Walk into any breast augmentation consultation, and one of the first questions that comes up is: silicone or saline? On paper, it sounds simple—two materials, two options. But in reality, it’s a bit more personal than that.
At The Aesthetics Centers in Newport Beach, Dr. Siamak Agha helps patients make this choice every day. And if you sit in on a consultation, you’ll hear him say something that surprises most people: there isn’t a “better” option—just the one that fits your body best.
“Each implant type has its own character,” he says. “The real question is: which one feels more like you?”
The feel of it all
If you hold both types in your hands, you can tell the difference instantly. Silicone implants feel soft and pliable—almost like natural tissue. The newer cohesive-gel versions (often called “gummy bear” implants) hold their shape while moving gently with your body. They’re the closest match we’ve ever had to natural breast texture.
Saline implants, on the other hand, are filled with a sterile saltwater solution. They’re inserted empty, then filled once in place. That means the incision can be slightly smaller, and the size can be adjusted during surgery for near-perfect symmetry.
Dr. Agha often has patients handle both options during their consultation. “You have to feel them,” he says. “It’s like trying on shoes. You’ll know what feels right.”
How they look in real life
Silicone tends to win when it comes to natural appearance. Because the gel is thicker, the edges blend better with existing tissue, especially in thinner patients. Saline implants can look just as beautiful, but in certain cases—like with less breast tissue—they might show faint rippling under the skin.
That said, some patients prefer saline for peace of mind. If a rupture happens, the saline solution is harmlessly absorbed by the body. With silicone, leaks are rare but require MRI or ultrasound checkups every few years to monitor implant integrity.
Dr. Agha is transparent about these differences. “The goal isn’t to sell one over the other,” he explains. “It’s to help you make a decision that feels comfortable five years from now, not just five days after surgery.”
What really matters: placement and proportion
Here’s something most patients don’t expect: the implant material is only one piece of the puzzle. How the implant is placed—above or below the chest muscle, the angle, the projection—makes an even bigger difference in the final look.
Dr. Agha uses 3D simulation to show exactly how each implant will look on a patient’s frame. “Once women see the difference on their own body, the decision gets a lot easier,” he says. “Sometimes what they imagined isn’t what actually fits best.”
That visual clarity helps patients feel empowered, not overwhelmed.
The subtle emotional side
Choosing between saline and silicone isn’t just about texture or safety—it’s about how you want to feel. Some women care most about natural movement; others want reassurance about the fill material. A few simply prefer the idea of something that feels “real.”
There’s no wrong answer here. What matters is that the choice feels like yours.
Patients often tell Dr. Agha that once they made the decision, the rest of the process felt effortless. “They stop overthinking and start picturing how confident they’ll feel,” he says. “That’s when you know the decision’s right.”
The takeaway
In the end, silicone and saline are just tools. The artistry comes in knowing how to use them. With the right surgeon—and a design that respects your anatomy—both can look beautiful, natural, and completely your own.At The Aesthetics Centers in Newport Beach, Dr. Siamak Agha approaches every augmentation as a collaboration. He guides, explains, and listens. The final result isn’t just about implants—it’s about creating balance that feels as natural as it looks.
