Breast Implant Revision, Going From Silicone to Saline to Adjust Asymmetry, is this best Choice?

I am having revision surgery, I currently have silicone 286 and 310cc's My breasts were different sizes. They're still different size so I'm going with saline probably 400cc, he will be able to make them more even with saline, correct? I'm 5'2" and about 98lbs. How big should I go? Am I making a good choice to go from silicone to saline? The MRI thing freaks me out also, and not knowing if they're broken does too with the silicone, please help!

Doctor Answers 4

Breast Augmentation Revision - Asymmetry

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Significant  breast asymmetry can be improved with breast procedures.  These procedures may include, breast augmentation, breast reduction and or breast lift procedures.   Only an examination with your doctor will determine which options are appropriate.  Performing these procedures can improve symmetry but, identical symmetric results will never be achieved.  Advantages and disadvantages of implant type needs to be discussed with your doctor. 

Philadelphia Plastic Surgeon

Switching from Silicone to Saline???

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At 5'2 and 98 lbs., you are thin.  I NEVER recommend saline implants for someone who is thin because you can feel the difference and rippling can be seen.  I think it would be a mistake for you to change from slicone to saline implants.  If you want to go bigger that is understandable.  You did not give your cup size or any photographs so it is hard to decide what size would be best for you.  I would leave it up to the surgeon's discretion to use different sizes on each breast to obtain the symmetry you desire.

Best of Luck,

Gary Horndeski, M.D.

Gary M. Horndeski, MD
Texas Plastic Surgeon
4.6 out of 5 stars 230 reviews

Saline or Silicone Breast Implants for Revisionary Breast Surgery?

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Thank you for the question.

In your question you expressed several concerns regarding the pros and cons of silicone and saline breast implants. When a patient states that she is “freaked out” about a certain size of breast implant, it is generally best to avoid that implant.  I usually suggest that patients educate themselves as much as possible so that they make as rational/objective a decision as possible. You may find the FDA website  a useful resource while doing your homework about the pros and cons of saline versus silicone breast implants.

Although saline breast implants are “adjustable” to a greater degree than silicone breast implants, it is likely that you can  achieve improved symmetry with either type of implant;  surgeon selection and  realistic expectations are critical. The breasts will never be identical  regardless of choice of plastic surgeon or breast implant type.

Given your body type description,  be careful about the use of saline breast implants given their increased propensity for rippling/palpability.

Again, I would suggest that you do your due diligence carefully in regards to the pros and cons of saline versus silicone breast implants and make  your decisions based on objective data ( as opposed to emotion) as much as possible.

The type of implant used may  determine the final outcome, especially if a patient does not have significant covering breast or adipose tissue. For example, some surgeons feel that silicone implants have a more natural look and feel than saline implants because silicone gel has a texture that is similar to breast tissue. Each patient differs in the amount of breast tissue that they have.  If a patient has enough breast tissue to cover the implant, the final result will be similar when comparing saline implants versus silicone gel implants.  If a patient has very low body fat and/or very little breast tissue, the silicone gel implants may provide a more "natural" result.
On the other hand, saline implants have some advantages over silicone implants. Silicone implant ruptures are harder to detect. When saline implants rupture, they deflate and the results are seen almost immediately. When silicone implants rupture, the breast often looks and feels the same because the silicone gel may leak into surrounding areas of the breast without a visible difference.  Patients may need an MRI to diagnose a silicone gel rupture.   Saline implants are also less expensive than the silicone gel implants.
Other differences involve how the breast implants are filled. Saline implants are filled after they’re implanted, so saline implants require a smaller incision than prefilled silicone breast implants.
On May 10, 2000, the FDA granted approval of saline-filled breast implants manufactured by Mentor Corporation and McGhan Medical. To date, all other manufacturers’ saline-filled breast implants are considered investigational.
As of 2006, the FDA has approved the use of silicone gel implants manufactured by the Mentor Corporation and Allergan (formerly McGhan) for breast augmentation surgery for patients over the age of 22.

Best wishes.

Revision breast implants

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No two breasts are exactly the same.  So even after revision they may not look as close as you  may like.  Saline does afford modifications to adjust the volume a bit easier, but silicone implants can be used as well.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.