Many patients ask me if they should change their breast implants. There are some definite reasons to do it, and then there are some more subtle reasons to change them.

Most patients who have older implants probably have saline implants. Silicone gel implants have been FDA approved for cosmetic use since November, 2006. Most patients who are interested in changing implants want to switch from saline to silicone implants. The main reason is because the of more natural feel of a silicone breast implant compared to a saline breast implant.

A breast implant exchange can also correct the following problems of capsular contracture, rippling or wrinkling of the implant, and malposition of the breast implant

The plastic surgery term for this surgery is a breast implant exchange. In the operating room, the plastic surgeon goes through the old breast augmentation incision, and then removes the old implants. Then, the plastic surgeon places new implants into the pocket. While you are in the operating room, the plastic surgeon can several different maneuvers, including

– make the pocket bigger to accomodate a bigger breast implant

– make the pocket smaller to accomodate a smaller breast implant

– make the pocket more lateral, so that your breast implants no longer touch in the middle

– make the pocket more medial, so that your breast implants are closer together, generating more cleavage

– make the pocket higher or lower, so that your breast implants are more even in terms of vertical position or height. If your breast implants are too low, this is called bottoming out, and placing the pocket higher or revising the pocket can improve the position of your breast implant.

– perform a capsulectomy, which removes the old scar tissue around the implant, and potentially eliminate any hardening of your breast implant

– create a new pocket for your new implant, so that you have more tissue that can cover your new breast implant. This will help to reduce or eliminate rippling or wrinkling, which occurs when you can feel or see the edges of your implant. The optimal situation is converting old saline implants placed above the muscle to new silicone gel implants placed under the muscle. Aesthetically, this should siginificantly reduce rippling and wrinkling.

– if your old breast implant is defective, then a new implant can replace the older one.

Generally, insurance will not cover an exchange of implants. If your implants are defective, and your implants are under warranty, then your breast implant company may cover some of the cost of surgery as well as free new implants.

If you’d like more information about breast implant exchange or schedule a consultation, please contact Caroline at or 415 362 1846.


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