Breast implants

Silicone or saline breast implants?

What is the best option for breast enlargement: breast implants filled with silicone gel or a saline solution?

Silicone prostheses are again available; hey had been withdrawn in 1992 following legal pressures demanding studies that would prove their innocuousness for women’s health in general. Several major, serious and independent studies have confirmed this innocuousness: There is no increased risk of generalized diseases, such as rheumatoid arthritis, lupus or other autoimmune diseases. Incidentally, there appears to be a slightly reduced risk of breast cancer in women with silicone implants.

Both types of implants have their own advantages and disadvantages: Silicone prostheses are more similar to the touch to the natural breast. Silicone prostheses also form less frequently the folds that occasionally occur with saline prostheses. This happens in particular with under-filled saline implants but under-filling is rarely done today. However, silicone prostheses have a higher rate of firm-shell formation over the saline-filled implant. If placed behind the muscle, 12% of silicone implants will form a firm shell compared to 2% for the saline filled implants.


A thorough discussion with Dr. Bernier will help you to make the right decision.


Implant volume

The choice of implant volume is the responsibility of the patient. A variety of methods can help you. During your consultation, you can try out various sizers templates as a reference. Then, depending on the dimensions of your breast and thorax, you can build your own templates at home. For example, if your breast is twelve centimetres wide (note that it is preferable for a more natural appearance to use an implant with a width of 1 to 2 centimetres less, depending on your thickness of covering tissue) take a round bowl of the same diameter, line the bottom with water-resistant cellophane paper and fill the container with basmati rice, barley or lentils, measuring in ml the quantity. Close the film and remove from the container. This results in a half-sphere similar to an implant. Depending on the preferred volume, different projection prostheses will be offered.

When the implant is inserted under the tissues and depending on its resistance to stretching, you will notice a little less projection than the template tested on your breasts. Also, in the months following the procedure, the implant will make its niche on your chest causing another change in projection or volume appearance. Your doctor will suggest an added value to the desired volume to compensate for these phenomena.

A frequent criticism after an increase is that the volume of the implant is too small. A woman wants breast implants to have larger and/or firmer breasts. The goal is to have a more beautiful breast. A beautiful breast should have a natural appearance and texture. However, implants that are too large or big lose these characteristics.

Satisfaction increases with implant size to a certain extent. A person who chooses implants that are too small may be disappointed, but a person who chooses implants that are too big may be very disappointed, much more disappointed than the person who has an implant that is too small.

My experience of several years and combined to several doctors experiences show that a woman who is disappointed with a too small implant is much less disappointed than a woman whose implant is too large. Moderation tastes much better.

There are several reasons why large breasts are more of a problem than small breasts. It is always possible to increase a volume and this with a minimum of scarring while the opposite is not true. An enlargement procedure is obvious with almost invisible scars. A procedure to reduce or lift the breast invariably leaves extensive scars that can sometimes be anesthetic. We can provide you with pictures of breast reduction scars. So you certainly don’t want to have too big implants for your tissues.


Other arguments are against large implants. There is the desire for a natural appearance, but also the feel of natural breasts. If you choose implants that are not proportional to your tissues, they will stretch and become thinner. The implants will then be more visible and palpable through the skin.



Some of the complications of hardening and creasing are proportional to the size of the implant.

If the implant is smaller, any creasing or hardening remains a small hidden problem. When the implant is large, the folds, hardening and palpabilities of the implant are much more evident.

With large implants, stretch marks are more likely to appear. This is why Dr. Bernier advises those who want larger implants to do so in 2 steps to allow the skin not to undergo too much sudden stretching, to better adapt and thus allow the formation of scar tissue helping the support.

Another very important factor against large implants is the stretching of the skin and the lowering of the prosthesis. Gravity will inevitably claim its due. In addition, most women with large implants will experience ptosis (lowering) of their breasts and regret having large implants. So choose the smallest implants for which you will be comfortable living with for a beautiful and natural result.

For your doctor, it is also easy to perform an enlargement with large, medium or small volume prostheses. Moderate volumes of 275 to 325 ml are the most popular. In other words, the surgeon has nothing to gain by using small implants. Dr. Elise Bernier does not use implants with a volume greater than 400 ml for a first procedure.

We have to inform you about the problems related to large implants because disappointment caused by large implants can be extreme.

The advantages of large breast implants are quite obvious and can include:

  • Big, voluptuous breasts
  • Fill the bra and clothes more easily
  • The natural attraction of large breasts
  • Make the waist and hips appear thinner

Disadvantages of large breast implants include:

  • Hardening due to capsular contractures
  • Visibility and distortion due to capsular contraction
  • Clear visibility of implants
  • Formation of visible and palpable folds
  • Unnatural palpability
  • Asymmetry
  • Sensitivity
  • Numbness – interference with breastfeeding
  • Risk of extrusion of the prosthesis through the skin
  • Sagging and lowering of the chest is more likely to happen with large implants.
  • A repositioning or reduction may become necessary, resulting in visible and sometimes anesthetic scars or breast deformity.
  • Stretch marks are more frequent.
  • Large implants can interfere with some sports such as horseback riding, jogging, golf, tennis, badminton, racquetball, bowling, swimming, diving, ballet, dancing, figure skating and many other sports or activities.
  • They can interfere with many daily activities such as: carrying groceries or bags, sleeping, caring for children, turning over in bed, dressing and undressing.
  • Large implants can change the appearance of the person, making her look older.
  • A pregnancy with large implants will often further amplify the problems described above.
  • If the desire to reduce the volume of the implant over the years is desired, the skin, having been stretched by large volumes, will not retract and a lifting operation or reduction will then be necessary. This leaves a scar around the areola and on the front of the breast and these scars can be anesthetic.


Frequently asked questions about breast implants

I am over 50 years old, am I too old to have breast implants?

Your physical condition, not your age, is the most important factor.

Will my breasts still move like normal breasts?

This depends on several factors, such as the type of implant, dissection of the dressing room, how your body carries the implant and the presence or absence of capsular contracture. For many women, it is impossible to have flexible and well-moving breast implants, while other women have firmer results with a more rigid implant.

What are the effects of smoking on the healing process after the procedure?

Smoking causes blood vessels to contract, reducing the supply of blood and oxygen to the operated area. Tissues need this supply of blood and oxygen to heal. When the blood supply is reduced, the tissues heal more slowly. Dr. Elise Bernier recommends quitting smoking 4 weeks before and 4 weeks after.

Can I tan in the cabin or sunbathe if I have an implant?

Tanning in the cabin or in the sun will have no effect on the implant but may cause more pronounced scars. You should avoid exposing the scars to sunlight or ultraviolet rays for at least one year after the procedure, as this exposure may give the incision site a permanent dark colour. The implant may become hot and take longer to cool than your body.

Can I fly or dive?

Many women with breast implants dive and fly. Changes in pressure can cause a slight expansion and contraction of the capsule. This can cause a small number of air bubbles to appear in the implant. With gel-filled implants as well as saline-filled implants, it is possible that the liquid (gurgling) may be felt or heard. This sensation normally disappears within 24 to 48 hours.

In conclusion

It is true that: when seen from a distance or in a movie, the bigger the implant, the better it looks, but most women in real life want to look as natural as possible and do not want the sensation or appearance of enlarged breasts. There is no doubt that large breast implants do not look very natural and can cause the problems mentioned above.

Having undergone a breast enlargement procedure, I understand that the choice and volume of implants are unique to me. The choice of breast implant volume is my responsibility. The volume used by the doctor may differ slightly depending on the quality of my tissues, but it usually remains within 10 to 15% of the chosen volume. Moreover, my satisfaction and disappointment with the volume are entirely my responsibility. This information about the consequences of choosing the right size helps me to choose what is right for me now and in the future. This Information is not intended to change your preference or to convince you that one volume is better than another.

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