23/2026
The main difference between silicone and saline breast implants is what they are filled with. Silicone implants use a cohesive gel that often feels more like natural breast tissue. Saline implants are filled with sterile saltwater and tend to lose volume quickly if they leak. Both types have a silicone outer shell.
This difference affects how the implant feels, how noticeable its edges or folds are, and what kind of follow-up is needed. Silicone implants also come in different firmness levels, shapes, and sizes, with each brand offering its own options.
At Austin-Weston, The Center for Cosmetic Surgery, we offer breast implants from Natrelle, Motiva, and Mentor. To see what makes each brand unique, it helps to first understand the materials used in these implants.
| Feature | Silicone Implants | Saline Implants |
|---|---|---|
| Filling | Cohesive silicone gel | Sterile saltwater |
| Outer shell | Silicone | Silicone |
| Feel | Generally closer to the give of natural breast tissue; varies by gel and model | Often firmer or more noticeably fluid, particularly with limited tissue coverage |
| Rippling | Usually less noticeable, although still possible | Folds may be more visible or palpable through thin tissue |
| Volume adjustment | Prefilled to a set volume | Conventional saline implants are filled during surgery within the manufacturer’s specified range |
| Rupture signs | May have no visible change or symptoms | Usually causes noticeable loss of breast volume |
| Routine rupture screening | Ultrasound or MRI is recommended even without symptoms | Does not follow the same routine silent-rupture screening schedule |
| FDA-approved age for cosmetic augmentation | 22 and older | 18 and older |
The FDA’s implant overview explains the materials and age indications. Age eligibility is one part of candidacy; health, breast development, expectations, and readiness for ongoing care also matter.
Silicone gel is thicker and feels more like natural tissue compared to saltwater. When you press on a silicone implant, it usually gives in a way that feels similar to real breast tissue. Saline implants can feel firmer, and their liquid filling can make folds in the shell easier to feel or see.
This difference is most noticeable when there is not much natural tissue covering the implant. If you have fuller breasts, you may mostly feel your own tissue. If you have very little breast tissue, you might notice the implant more. The American Society of Plastic Surgeons explains these differences in consistency and rippling.
During your consultation, you can hold sample implants to compare how they feel. However, holding a sample in your hand is not the same as how the implant will feel under your skin, tissue, and muscle after surgery.
If you want breast implants that feel as natural as possible, silicone is often a good place to start. Your final choice will also depend on how much tissue covers the implant, its size and shape, where it is placed, and how much support your breast needs.
“Gummy bear” is a nickname for highly cohesive silicone gel implants. These are still silicone implants and are not a separate type from silicone or saline.
Cohesivity means how well the gel holds together. Today’s silicone implants come in different levels of cohesivity, which affects how easily the gel changes shape and how much support it gives.
A gel with higher cohesivity usually keeps its shape better, while a less cohesive gel feels softer and moves more easily. There is no single best option—some people want a softer feel, while others prefer more support and fullness at the top of the breast. A clinical review of gel cohesivity explains how surgeons match these features to your tissue and desired look.
If you are looking into cohesive gel or gummy bear implants in Northern Virginia, it’s important to know that gel consistency is just one feature. Other factors also matter:
A cohesive implant can be round and smooth. The term “gummy bear” does not always mean the implant is teardrop-shaped or has a textured surface.
Cohesive gel implants can still rupture. Even though the gel holds together well, regular monitoring is still important.
At Austin-Weston, we offer these three brands to help match implants to your body shape, tissue, and personal preferences. Each brand has several options. Your surgeon will explain which models are available and which ones may work best for you.
Natrelle’s INSPIRA smooth round silicone collection includes three gel options:
These choices let your surgeon consider both the gel’s feel and the implant’s width and projection. If you want a softer, more flexible implant, your needs may be different from someone who wants the implant to hold its shape more firmly.
Natrelle’s manufacturer explains these differences, but also notes that lab tests do not always show exactly how the implant will behave in your body. Natrelle also makes saline implants.
Motiva’s FDA-approved U.S. silicone options include SmoothSilk Round and SmoothSilk Round Ergonomix. Both are indicated for primary and revision breast augmentation in women age 22 and older. See the FDA’s Motiva approval information.
The manufacturer says SmoothSilk Round is made to give a fuller, rounder look at the top of the breast. Ergonomix uses a gel that shifts with your body position, so it looks rounder when you lie down and more sloped when you stand up. However, your own breast tissue, skin, and the surgical pocket also affect how the implant moves and looks. Motiva explains the Ergonomix design here.
Motiva’s U.S. implants are silicone gel devices. They require the same attention to silent rupture and long-term follow-up as other silicone implants.
Austin-Weston specifically identifies Mentor’s MemoryGel line among its silicone offerings. Mentor’s broader U.S. portfolio includes:
These differences are all within one brand, so the exact model you choose matters when comparing brands. Mentor also makes saline implants. Your consultation will help you decide which option is right for you.
It’s most helpful to compare specific models with similar sizes and shapes. Comparing all of Motiva to all of Mentor can miss important differences between their individual products.
Ask your surgeon to explain how the implants compare in width, projection, how the gel feels, and how much tissue will cover them. Two implants with the same volume can look and feel different because of their shape and proportions.
It’s also important to think about what “natural” means to you. You might want a gentle slope at the top, a soft feel, movement when you lie down, or just a small size increase that fits your clothes. Sharing these preferences with your surgeon is more helpful than picking a brand based on photos.
You should use the same approach when comparing either brand with Natrelle.
If a saline implant leaks, the breast usually gets smaller as the saltwater leaves the shell and is absorbed by your body. The empty shell stays in place and needs to be checked by a surgeon, even though the fluid is absorbed.
A silicone implant can break without any visible change in the breast. This is called a silent rupture. The gel may stay inside the scar tissue around the implant or move beyond it. A physical exam alone cannot always detect this.
For patients without symptoms, If you have no symptoms, it’s recommended to start screening silicone implants with an ultrasound or MRI five to six years after they are placed, and then every two to three years. If you have new symptoms, you may need to be checked sooner. Saline implants do not need the same regular screening. You should still get mammograms or other breast checks as recommended for your age and risk. Be sure to tell the imaging center that you have implants.
One difference is that your body absorbs leaked saline, but this does not mean saline implants are risk-free.
Both types can develop capsular contracture, where scar tissue tightens around the implant. Other risks include infection, changes in sensation, implant displacement, rupture, and additional surgery. Both types also require a discussion of implant-associated cancers and reported systemic symptoms. BIA-ALCL, a lymphoma associated with breast implants, occurs more frequently with textured surfaces; filling and surface are separate considerations.
The FDA’s guidance on breast implant risks is important to review. Your surgeon should go over the patient decision checklist for your chosen implant and explain how the risks apply to you.
Whether you choose silicone or saline doesn't determine how much time you’ll need off work or exercise. Recovery also depends on where the implant is placed, how much surgery is done, how tight your tissue is, and if you have a breast lift at the same time.
Both options involve healing incisions and a surgical pocket. Expect instructions about lifting, sleep position, support garments, and a gradual return to activity. A softer implant does not necessarily mean an easier recovery, and choosing saline does not remove those restrictions. A good conversation about implants should help you understand why a certain device is right for your body. Here are some helpful questions to ask:e suits your body. Useful questions include:
No. Saline implants still have a silicone outer shell. The only difference is that they are filled with saltwater.
There is no rule requiring implants to be replaced every 10 years. However, breast implants are not meant to last a lifetime, and you may need to replace them if you have problems or your preferences change. Regular check-ups help decide when replacement is needed. The American Society of Plastic Surgeons recommends ongoing checks of your breast health and implant condition.
Yes, you can usually switch from saline to silicone with breast revision surgery. Your surgeon will check your current implants, scar tissue, skin, and breast tissue to see what the surgery would require.
The best implant for you should fit your chest, feel comfortable under your tissue, and give you the shape you want. Brand, filling, gel type, and placement all play a role in making that choice.
At Austin-Weston, the Center for Cosmetic Surgery in Reston, our plastic surgeons help patients in Northern Virginia and Washington, D.C. compare silicone and saline implants and learn about long-term care. Schedule a consultation to talk about Natrelle, Motiva, and Mentor implants and find the best fit for your body.
Our five, board-certified plastic surgeons have over 100 years of combined experience & work together in our dedicated, luxurious center providing combined knowledge on all procedures. Schedule your consultation today to learn how our surgeons can guide you on your journey to aesthetic harmony.
