Should I switch from saline to silicone gel? (Photos)

If one breast is higher and firmer, it may be a sign of capsular contracture. In that case you would need to consider capsulectomy (removal of the scar capsule) and implant replacement. Your photo also shows some asymmetry of nipple position, suggesting that you may need a lift. Those are more important considerations than the type of implant replacement, but most patients with saline are switching to silicone when they have the opportunity.

You should switch to a silicone round smooth implant.  The implant selection should be based on a combination of your desired size, soft tissue dynamics, breast base diameter and skin elasticity.  I recommend an in-office examination as well as a detailed discussion with a surgeon who you are comfortable with.   Finally, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS), a member of the American Society of Aesthetic Plastic Surgery (ASAPS), and a fellow of the American College of Surgeons (FACS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach TrainedDouble Board-Certified, Double Fellowship-Trained Beverly Hills Plastic Surgeon

Thank you for the question and photo. I would highly recommend that you switch your saline implants to silicone because they have less rippling, less capsular contracture and feel more natural and could last you a much longer time. Now the hardness that you are feeling is most likely capsular contracture and you would possibly need a lift to improve the feel and shape of your breasts. During the in office consultation you can feel and try the sample silicone sizers and compare them to the saline and choose the size that best suits you. Best of luck!Dr. Khuthaila 

Hello,With virtually 95% of all American women choosing silicone gel, its no wonder that it is superior to saline in every way. However, you will need more than just a great, new implant to help you; you need a breast lift too.  Go visit a few ABPS certified/ASAPS member surgeons who specialize in revision breast surgery. Best of luck!

It looks like you have a capsular contracture in the left breast which is making it harder and higher.  You'll need to remove the scar tissue and change the implants.  If you wish to lower your chance of getting another capsular contracture, textured silicone implants may be a good option.  Silicone implants have a nicer feel and they will look similar to the saline implants that you have.  I recommend seeing a plastic surgeon for consultation. 

 I think the changes you are seen have nothing to do with your implants being saline.  I agree that you appear to be higher on the one side and it sounds like a bit more firm and gravity has had an affair over the years. You may benefit from some capsule work and a breast lift. But the implant choice is really up to you. For some women it’s a physical choice (they have rippling, very thin tissue, exceptionally lean build…) While with other patients it’s more psychosocial (they don’t want to Deflate at a really inconvenient time like saline will....other women are still nervous about silicone and don’t want to do MRIs....  I don’t think you would have a problem going back to saline because you said it yourself… You have never had a problem with them. Because silicone is more expensive I try not to give a knee-jerk response and tell every woman she should go with silicone. Really there are pros and cons and is really up to you, but I think what you are seeing now has nothing to do with your type of implant!!

Dear mtd.0821,The pros of silicone implants are that they look and feel more natural and ripple less. 
The pros of saline implants are that they do not require as large of an incision as silicone, less expensive, they have less incidence of capsular contracture (scarring around the implant), one can tell immediately if there is a rupture, the size can be slightly adjusted. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. You will get the best recommendations after a thorough examination.Daniel Barrett, MD, MHA, MS 
Certified, American Board of Plastic Surgery  
Member, Am. Society of Plastic Surgery

Silicone is more natural looking and feeling. They don't ripple as much and they won't deflate when they rupture. They are a little more expensive but almost all of my patients get silicone. 

Yes ..after 16 years I would recommend switching to silicone gel implants.   If you are hard you might have an encapsulation.  The scar tissue will need to be removed and then I would remove and replace your implants with gel. Best to see a board certified plastic surgeon  to get the best results.   You should do very well.   Good luck!

Thank you for your question. The fact that one breast is firmer than the other, and now higher, may indicate that you have what's called capsular contracture on that side - it's something that your Plastic Surgeon can evaluate. If you do have this, it is something that can be handled surgically, and at the time of your exchange.Silicone vs. Saline is a very personal choice - you seem to have enough breast tissue that the implant feeling natural may be relatively moot for you. You are correct in stating that it is easier (usually) to diagnose a saline rupture than a silicone rupture. Also, the FDA recommends that you should have an MRI every 2 or 3 years if you have silicone implants. There are a number of other differences too; your best bet is to have an in person consultation with an American Board-certified Plastic Surgeon to review all of your options. Best of luck!