Implant Exchange, Saline To Gel, Raleigh, NC*

This 54-year-old woman had prior submuscular saline breast implants placed 20 years before she came in for evaluation for implant exchange. She wanted to have more fullness and a more natural feeling breast. She did not like the"fake" feel of the saline devices. She was noted to have some breast ptosis or drooping but did not want to have a breast lift. She underwent exchange of her 250 cc saline implants to 400 cc Smooth-walled silicone gel implants. Some degree of capsular manipulation and release was necessary to allow the implant to be positioned properly and elevate the nipple appearance without lifting. The patient was very pleased with her larger natural feeling breasts and went up a full cup size. Silicone gel breast implants were taken off the market in 1992. During this time, breast augmentation patient's could only receive saline implants in the US. During this period most plastic surgeons switched to submuscular positioning to reduce palpability and visibility of the saline implant.In November 2006, the FDA allowed the reintroduction of silicone gel implants back on the market. Many women who had received saline implants desired exchange to the more natural feeling gel implant. Implant exchange can be a relatively simple procedure but a degree of expertise in choosing implant size and proper performance of pocket manipulation is necessary to achieve good results.