Should I Switch from Silicone to Saline? (photo)

I always tell my patients that silicone gel implants are the Cadillac of implants and saline implants are the Honda of implants.  They will both get you to your destination but it's a matter of style.  By that analogy I mean that silicone gel implants more closely approximate the look and feel of real breast tissue.  Saline implants are basically a bag full of water and they have the potential to look/feel like a bag full of water.  Both will add volume but I think the silicone gel implants are a lot nicer.  Another thing to consider is that, the larger volume you use, the more your natural tissue has to stretch and thin out in order to cover the implant.  If the layer of tissue coverage over the implant is very thin, you may be able to feel/see ripples and wrinkles in an implant, more so with saline than with silicone gel.  Finally, the largest volume implant made by the three manufacturers approved by the FDA for selling implants in this country is approximately 750 -800 cc's.  These companies used to make custom-made implants for patients who wanted larger sizes but they don't do that anymore.  I know there are women out there with larger volume implants but I don't know where they are getting them or what the quality of those larger volume implants might be.

Your implants are very shapely and appear to fit your frame.  The implants are already large (700 ml).  You currently run the risk of stretching the skin over time with the implant size you currently have.  I would not recommend ANY larger implants whether they are silicone or saline.

 

Dr. ES

I would urge caution going larger with saline. I have placed several sets of implants larger than 1200cc, but all were silicone imported from Europe with permission from the FDA. With saline implants you will be at high risk to get visible rippling.You will get significant thinning of the skin. You can get the skin lifting off the sternum. 

   This upsize is technically possible and is done in a few women if they understand and accept the risks.  Tissue thinning as others have mentioned, back, neck, and shoulder pain, increased rippling, increased risk for extrusion, and increased droop over time, among others.

Hello,

I can't tell you whether your 'favorite boobs' pic is a woman with saline or silicone. However, based on your current appearance, you would need around 1000 cc implant to achieve that result (roughly 40 to 50% increase in current volume), and could only be gotten using saline.

As the others have said, it's a trade off between the size you want and unwanted potential problems that will, sooner or later, rear their ugly heads: tissue thinning causing unpredictable breast shape or feel, malposition and dropout, rupture and deflation, and capsular contracture.  Having said that, the first silicone to oversized saline switch I performed was in 2008, and she is still extremely happy (even though her breasts are not as naturally soft as I would want for my patients due to the thinness of her tissues).  I perform a few every year, and it does not require any specialized training or techniques over and above those required to be a competent breast implant surgeon.

Dr. John Grossman is in Denver, and he is a seasoned, well-respected surgeon capable of performing this surgery.  Dr. Paul Zwiebel is in Littleton as well, although I am not as familiar with him.

Best of luck!