Implant Exchange-Saline to Gel in Raleigh, North Carolina*

After the moratorium on silicone gel breast implants in 1992, saline breast implants became much more popular owing to the limited availability of silicone gel implants. Many plastic surgeons had adopted saline devices as the preferred choice of implant during this timeframe. Silicone gel implants became widely available again in 2006 and the manufacturers have made significant improvements in their design and durability. Patients with existing saline implants often notice changes in their breasts and wonder if the saline implants need to be changed. If the implants are intact ( not leaking) and there is no capsular contracture , there should be no compelling reason to arbitrarily remove them or replace them. Over time however, as the breast changes and the implants remain in position, the appearance of the breasts can change and despite an intact implant -women desire a more natural appearance. Saline devices also did not have as natural a feel. This patient had saline implants for over 20 years and although she was pleased with them-she noted more palpability and a somewhat flattened appearance. She had an exchange from a 375 cc submuscular saline device to a Sientra 470 ccc High profile gel implant. She was very pleased with the improvements with a more natural result. Exchange can be a very simple procedure but can also require manipulation of the capsule, whether it be capsulotomy, capsulectomy or even capsulorrhaphy- which is tightening of the pocket.