How Complicated is the Surgery to Replace Saline Implants with Cohesive Silicone Gel?

Because you already have a mature scar capsule around the implants, it usually is not a complicated procedure to exchange the implants, and recovery is quick. Going larger will require that the pockets be enlarged, and you will still need to respect the base diameter of the breasts in determining the size. However, you have options now in terms of profiles that were not available 18 years ago. All silicone implants have cohesive gel, so you need to be certain about the type. Round silicone gel implants usually feel more natural than saline, but form-stable or "anatomic implants"  (also called gummy bear) will be quite firm and less natural feeling.

It is very common for women to want to switch their breast
implants from saline to silicone. In
fact the majority of breast augmentations performed in my practice are silicone
implants at this point because they give a much more natural soft feel.



Many women who are very thin and go with larger implants can
have rippling or a firm feel and look to their implants. Many of my patients have been switched from
saline to silicone to have a more natural appearance or decrease their
rippling.



The surgery is very straightforward in comparison to the
original breast augmentation. The muscle
has already been stretched so patients do not feel the same pressure after
their surgery. Patients are typically surprised how easy the recovery is for an
implant exchange.

Generally it's a fairly straightforward operation but after 18 years, there may be some ptosis (sag) that may need correction with a breast lift. Going to a larger implant may achieve this on its own however.

If your implants are malpositioned or too mobile, it may be necessary to make a new pocket for the implants which ads complexity to the surgery.