Deflated Implant exchanged in Raleigh*

This 45 year old woman had prior subglandular saline breast implants placed over 14 years ago. She noted a sudden deflation and came in for exchange. She wanted to stay in the subglandular plane but wanted a more natural feel . She had easily palpable breast implants with her saline devices. She chose gel devices. She had exchange from 390 cc saline implants to 500 cc silicone gel implants and was very pleased. Exchange of a deflated breast implant is not as simple as it seems. Many factors have to be taken into consideration including pocket location, implant type, capsule formation and desired size. Almost inevitably-maintaining the same cup size requires a somewhat larger implant to fit the now stretched out pocket. Downsizing may requiring pocket modification and even mastopexy. Exchanging silicone gel for saline will help with palpability but will not eliminate it entirely. Capsule will often have to be removed or modified and in cases of contracture or thin breast tissue- change to a submuscular pocket may be recommended.