Saline to Silicone Implant Exchange

I went from a natural A cup to C cup in Dec 2008(saline implants). I went from a C cup to a D cup in Dec 2009 because I wanted larger breasts(saline implants). I am now happy with the size, but because I don't have much breast tissue, the rippling and the unnatural feel of the implant is bothersome. The look of them is nice, but I want them to feel more natural. Can I do an implant exchange for the same size in silicone? If so, how long should I wait before I do?

Doctor Answers 10

Saline to Silicone

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You could make the switch any time.  If the implant pocket stays the same size and in the same plane (under or over the muscle), recovery is usually rapid.

Lisa Lynn Sowder, M.D.

Seattle Plastic Surgeon
5.0 out of 5 stars 77 reviews

Will exchanging my breast implants from saline to silicone give me a more natural feel to my breasts?

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Silicone implants have become extremely popular in the U.S. since they were re-introduced in 2006. In my current practice the vast majority of breast implants used in breast augmentations are silicone. This is for several reasons, first, of which is the natural feel and appearance that silicone implants can provide for patients. Silicone implants also tend to have less visible rippling than can be present with saline implants.

Many women who are very thin and go with larger implants may have rippling or a firm feel and looks to their breasts with saline implants. Many of my patients have switched from saline to silicone to have a more natural appearance or decrease their rippling. In general patients are extremely happy with silicone implants as they have a much softer and natural aesthetic result.

I typically have patients wait at least six months before changing out their implants as this will give time for the swelling resolve. This gives the breasts a chance to heal before going through another surgery.

Please discuss your breast implant exchange with your board certified plastic surgeon.

Saline to Silicone implant exchange

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A history lesson is needed before answering this question.  When implants were first utilized around 40 years ago, they were made out of a variety of substances, none of which worked well, until Silicone was utilized.  Two plastic surgeons in Houston, Texas, started using bags filled with a Silicone formulation, Dr's Cronin and Gerow.  I believe that one of their sons worked for NASA in Houston and mentioned to dad that the lubricant they were using for the engines of the rockets might work well in breast implants..  So, silicone was (and may still be) a jet engine lubricant.  The modern era of breast implants was born!

In 1992, silicone breast implants were pulled off the market by the FDA because of health issue concerns.  The implants were implicated in causing a variety of diseases including Lupus, arthritis, chronic fatigue syndrome and other auto-immune diseases. This led to extensive testing and trials of the silicone implants including a new formulation by the implant manufacturers.  All of the studies proved that the implants were safe and were released by the FDA in 2006.  The new implants were filled with silicone that was firm than previously.

In the 14 years that silicone was not available, saline implants were used exclusively.  Saline implants have been around for a long time, even when the old silicone implants were available.  The saline implants work fine, but there are disadvantages to using saline.  They are:

  • Do not feel as natural as silicone implants or native breast tissue
  • They tend to wrinkle or ripple, especially on the edges (scalloping)
  • Even a small leak or tear in the implant capsule will lead to a complete deflation

But, they do have some advantages over silicone:

  • Smaller incision than silicone, they are placed deflated and then filled with saline
  • Allows for remote incision access (belly button)
  • Less expensive than silicone (around $1,000)
  • Easier to adjust during the procedure to "fine tune" size discrepancy between the breasts
  • If they do break or rupture, the saline is absorbed by the body and is not harmful

One of the most common procedures I now perform is the exchange of older saline implants for the newer silicone implants.  The two main reasons are the wrinkling/rippling and the unnatural feel of the saline.  My exchange patients are some of the most happy patients in my practice.  Women who truly have disliked the saline, LOVE THE SILICONE IMPLANTS!

An exchange procedure is very straight forward and there is minimal down time.  All the pain and discomfort from the stretching and pulling from the original procedure, is not present for the exchange procedure.  Most women are back to work in 3 days.  Old incisions or scars can be used, you can even switch size if desired or just keep the same size.  If you have a ruptured saline implant, you may even be eligible for a free implant or a credit towards a silicone implant on BOTH SIDES from the manufacturer, including financial reimbursement!  If any of my patients have a saline implant rupture that I placed, we do not charge a professional fee for the replacement.

In answer to the question, you can undergo the procedure any time and you can basically choose any size implant you and your plastic surgeon decide on. 

Good Luck!

David Finkle, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 82 reviews

Breast Implant Change: Saline to SIlicone

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Breast implant exchange for size is the most common reason why women elect to undergo revision breast augmentation. It sounds like you have a thin breast envelope which will allow you to feel the implant and the normal capsule which forms around the implant. Changing from saline to silicone will help with the feel of the implant and you may want to increase the volume slightly to achieve the same visual size. The rippling is more caused by the capsule around the implant which if you are thin you will feel. This capsule can be removed or expanded, however they have a tendency to return. Other modalities for correction of rippling is the use of an acellular dermal matrix to interpose a layer between the breast implant and skin. Downside with this is cost.

I hope this helps.

Dr. Trussler

Andrew P. Trussler, MD
Austin Plastic Surgeon
4.9 out of 5 stars 52 reviews

Exchanging saline implants with silicone implants

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What you are describing is really common, and many women now want to have their saline implant removed and replaced with silicone implants-- the look and feel is far more natural in most cases, in particular if the implant is placed behind the muscle.  I would wait a couple of months before having the procedure, but in most cases this is a straight-forward procedure.

Shahram Salemy, MD, FACS
Seattle Plastic Surgeon
4.9 out of 5 stars 155 reviews

Changing Implants from Saline to Silicone

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Many women have decided to change their implants from saline to silicone to improve, the look, feel and behavior of their implants.  This is usually a very effective means to make improvements under local anesthesia and with little downtime. Waiting at least 4-6 months from the original procedure is usually sufficient. 
However, with each procedure there is additional scarring.  There is one thing that you need to consider and that is the fact that silicone implants appear smaller than an equal volume saline implant.  Thus, you usually need to up-size 1 to 2 sizes just to maintain the same volume.

Best of luck

Vincent Marin, MD, FACS

La Jolla Plastic Surgeon

Vincent P. Marin, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 52 reviews

Saline to Silicone

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I agree that your rippling and concerns about feel would be improved with silicone implants.  You did not state the location of your implants.  If they are above the muscle, you would likely see improvement also with moving the silicone implants below the muscle.  There is nothing to gain at this point with waiting.

John Whitt, MD (retired)
Louisville Plastic Surgeon

Saline to silicone implants

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You certainly can have silicone implants in an exchange provided that you are at least 22 years of age.  But, you still may get rippling.  If rippling is a problem alloderm may help camouflage it.

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

Silicone to saline

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At this point in time, it sounds reasonable to undergo a transition from saline to silicone. You may require a slightly larger silicone implant to achieve comparable results.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Can I exchange my saline implants to same size silicone.

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I believe that one can use a saline implant with good results if there is more breast tissue that implant. For example if you go from a B to a C cup. When there is more implant than breast tissue, saline will often cause the problems that you are describing. It is easy to exchange to the same size silicone implant. There is less chance of having rippling but you might still get it with gel implants. The large gel implants are more stable than large saline implants. Good luck.

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.