Implant Exchange -Silicone gel for Saline. Improves Palpability*

This 51 year old woman had undergone sub muscular saline breast augmentation about 17 years prior to evaluation. She was generally pleased with her result. Over the years, with aging, she noted more palpability of the implants. She sought help to determine if her implants might be leaking and if anything could be done to improve the feel of her implants. She did not want to change much else. She was noted to have intact implants with very little contracture. Generally, saline implants are more palpable than gel devices- especially in thin patients and are usually placed under the muscle. Since they were not deflated- there was no indication to remove them. However, the patient did want improvement in the unnatural feel of her breasts. She chose to have an exchange to gel devices. At surgery, she was found to have intact McGhan ( now Allergan) 330 cc saline devices, filled to 350 cc. Minimal capsule ( scar) had formed around the implants. During the exchange, a small amount of release of the capsule was performed to improve cleavage and expand the lower pole of the breast. She had Allergan smooth walled SRM 385 cc devices placed. She was very pleased with the improved shape and more natural feel of her implants. Gel devices have a more natural consistency than saline devices. Risks and benefits of each implant have to be discussed preoperatively. Gel devices do not deflate when they rupture so imaging is recommended for monitoring while saline devices do not need imaging.