Medial descriptors have attracted increasing interest in image representation, simplification, and compression. Recently, such descriptors have been separately used to (a) increase the local quality of representing salient features in an image and (b) globally compress an entire image via a B-spline encoding. To date, the two desiderates, (a) high local quality and (b) high overall compression of images, have not been addressed by a single medial method. We achieve this integration by presenting Spatial Saliency Spline Dense Medial Descriptors (3S-DMD) for saliency-aware image simplification-and-compression. Our method significantly improves the trade-off between compression and image quality of earlier medial-based methods while keeping perceptually salient features. We also demonstrate the added-value of user-designed, as compared to automaticallycomputed, saliency maps. We show that our method achieves both higher compression and better quality than JPEG for a broad range of images and, for specific image types, yields higher compression and similar quality than JPEG 2000.