The authors performed 57 cases of augmentation mammoplasty with saline-filled implants during the recent 2 years. Thirty five of aesthetic augmentation mammoplasties were reviewed, and the remaining 22 cases were immediate breast reconstruction cases after mastectomy or tissue expander insertion.
  There were 16 cases of problems, the most serious complication was 5 cases of capsular contracture and 1 case of hematoma, 2 cases of skin rippling and 1 case of asymmetry progressing to capsular contracture. They were managed with appropriate method.
  In summary, saline-filled prosthesis has less benefit than silicone-filled implant, and it also has many problems as gel-filled prosthesis. Therefore, we propose the ideal procedures for augmentation mammoplasty with saline-filled prosthesis as follows: Suitable bag size and shape, sufficient pocket dissection, absolute bleeding control, full saline filling followed by adequate postoperative massage.