Silicone gel implants have continued to make increasing strides in capturing market share from saline implants especially in such places as southern California and in Florida. Data released by a mentor corporation over a year ago said that patient satisfaction of silicone gel implants was slightly higher than that with saline implants over time and the capsular contracture rate was only slightly worse than saline implants. For those patients who do not mind having an incision under their breasts, silicone gel implants seem to be an excellent product giving a highly aesthetic feel to the breasts with good shape and a low incidence of rippling and capsular contracture. On the other hand, patients who are interested in no scar on the breasts techniques such as through the umbilicus or through the axilla are still likely better off with saline implants as long as they have good tissue for coverage of the implant. While some centers such as Core Plastic Surgery are producing an early experience with silicone gel implants through the axilla, it is still a very early experience and too early to recommend this approach routinely. Mentor Corporation reports that in most practices across the country, silicone gel has reached at least 50 percent of the volume of new breast augmentations coming into the surgeons’ practices. In many practices, silicone has now passed saline as the dominant implant in terms of percentage of the practices’ new augmentation patients. However, in other practices such as Core Plastic Surgery, saline continues to be the leader by a wide margin due to requests for endoscopic techniques. For further information regarding silicone gel implants or saline implants, call Core Plastic Surgery, (205) 397-2100.