Revision Surgery After 6 Years...Should I Replace One Implant or Both? (photo)

After 6 years, I want a revision of my right saline implant due asymmetry (its smaller than my left). One surgeon recommends replacing both implants, another surgeon recommends operating only on my right breast using the existing implant and adding 30ccs to even me out and give me a fuller, rounder look. My implants are currently filled 360cc on the left, and 345cc on the right. I want to be even but not go bigger. Should I have revision on one breast or replace both implants?

Doctor Answers 9

Replacing one versus both implants

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Hi there-

Clearly there is no answer that is absolutely right or wrong. Both options are open to you.

On the other hand, I would answer your question by posing another (go with me here...):

If you only had one replaced now and had the volume in the other adjusted as one surgeon is suggesting, then 1-2 years from now the one that was not replaced ruptures and you need ANOTHER operation (at additional expense), how will you feel about your decision?

Bottom line- if you were my sister, wife, or mother, I would tell you that if you are already planning to undergo surgery, you should have them both replaced and get a fresh start on both sides.

Having them both replaced will also maximally free your surgeon to achieve maximum symmetry.

Implant Options In Breast Revisional Surgery

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The decision to operate on one breast vs. both breasts for breast implant revision is largely an economic one in your case. The least invasive method, and the one with less cost, is to simply add volume to the smaller implant only. How long these existing saline breast implants will last after this type of revision is unknown. Exchanging both implants for new saline vs silicone implants is a consideration given that you are considering revisional surgery. This will buy greater longevity with new implants as well as help improve your asymmetry. This will obviously cost more but you get a new time period of implant security. Neither approach is wrong and both will provide benefit. You need to look and consider these device longevity considerations. 

Breast Implant Asymmetry

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Hello Oakland 1669,

Enless the photographs you posted are tricking me, I think that you'll need more than 30cc to make your breast size symmetrical.  Although you did not post what your implant size is, I can assume it is a 330, filled to 345 on the right and 360 on the left.  Even if 30cc more in the right would create symmetry in volume, your right implant would be over filled by 15 cc, or 15 cc more than the recommended volume.  Your right implant will now be firmer and more projecting than your left, and it will also be narrower than it is now.  Because of this, you should get a larger implant on the right, and not simply overfill it.

Whether or not you want to change the implant on the left is up to you.  Additionally, now is the time to start thinking about silicone gel implants as a possible alternative.

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 100 reviews

Replacing one implant....or two

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Both opinions are reasonable so you will have to make the ultimate decision. Personally, unless you are switching from saline to silicone, I would not waste the money and would replace only the implant on the right side. Every time you operate on the breast, there is a risk of infection or postoperative problems so, if the left side is doing fine, why look for trouble? On the other hand, if you are now considering silicone implants, which were not available at the time of your initial surgery, then it would be reasonable to replace both.

Unilateral revision of breast implant

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Based on your photos, the asymmetry appears quite minimal. I think you need to contemplate your ability to accept imperfections and asymmetries since it is nearly impossible to produce symmetrical breasts. A small volume increase may not show much in the overall size of the breast and might change other characteristic such as projection, width, or fullness. Often it is smarted to accept minor asymmetries than to "chase the imperfection."

Robin T.W.Yuan, M.D.

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

Revise one implant or both

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It is so simple to replace a saline breast implant that is it very resonable to replace both if you plan a revision. The leak rate is about 8% at ten years and starts to increase, so a replacement now is a small investment for the six year advantage. The current implant should not be reused or filled further, new is best.

Best of luck,

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Revision Surgery After 6 Years...Should I Replace One Implant or Both?

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If the left implant is doing well, I would consider just working on the right side. If the implant can tolerate more fill (you don't say what your implant sizes are, just their fill volume), then adding more saline to the right side may be the answer. If the right implant is smaller in size and you add excessive volume to it, it will become somewhat firmer as it is overfilled, and sometimes develops some edge "scalloping", which are wrinkles you feel around the edges of a saline implant that is overfilled.  In this case, depending on its size, implant replacement might be required. If the implants are the same size, and the left one is just filled more than the right one, then adding additional fill to right implant might be an option.

Breast revision

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Since the implants are 6 years old, it may be worthwhile to have both changed and fill them to the desired amount. At this point, you also may want silicone if you are eligible?

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

Revision Breast Surgery?

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Thank you for the question pictures.

Although I can see both surgeons'  logic behind the recommendations I would have suggested revisionary surgery only on the right breast if you are pleased ( and there have been no complications) with the left breast.

Keep in mind, that every time you enter the breast implant pocket you are exposing a breast implant to the environment and the potential  risks  of complications. For example,  operating on the left breast in your case would expose you to the risk of encapsulation etc. whereas the breast has been problem free up to this point.

I would suggest “if it ain't broke don't fix it”.

I hope this helps.


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.