Change Implant Type

The vast majority of breast implants placed today are silicone. They are simply the best in terms of feel, comfort, and naturalness—hands down. Patients who currently have the saline variety are switching over to silicone implants in large numbers. Patients considering a breast revision can use the time for an or implant switch out as well.

In my practice, other than patients changing out their saline implants for the silicone variety, the next biggest category of patients are those changing out their lower-profile implants for the high-profile variety. High-profile breast implants look perkier in most patients—they are ideal for those patients with wide, matronly breasts.

The newest “form stable,” or highly cohesive, implants were approved by the FDA in 2013. I predicted a rush for these implants, but this has not been the case. It seems that they are a bit firmer than most patients prefer, and the problem with implant rotation (in the shaped implants) is a distinct possibility. The jury is still out, and the role that these implants will play in breast enhancement isn’t clear.

Do I have to change my implant pocket if I switch out my implants?

Not necessarily. There are many patients with subglandular breast implants that feel they would have a better result if the new ones were placed under the muscle. If you are having some problems with your implants like rippling or palpability issues, it may be best to move subglandular implants below the muscle, where they perform better.

Is switching out implants as uncomfortable as the first breast augmentation?

If the pocket stays the same, the procedure is relatively straightforward and only minimally uncomfortable. Typically, it’s the expansion of the submuscular pocket that is most uncomfortable. There is less discomfort with breast surgery when the implant is placed above the muscle than below the muscle.

Can I switch out my breast implants and have a lift at the same time? 

This is not typically a problem, but it is more complex than a simple breast augmentation alone, so make sure your surgeon is up to the task.

If I want to reduce the size of my breast implants, do I also need a pocket adjustment or breast lift? 

That all depends on several factors, like the location of your implants, the quality of your breast tissue, and the final size of your implants. If your breast implants move off to the side of your chest when you lie down, you probably need to have the pocket adjusted internally.

I saw several different plastic surgeons about implant exchange and got different opinions, and I’m confused now about what option is best for me. 

This is not uncommon. I have found it quite interesting how different plastic surgeons can be. Go to someone who is highly recommended and regarded and make sure that you can see their work on their website. The proof is in the pudding. Experience matters big time.

Why are textured implants used so infrequently in the USA yet widely used overseas? 

This is a good question that I don’t know the answer to. The fact remains that textured breast implants are generally not the first choice of most experienced surgeons. The proposed benefits of breast implant texturing have simply not been realized in real-world use.

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