Replacing Silicone Implants to Saline Implants Help to Reduce/minimize Capsular Contracture?

I’m Asian, small frame, & don’t have much breast tissue. I had breast implants over 2 yrs - silicone gel under the muscle. They look nice but don’t feel soft at all & the left breast harder than the right breast. My doctor said I have a capsular contracture on both sides & suggested to replace the silicone to saline with 50% chance of not having capsular contracture after changing to saline. If I replaced the silicone with saline, would my breast get softer or could the capsular contracture be worse?

Doctor Answers 5

Replacing Silicone Implants to Saline Implants Help to Reduce/minimize Capsular Contracture?

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Our understanding of capsular contracture is imperfect and the treatment suggestions can vary. Saline is still said to decrease the chances when compared to silicone, but it is not clear to some of us at least if that applies to submuscular positioned implants. 

I would suggest that you discuss with your surgeon the possibility of using an acellular dermal matrix, such as Strattice, as part of the solution. Some of its advocates claim a dramatically lower rate of recurrence of contracture when compared with other treatments.

Thanks, and best wishes.

Seattle Plastic Surgeon

Capsular contracture is unpredictable

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Switching to saline implants, smooth or textured, when the implants are under the muscle may or may not help prevent capsular contracture.  Unfortunately, there is not a predictable answer to your problem.  I wish there was.  But, capsular contracture can occur and it is a risk in all women who have breast implants.  Once it happens, surgery can correct the problem but it can come back even if everything is done absolutely correctly and in the best of hands.  I really wish we, as plastic surgeons, had better answers to this problem but this is one problem that has proven to be quite difficult to address predictably.  

Richard H. Lee, MD
Newport Beach Plastic Surgeon
5.0 out of 5 stars 28 reviews

Predicting capsular contracture with breast implants

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Nobody can predict if you will get a recurrence or not, and if you do, will it be worse than what you have now.  You might want to consider textured implants as well, since the textured implant will decrease chance of cc, though not significant when under the muscle.

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Capsular contracture

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Unfortunately there is not guarantee that anything you do will be helpful in that there are various side effects and complications that are compounded by the fact that you have very little breast tissue. All breast implants and procedures have imperfections that are minimized to some degree by the implant being covered by natural breast tissue. For example, while saline implants have an overall lower incidence of grade 3 and 4 capsular contracture, there generally feel more firm than silicone implants when in their natural state. In addition, saline implants will generally show more of the intrinsic rippling especially when there is minimal soft tissue coverage and if they are textured rather than smooth.

I would suggest going over all the potential advantages and disadvantages with the various options on revision but focus on what imperfections you are willing to tolerate.

Robin T.W. Yuan, M..D.

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

Capsular Contracture

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 Breast Augmentation capsular contracture is indeed a very difficult issue to correct. Many surgeons will first consider changing out the implant from a smooth to a textured product. This may be what your surgeon is suggesting in exchanging out your silicone implants for a textured saline implant. If this should fail then, many surgeons will suggest the use of a very expensive product called artificial dermis to prevent the capsular contracture. Cost for this product can increase the cost of breast augmentation by approximately 4 to 6 thousand dollars. Good luck with your procedure. Best,


Gary R Culbertson, MD, FACS

Gary R. Culbertson, MD
Columbia Plastic Surgeon

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.