MtF breast implants can be filled with either saline or silicone gel. The silicone gel has a more natural feel, and provides a stable form and projection over time. Moreover, the gel nowadays is cohesive, so in the unlikely case of a shell leak, the gel always remains in one piece. Cohesive gel implants exist in both round and anatomical forms. Saline-filled implants only exist in round forms. However, since they can be inserted through small incisions, in selected cases and retromuscular placement, excellent results can still be obtained.
Silicon MtF breast implantsPros ▪ More natural feel—Softer, mushier and more natural feeling. ▪ More natural look—Prefer for a woman with little or no breast tissue. ▪ Less rippling or waving under the breast. ▪ Round and teardrop shapes available
Cons ▪ Larger incision—Can take a slightly larger incision to place. ▪ No volume adjustments—cannot adjust the volume during the operation because they are sealed ▪ Requires surveillance by MRI to detect possible rupture ▪ More expensive
Saline MtF breast implantsPros ▪ No surveillance by MRI—Saline absorbed by the body if ruptured ▪ Smaller incisions—Can be inserted trough a very small incision because they are filled after insertion. ▪ Cheaper
Cons ▪ Less natural look and feel ▪ Only round shapes
How long do breast implants last? As part of thinking about whether or not to get implants, it is important to be realistic that breast implants are not considered to be lifetime devices. Though recent advancements in the science of breast implants have made them safer and more durable than ever, it is possible that you will need to replace or remove your implants eventually due to leakage or deflation.
If this happens your implants will probably have to be removed, and you will have to decide whether or not to replace them. Implants stretch the skin. If you have implants removed and do not replace them, your skin will likely be wrinkled, dimpled, or puckered.
Saline Implant Deflation — It is possible for saline implants to leak or deflate. If this happens, it will happen quickly. Your chest will shrink down to its original size in a matter of hours or days. Because saline implants are filled with saltwater, deflation is not dangerous. However, you will need to undergo implant replacement surgery. The risk of deflation is about 4 percent during the first year post-surgery, and then reduces to about 1 percent thereafter.
Silicone Implant Rupture — Silicone implant rupture is essentially the same thing as saline implant deflation except that silicone is not quickly absorbed by your body. Because silicone gel is cohesive, you may not notice for months or even years. For this reason, it is recommended that an MRI be performed three years after your initial surgery, and then every two years thereafter to screen for the presence of a leak. If silicone gel extrudes from the implant shell, it may lead to an inflammatory response and possibly capsular contracture.