Implant Exchange Not Always So Simple, Raleigh, NC*

Breast augmentation can often be a very straightforward procedure, however the procedure is associated with a relatively high revision rate. Many women shoes to have implant exchange after initially being very pleased with their surgical outcome. From 1990 to 2006, patients in the United States could only receive saline implants for straightforward primary breast augmentation. Silicone gel implants became widely available after November 17, 2006. When in with saline implants who are hoping for a more natural feel, opted to change implants to silicone gel. This 35-year-old woman had previous submuscular saline implants placed and desired a more natural feel. Her existing implants were somewhat palpable. She was hopeful to have a similar size with slightly more fullness. She underwent exchange for 375 cc moderate plus saline devices to 535 cc full profile Sientra gel prostheses. Implant exchange is not as simple as it seems. Although it can frequently be a relatively easy procedure with minimal manipulation, oftentimes, capsular modification as necessary and the choice of implant is decided upon based on dimensions and pocket volume. Site change from prepectoral to subpectoral or vice versa a be necessary if the patient has had prior encapsulation. Downsizing is actually more difficult as it almost always require some degree of pocket manipulation to accommodate a smaller device. Generally, larger implants are used to fill the loose pocket .