Toronto, ON

Overfilling VS Underfilling Your Saline Implants

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By Jerome Edelstein, MD

Although silicone breast augmentations have recently gained popularity, saline breast implants have been used with success for over thirty years. Like silicone implants, saline implants have a silicone shell, however, they are filled with a sterile, salt-water solution which is very natural and safe. One of the advantages of saline implants is that they can be filled by your surgeon during the procedure, which means the incision is can be smaller than that required for silicone implants, and breast asymmetry can successfully be addressed during the procedure.

However, this also means that there is the potential for the implants to be over or under filled. The implications or overfilling or underfilling your saline implants are outlined below.


The manufacturers of saline implants provide a maximum recommended fill amount for each size of implant. For example, a 300cc implant may be filled to 325cc; thus, 300cc is the minimum amount recommended and 325cc would be the highest suggested amount. If during the procedure, however, the surgeon opts to fill the implant past the manufacturer’s recommendation, it is considered overfilled. Some surgeons overfill saline implants by up to 15-20% in order to create a more rounded result and satisfy a patient’s request.

In addition, proponents of this technique believe that it reduces the risk that the implant will ripple or wrinkle. It is important to be aware that overfilling the implant may void the implant’s warranty in the case of a leak or rupture. It makes the implant feel firmer and may actually increase the likelihood of obvious rippling.


As its name suggests, underfilling is classified as filling the implant below the manufacturer’s recommendations. While some surgeons intentionally overfill saline implants, underfilling them is not a common practice as it can impact the stability of the implant. When underfilled, the implant will fold into itself, rubbing implant walls together and making it vulnerable to rupturing. In addition, failing to use the required cc’s may cause the implant to visibly wrinkle and ripple, which is an obvious sign of augmentation.

While an underfilled implant may be lead to softer, more malleable breasts, patients who hope to achieve these results should consider silicone implants, which are available in full projections that do not pose the risk of voiding the manufacturer’s warranty.

Although overfilling or underfilling saline implants goes against the manufacturer’s recommendations, some surgeons choose to do so in order to achieve a particular aesthetic look.

It is important, however, to select a surgeon who takes a more conservative approach, adhering to all rules and safety regulations, as this will help ensure that you are satisfied with your results and do not experience side effects such as rippling, rupturing, or leaking, which may necessitate a second surgery.

Your health and safety are of the upmost importance and should never be compromised.To learn more about the various breast implant options in order to determine whether saline or silicone is best for you, we welcome you to schedule a consultation with Dr. Edelstein or Dr. Jindal – qualified and experienced plastic surgeons dedicated to meeting patient’s aesthetic goals in a safe manner.

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