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Dr. Ramsey J. Choucair answers frequently asked questions about plastic surgery and the different types of breast implants at http://www.DrCPlasticSurgery.com Two FDA approved choices: Saline: a silicone rubber bag filled with saline Silicone gel: New-Generation - "Cohesive implant" A cohesive implant means the silicone gel is made in a more firm fashion - if you cut the implant in half with a knife it separates like congealed or cold jello. How do you choose? Saline implants: a little firmer a little less soft and compressible character of your breasts is firmer Silicone gel: much more compressible softer more natural 85% of women in our practice choose silicone gel Issues in following the breast that's been augmented: Saline: inflated and OK deflates and you know it normal mammograms normal breast surveillance special views confirm seeing all parts of the breast When saline implants fail, your breast deflates. Typically, the saline will come out from a small, pinpoint hole in the implant. Many times saline implants will have little folds that move and create a small, tiny hole. The saline is dissolved in your body and you simply replace the implant. Silicone (cohesive silicon gel implant): FDA advises MRI every three years mammogram typically will not show rupture of an implant MRI will show any defect in the implant Most patients will succeed in achieving their goal with either implant. It comes down to your own comfort level, seeing and feeling the implant, and considering the size difference you're trying to achieve.