Exchanging implants from saline to silicone. Do I need to go slightly larger?

Hello,You are the perfect candidate for an 'overfilled' silicone gel implant.  These devices are designed for you in mind: to achieve the same bubbly look of saline in a silicone gel implant. Unfortunately, Sientra doesn't make one yet. Mentor is about to come out with one, but the only one actually available is Natrelle's Inspira line of implants. In the past, what your surgeon recommended was the only alternative. Best of luck!

Saline breast implants can be changed for silicone breast implants - its a simple procedure for patients that do not have issues with capsular contracture or implant malposition. I generally recommend swapping implants for smooth round silicone implants in revisionary breast surgery.

so your question suggests you may have a capsule that creates a firmer feel.  Releasing the bottom half of your breast confirms that some release of your tissue is needed to achieve a look that is aesthetically pleasing.  You do not need the super cohesive gel implants that don't change shape - do you want a circular mound that is fake?  If you can accept the concept of being an ounce or so larger, you should.  It will not make any difference in your ability to maintain your active lifestyle.  If you don't mind possibly being a little smaller in look, then keep the switch even in terms of dimensions and volume.  And if you have a contracture issue,  you should be asking your surgeon for other ways to help prevent its recurrence.  BTW, I loved the PIP implants and am surprised yours are still intact.

You must be very cautious about making your implants larger IF you are already happy with the size.  Sometimes surgeons will advocate a size increase if they believe that the shape will be better with a larger implant.  However, this WILL make you larger, and if you are already comfortable with your size, you may be unhappy after the surgery.  You really should have a frank discussion with your surgeon about what he is trying to achieve with the larger size, and especially express to him about your preference to stay the same.  When changing from saline to silicone, that procedure in itself does NOT require a size increase.  

Silicone gel implants not only 'feel' softer then saline, they usually 'look' softer as well. Saline devices tend to project more than silicone gel. For these reasons, a comparable size gel implant often appears smaller than its saline counterpart. Many surgeons will opt to go up slightly in volume to account for these differences when switching from saline to gels. As long as the increase in volume is not great, your cup size should not necessarily change. Some of your firmness may be due to capsular contracture, and it sounds as though your surgeon plans to correct this as well to maintain softness. You've raised a very good question that many patients share. I would discuss your concerns directly with your plastic surgeon.