Silicone Vs. Saline: Implant Replacement After Capsular Contracture

asked 3 years ago by CCGirl28 in Tustin, CA
Latest answer by Larry S. Nichter, MD, MS
Question viewed 8,724 times
Tags: capsular contracture

I'm 28, and I have 425cc Saline breast implants with a capsular contracture ("CC") on my right side. It's severe and painful, and will need to be removed. My doctor suggested replacing the saline with silicone. He said that there is only a 1% chance of the CC occuring again. Is that true? Which should I go for? I also am planning to go smaller, so both implants will be replaced.

10 answers to Silicone Vs. Saline: Implant Replacement After Capsular Contracture

You may want to consider having both implants replaced...

You may want to consider having both implants replaced under the muscle. Though no definitive data is available, your best option for decreasing capsular contracture would be a site change from the "above muscle" pocket to the "under muscle pocket." I've recently published an article on this "Pocket Conversion Made Easy: A Simple Technique to Convert Subglandular Breast Implants to the Dual Plane Position" in the Aesthetic Surgery Journal (February 2009). The... more

M. Mark Mofid, MD
San Diego Plastic Surgeon

Capsular Contracture and Implants

Once you have capsular contracture (cc), your chances of having the same is increased. Nationwide, the risk of a primary augmentation and cc is around 7-8% with saline. The new data from one of the implant company shows that their silicone implant CC rate is close to 9%. This is nationwide, so look at these numbers with a grain of salt. So, silicone is not that dramatically higher as being stated in some of the comments here. You have to weigh the risks and benefits, but in redo... more

Farbod Esmailian, MD
Orange County Plastic Surgeon

Capsular Contracture and Implant Choice

It's unlikely that your choice of silicone vs. saline will dictate the success of your procedure. Replacing the implants does makes sense, as some capsular contracture (cc) arises due to bacterial contamination of the implant. Going smaller will present some challenges. Depending on your skin tone, you may have excess skin after changing implant size and a breast lift may become a consideration. The internal pocket will be also oversized for the new smaller implant (especially after... more

Michael Kreidstein, MD
Toronto Plastic Surgeon

Silicone implants give better results.

Silicone implants in general look and feel more natural. But you can get another capsular contracture with any kind of implant, and the risk is more like 5%. How the surgery is done is more important than what implant you use. Even without seeing you, I can tell you that going smaller is a good idea. You need to have part of the capsule removed to release the contracture (called a capsulectomy) and you also need the pocket made smaller to accomodate the smaller implant (called a... more

George J. Beraka, MD
Manhattan Plastic Surgeon

Your risk is HIGHER than 1%

Once your body has shown that it "knows" how to make CC, your future risk will certainly be more than 1%. The lowest rates come with saline under the muscle so if you are above the muscle you might consider submuscular conversion. The risk remains higher with gel. Size doesn't really matter so much.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon

Many Choices, One Guarantee

Capsular Contracture (CC) has a variable rate of occurrence, can be unilateral or bilateral, and can occur within months or take many years to develop. Patients who have experienced CC are more likely to have it happen again with subsequent implant replacement. However, if the implants are placed below the pectoral muscle, into a large pocket, and are massaged early in the post-operative period in order to maintain the space around the implant, there may be improvement, or at least... more

Athleo Louis Cambre, MD
Los Angeles Plastic Surgeon

Silicone Vs Saline and Capsular Contracture

The large simple trial data for Capsule contractures that are moderate to severe ((Baker 3 & 4) for saline implants are - between 5-7% at one year for primary augmentation and between 8-15% for replacement implants. In my extensive experience as well as others changing the pocket to a submuscular one and using a silicone implant is in your best interest. Have your plastic surgeon also discuss with you the potential use of textured implants and other potential methods to... more

Larry S. Nichter, MD, MS
Orange County Plastic Surgeon

Encapsulation seems more likely with silicone gel implants

Hello, I am not a big fan of silicone gel implants unless you have really thin tissue and are having problems with rippling. In my experience, the silicone gel implants have a very high encapsulation rate over the long term. In fact, my saline implant patients rarely develop capsular contracture. Some patients do prefer silicone because of the feel however. To say you have a 1% risk of repeat contracture is "guilding the lilly" a bit. Most studies have shown repeat contracture... more

John P. Di Saia, MD
Orange Plastic Surgeon

Changing the Implant is correct, the type doesn't matter.

Your doctor is correct that doing something different the second time is the right choice. However changing from a saline to silicone implant won't make much difference in your chances of getting a capsular contracture. The contracture is caused by unclear reasons. It isn't just a reaction from your body, or it would have happened on both sides. It isn't just bleeding or infection, because it happens in people with no problems and even many years after surgery. So, without knowing the... more

David A. Dreyfuss, MD
Chicago Plastic Surgeon

The rate is higher

The rate of capsular contracture is much higher than 1% for patients that have had a previous CC. Some studies suggest it is about 20-30%, and may even be higher.