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.

It most cases it is not a difficult procedure to swtich from saline to silicone implants. Overall the second surgery should be less painful then your original one since the pocket is already there and you are only going slightly larger.

Thank you for your question. The change from your current saline implants to a cohesive gel type is usually a fairly straight forward procedure. Because the pocket has already been created from your prior breast augmentation, the recovery from an implant exchange is typically minimal, with most women able to drive the following day. There are potential complications, as there are with any surgery, but they are not very common.

The most important part of changing from saline to silicone implants is the planning. Because the saline and silicone implants are different in their dimensions, the implants have to be selected carefully, taking into consideration the width, projection, and the volume. It is important to use an implant that at least matches the width of your current implants since it is difficult to reduce the size of the pocket. Your plastic surgeon can help you with this choice.

Overall, I suspect that you will prefer the look and feel of the silicone, as they are softer and more natural. 

Best of luck with the exchange.

Jeff Rockmore

Although the operation is not complicated, exchanging implants does have the same risks and complications as the initial augmentation. If you want to be larger, then you should get an exchange, but if you are happy with your saline, then I would consider not doing an exchange, and keep what you have.

It is great that you have had no problems with your implants to date.  Although the surgery to replace your implants is fairly routine and commonly performed, there are many different approaches and complications can occur as with any surgery.

Switching to the newest generation of cohesive silicone gel can definitely improve the feel of your breasts, minimizing rippling and creating a better appearance.  Possible complications include bleeding, infection, numbness, asymmetry, malposition and encapsulation.

Be sure to consult with one or more plastic surgeons before proceeding with revision.

Implant exchange typically is not a difficult surgery depending on certain issues.  These issue may revolve around the need of changing the site of the implant (below or above the muscle) and the need to alter the internal capsule to improve shape and feel. 

Dr. ES

In general, breast implant exchange from saline to silicone is a straight-foward procedure. There may need to be some adjustment of the pocket to fit a new implant with different dimensions.  If you have extensive scar tissue or need more revision, then the surgery can be more complicated.

In general this procedure is very straightforward and less painful than primary augmentation. Make sure you ask your physician preoperatively if you need any capsular repair, repositioning Etc.. Good luck