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Authored by: Dr. Sam Sukkar, MD on September 12th, 2025
Silicone breast implants have become a popular choice for those looking to enhance breast shape or restore volume after surgery. They are filled with a soft, cohesive silicone gel that closely mimics the feel of natural breast tissue. They offer a smooth, realistic look and feel that many find more natural than saline implants.
These implants come in different shapes, sizes, and firmness levels, allowing a customized result that matches personal goals. Options range from round to teardrop-shaped designs, and some have textured shells to help them stay in place. Learning about these choices can help someone decide which type best fits their needs during breast enlargement.
Breast enhancement with silicone breast implants use a soft, cohesive gel that aims to feel similar to natural breast tissue. They are a common choice for both cosmetic breast augmentation and reconstructive surgery after injury or mastectomy.
Silicone implants have an outer shell made of durable, elastic silicone. Inside, they are filled with a medical-grade silicone gel. This gel can be either cohesive (holds its shape) or form-stable (often called “gummy bear” implants).
The gel’s consistency helps it maintain shape while feeling soft to the touch. Many people choose silicone gel implants because they tend to feel more like natural breast tissue compared to saline-filled breast implants.
They come in round or teardrop (anatomical) shapes and in smooth or textured shell surfaces. Smooth shells can move more naturally, while textured shells may help reduce implant shifting.
The main difference is the filling material. Silicone implants use a gel, while saline implants are filled with sterile saltwater. Saline implants are inserted empty and filled during surgery, but silicone implants come pre-filled. Silicone implants generally feel softer and more natural. Saline implants may feel firmer and are more prone to visible rippling under thin skin. Silicone gel can better mimic the weight and texture of natural breast tissue.
If a saline implant leaks, the body absorbs the saltwater safely, and the implant visibly deflates. A silicone implant rupture may not cause an immediate change in size, which is why monitoring is important. Both types have FDA approval for specific age groups: silicone implants for augmentation in women 22 and older, and saline implants for women 18 and older.
Silicone breast implants come in different designs that vary in shape, firmness, and shell texture. Each type uses a silicone outer shell filled with silicone gel, but the gel’s consistency and the shell’s surface can change how the implant feels, looks, and holds its shape over time.
Traditional silicone implants use a silicone outer shell filled with soft silicone gel. This gel has a consistency similar to natural breast tissue, which many people find appealing. They are available in a variety of sizes and profiles to match different body types and aesthetic goals. The gel is not form-stable, so if the implant shell breaks, the gel may leak into the surrounding tissue.
These implants have been used for decades and are approved by the FDA for breast augmentation in women age 22 or older. They can be smooth or textured, and they are often chosen for their natural feel rather than their shape retention.
Gummy bear breast implants, also called form-stable implants, are filled with a cohesive silicone gel that is thicker than the gel in traditional implants. This gel holds its shape even if the shell is damaged.
They are often teardrop-shaped to mimic the natural slope of the breast. The thicker gel makes them firmer to the touch, which can reduce wrinkling and rippling under the skin. Because of their shape, they usually have a textured shell to help them stay in place. Many patients choose gummy bear implants for their durability and shape stability, though they can feel less soft than traditional silicone types.
Smooth silicone implants have a soft outer shell with no texture. This allows them to move more freely within the breast pocket, which can create a more natural movement. They usually feel softer than textured implants but may have a higher chance of shifting position over time. Smooth shells are available with both traditional and cohesive gel fillings.
Many people choose smooth implants because they tend to have a lower risk of visible rippling in women with more natural breast tissue. They also tend to cost less than some specialty designs.
Textured silicone implants have a roughened outer shell designed to help the implant stay in place. The texture encourages tissue to grow into the surface, which can reduce movement inside the breast pocket.
They are often used with teardrop-shaped or form-stable implants to prevent rotation. Textured shells can be paired with both softer and more cohesive silicone gels.
While they can improve stability, textured implants have been linked to a rare condition called breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). Patients considering textured implants should discuss the risks and benefits with a qualified surgeon.
Silicone breast implants use a cohesive silicone gel that holds its shape while feeling soft to the touch. Many people choose them in breast augmentation because they can closely match the appearance and texture of natural breast tissue. They also come in many styles to fit different body types and goals.
Silicone gel implants are often chosen for their realistic texture. The gel inside is thick and cohesive, which helps it mimic the softness of natural breast tissue. This can make them less likely to wrinkle or ripple under the skin compared to saline implants.
Many patients say that after healing, the implants feel more like their own breasts. Silicone implants are widely preferred for their natural appearance in both look and touch. They also maintain their shape well when a person moves or changes position. This can be important for those who want results that blend well with the rest of their body.
Silicone gel filled implants are built with a strong outer shell that helps them last for many years. The cohesive gel inside holds its form even if the shell is damaged, so the implant does not collapse like a saline-filled one might.
Many surgeons note that silicone implants can offer longer-lasting results compared to some other options. While no implant is permanent, they often remain in good condition for 10 years or more before replacement is considered.
They are also less likely to show visible folds or ripples over time. This durability can be especially important for patients with less natural breast tissue to cover the implant.
Silicone gel implants are available in a wide variety of shapes, profiles, and sizes. Patients can choose between round implants for more fullness or teardrop-shaped implants for a sloped, natural look.
This variety allows surgeons to match the implant to the patient’s chest width, breast base, and desired projection. The range of options makes it easier to create balanced proportions during cosmetic surgery.
Silicone breast implants can lead to specific medical issues over time. These may include damage to the implant shell, changes in breast shape or feel, and in rare cases, certain cancers linked to the implant surface. Early detection and proper medical follow-up can help reduce long-term problems.
An implant rupture happens when the silicone shell tears or develops a hole. This can occur from aging of the implant, injury, or during certain medical procedures. Unlike saline breast implants, silicone ruptures are often “silent” because the gel may stay inside the scar tissue around the implant.
Because symptoms are not always obvious, the U.S. Food and Drug Administration recommends routine imaging such as MRI or ultrasound to detect a rupture. Common signs can include changes in breast size, shape, or firmness.
If a rupture is confirmed, doctors usually recommend removing or replacing the implant. According to the FDA, leaving a ruptured silicone implant in place can lead to pain, swelling, or further complications.
Capsular contracture occurs when the body forms scar tissue around the implant that becomes unusually tight or hard. This can cause the breast to feel firm, change shape, or become painful. The exact cause is not always known, but infection, bleeding, or implant rupture may increase the risk.
Doctors classify capsular contracture in grades from mild to severe. In severe cases, the breast may look distorted and revision surgery may be needed to remove or replace the implant.
Treatment options can include surgical removal of the scar tissue (capsulectomy) or replacing the implant with a different type or surface texture. The American Board of Cosmetic Surgery notes that proper surgical technique and post-operative care can help lower the risk.
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare cancer of the immune system. It is not breast cancer but a type of non-Hodgkin’s lymphoma. Most cases have been linked to textured-surface implants rather than smooth ones.
Symptoms can include swelling, pain, or fluid buildup around the implant, often years after surgery. Diagnosis usually involves imaging and fluid or tissue testing.
The Harvard Health review notes that early treatment, which often includes removing the implant and surrounding scar tissue, can lead to good outcomes. The FDA advises patients with implants to be aware of symptoms and seek medical evaluation if they occur.
Silicone breast implant surgery involves several important steps that affect the final look, feel, and recovery. Patients work closely with a qualified surgeon to select the right implant type, surgical method, and aftercare plan for their needs.
The process begins with a meeting with a board-certified plastic surgeon. During this consultation, the surgeon reviews the patient’s medical history, breast measurements, and desired results.
They discuss implant options, including size, shape, and profile. Many choose silicone breast implants because they tend to feel more natural than saline options. The surgeon may also recommend a breast lift if the patient has sagging tissue. This can be done at the same time as the implant procedure.
To help visualize results, some clinics use 3D imaging or allow patients to try sizers inside a bra. This step helps set realistic expectations before surgery.
The breast implant procedure is usually done under general anesthesia. The surgeon makes an incision in one of three common locations:
The implant can be placed above or below the chest muscle. Placement choice depends on body type, implant size, and tissue thickness.
The surgeon inserts the silicone implant, checks symmetry, and closes the incision with sutures. Surgery usually takes one to two hours.
Most patients go home the same day. During breast augmentation recovery patients wear a surgical bra or compression garment to reduce swelling and support healing. Mild discomfort, swelling, and bruising are common in the first week. Pain is usually managed with prescribed medication.
Surgeons often advise avoiding heavy lifting or strenuous activity for at least four to six weeks. Follow-up visits are important to check healing and implant position. Long-term care includes regular self-checks and occasional imaging to monitor implant condition. Silicone implants may require MRI or ultrasound scans over time to detect silent ruptures.
Silicone breast implants are often chosen to restore breast shape after surgery for breast cancer. They have a soft, gel-like filling that feels closer to natural breast tissue than saline implants, and they come in different sizes and shapes to match a patient’s body.
After a mastectomy, many patients choose silicone implants to help recreate the breast mound. These implants have a silicone outer shell and are filled with silicone gel, which can provide a more natural look and feel compared to saline.
Some surgeons prefer silicone for its lower risk of visible rippling under the skin. However, patients should know that implants may need replacement in the future due to wear or complications.
Silicone implants are FDA-approved for breast reconstruction at any age and for augmentation in women aged 22 and older. They can be placed either above or below the chest muscle, depending on the patient’s anatomy and the surgeon’s plan.
In some cases, textured implants have been linked to a rare cancer called breast implant-associated anaplastic large cell lymphoma, so many doctors now use smooth-surfaced models.
When there is not enough skin or muscle to place a permanent implant right away, surgeons may use breast tissue expanders. These temporary devices are placed under the skin and gradually filled with saline over several weeks.
This process stretches the tissue to make space for the final silicone implant. The expansion is done in small steps during office visits to keep discomfort low.
In staged reconstruction, the expander is later removed and replaced with a silicone implant in a second surgery. This method can improve the final breast shape and position. According to the American Cancer Society, tissue expanders are common after mastectomy when the skin has been tightened or removed. They help ensure the implant fits well and looks balanced with the other breast.
Silicone breast implants can last for many years, but they are not designed to be permanent. Breast implant surgery cost vary widely depending on the surgeon, location, and type of implant, and replacement surgery may be necessary due to aging, damage, or a change in personal preference.
Most implant manufacturers suggest silicone implants can last 10–15 years before replacement is considered. However, some last longer if there are no complications.
Factors that affect lifespan include:
The FDA recommends periodic MRI or ultrasound scans to check for silent ruptures. For example, cohesive gel implants may remain intact even if the shell is damaged, but replacement is still advised if a rupture is confirmed.
Replacement surgery may be needed for several reasons:
A breast implant revision can involve removing the old implant, replacing it with a new one, or adjusting the pocket for better placement. Some patients combine revision with a breast lift to address sagging.
Revision surgeries can be more complex than the original augmentation, especially if scar tissue must be removed. Recovery time is usually similar to the first surgery.
The average cost for breast implant surgery in Houston is about $5,000 to $8,500, but revision or replacement can cost more. In high-demand areas, fees may range from $8,000 to $35,000.
Some implant manufacturers offer limited warranties that may cover part of the cost if there is a rupture within a certain time frame. Patients should review warranty terms before surgery to understand coverage limits.
Breast implants carry risks such as infection, scarring, changes in nipple or breast sensation, and implant rupture. Some may also experience capsular contracture, where scar tissue hardens around the implant. The FDA monitors implants for safety and has regulated them to set quality standards.
Breast implants are not considered lifetime devices. Many last 10–20 years, but they may need replacement sooner if problems occur. Regular check-ups help detect issues early and guide decisions about replacement or removal.
Many women can breastfeed after implants, whether they are silicone or saline. Studies show no higher silicone levels in the milk of women with implants compared to those without. However, some surgical techniques may affect milk production, depending on incision location and placement.
A saline implant rupture usually causes a sudden decrease in breast size. The body absorbs the saline safely. A silicone implant rupture may not cause visible changes. This is called a “silent rupture” and is often found through MRI or ultrasound imaging.
Most people return to light activities within a week. Strenuous exercise and heavy lifting are usually avoided for 4–6 weeks. Full healing and final results can take several months, depending on the individual’s health and the surgical approach used.
Silicone breast implants remain one of the most popular options for breast augmentation and reconstruction because of their natural look, soft feel, and long-lasting results. With a wide range of shapes, sizes, and textures available, patients can choose implants that best match their goals and body type.
While they offer many benefits, regular monitoring and awareness of potential complications, are important for maintaining health and results over time. Working with a skilled, board-certified plastic surgeon helps ensure safe placement, realistic outcomes, and proper follow-up care.
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Dr. Sam Sukkar, MD, FACS is a highly respected Board-Certified Plastic Surgeon in Houston, Texas, known for his expertise in advanced cosmetic and reconstructive procedures. As the founder of The Clinic for Plastic Surgery, Dr. Sukkar has set a new standard for excellence, performing over 20,000 procedures with a focus on delivering natural, refined results.
Dr. Sukkar earned his Doctor of Medicine (M.D.) degree from Louisiana State University School of Medicine in 1992 after graduating summa cum laude with a Bachelor of Science in Microbiology. He then completed an intensive General Surgery Residency at the University of Texas Hermann Hospital before being selected for a highly competitive Plastic Surgery Fellowship at Northwestern University in Chicago, one of the most prestigious training programs in the country.
With more than 20 years of experience, Dr. Sukkar is a Diplomate of the American Board of Plastic Surgery and a Fellow of the American College of Surgeons (FACS). He is also an active member of the American Society of Plastic Surgeons (ASPS) and the Houston Society of Plastic Surgery (HSPS). His dedication to innovation and continuing education has solidified his reputation as a leading expert in aesthetic surgery, specializing in breast surgery, body contouring, facial procedures, and non-invasive treatments.
Dr. Sukkar’s expertise has been recognized by Houston Magazine, naming him one of Houston’s “Top Docs for Women,” and he has been featured among RealSelf’s America’s Top Doctors. Committed to his patients, he prioritizes personalized care, ensuring every individual feels informed, comfortable, and confident in their aesthetic journey.
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Cover Image Credit: 3KStudio / 123RF.com (Licensed). Photo Illustration by: Dr. Sam Sukkar, MD, The Clinic for Plastic Surgery.
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