For a woman who has undergone breast augmentation surgery or even a breast lift with an enlargement, it is not necessarily one and done with regard to the implants. That is, there is a substantial likelihood that those aren’t the last pair of implants that she is going to have in her lifetime.

Why?

First of all, breast implants are not permanent medical devices and will not last forever if given long enough. At some point in time, they will either need to be replaced (implant exchange) or removed due to rupture or loss of integrity. It has been my experience that most women, even those in their 70’s, elect to have new implants put back in again rather than have them removed permanently. They just don’t want to be walking around without “breasts”.

This is not the only reason for changing out breast implants, a type of breast revision surgery. Some of the other reasons that women choose or need to obtain new implants include:

1) a desire to change their breast size – usually going bigger; rarely do they elect to go smaller
2) switching their type of implant from saline to silicone; the reverse, going from silicone to saline is extremely rare
3) a desire to alter the shape and projection of their breasts such as going to a higher profile implant to obtain more projection
4) to replace very old implants with newer but similar ones
5) to treat hardness or irregularities that have developed around the implants such as significant capsular contracture
6) development of infection (exceedingly rare)

This breast revision surgery is typically associated with minimal initial postoperative discomfort and is a far easier and more pleasant experience than the initial breast augmentation or breast lift with implants. I have found this to be almost universally true in my practice over more than 25 years.

The following patient of mine exemplifies a few of the reasons why women electively decide to pursue breast implant exchange surgery. At age 18 she underwent a breast augmentation that involved the submuscular placement of smooth surfaced moderate profile saline breast implants with 240cc on the left and 265cc on the right (Fig A, C and E). This gave her the shape and “C” cup that she had wanted so that she was very happy with the results.

A) Breast augmentation with saline implants – prior to implant exchange

B) After breast implant exchange, going from saline to silicone

C) Before implant exchange – side view

D) After implant exchange – oblique view

E) Before implant exchange – side view

F) After implant exchange – side view

After several years and experiencing no problems whatsoever, she decided that she wanted her breasts to be even larger and to also switch to the much more natural feeling silicone breast implants. For her breast revision, she had placement of smooth surfaced ultra high profile silicone breast implants with 360cc on the left and 400cc on the right (Fig B, D and F). There was virtually no discomfort following surgery and she went back to work within a few days. The results were just what she had desired and she was extremely happy.

For more information regarding breast revision surgery, breast augmentation or on any other plastic surgery procedure that I perform, please contact my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

For any breast procedure requiring the placement of breast implants, my patients are offered the option of using either silicone or saline implants. This would include women who are considering breast augmentation, breast lift with implants, breast implant exchange and breast reconstruction. I thoroughly discuss with them all the important and relevant information about these two types of implants such as appearance, feel, durability, aesthetics, rupture, risks and possible areas of concern. They also are able to touch and closely examine both the silicone and saline implants.

What have I found is the overwhelming majority of my patients select the silicone implants for both cosmetic and reconstructive procedures and they definitely don’t regret the choice. The aesthetic results and much higher level of satisfaction irrefutably support the substantially greater superiority of silicone implants as compared to the saline ones. This is true for both cosmetic and reconstructive procedures. In my practice it is quite rare now for a woman to opt for saline implants and when they do it is virtually always because they cost $1,000 less a pair which then makes the cosmetic surgery affordable.

This finding is consistent with the medical literature including research just published in the November issue of “Cancer”. This multicenter study examined and analyzed the responses obtained from 672 women who had post-mastectomy (for breast cancer) breast reconstruction utilizing either silicone or saline implants. The results revealed a statistically significant greater level of satisfaction in women who chose the silicone breast implants for their reconstruction as opposed to the saline ones.

So, if you are interesting in pursuing either a cosmetic or reconstructive breast procedure that involves the usage of breast implants and were initially leaning toward saline implants you may want to strongly reconsider.

For additional information on silicone or saline breast implants, breast augmentation, breast reconstruction or for any other plastic surgery procedure that I perform or to schedule a consultation, please call my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona

Replacing of a woman’s own implants for newer ones is referred to as breast implant exchange surgery which also is a category of breast revision surgery. The implants could have been originally placed for a breast augmentation, during a breast lift or in breast reconstruction.

There are several reasons why a woman would select this course of action with some of the most common ones being to:

1. change the size of the implant
2. alter the shape with regard to projection and width
3. change from saline to silicone implants or vice versa
4. replace an implant which has ruptured
5. change the implants as an incidental part of another breast issue such as drooping or capsular contracture

Usually the number one reason for a breast implant exchange is to obtain larger implants in order to have breasts that are significantly larger. Very uncommonly does a patient request going to a smaller size. In most of these situations, it is either because they were made excessively large initially by their surgeon or they gained a considerable amount of weight in the intervening period of time resulting in concomitant natural breast enlargement.

It is quite rare for my personal patients to desire different implant sizes and when they do, it is usually years later and often precipitated by another event such as an implant rupture. How is it that my implant exchange rate is very low? During my patient’s consultation, I listen carefully to their desires and concerns, take measurements, have them “try on” different implants as well as show them photographs of other patients that may be relevant for their situation. Finally, during surgery I will first use temporary “sizers” so as to precisely determine the perfect implant for them.

The relative proportions (profile) of the implant which affect the ultimate breast configuration, are also important. By explaining and offering different profile implants such moderate, high and super-high, my patients can realize the customized appearance they desire. For example, a patient who has a very narrow chest and wants a lot of projection but without excessive width, would benefit from a higher profile implant. A woman who is relatively broad, has a moderate amount of breast tissue and doesn’t want to be extremely large, would be better off with a moderate profile implant.

Finally, most of the patients that I see who have saline implants and are undergoing an exchange for whatever reason, switch to silicone implants. The reason is fairly obvious – they look and feel far more natural. Only in rare circumstances do they go from silicone to saline and it is never for aesthetic reasons.

For more information on breast implants, breast enlargement or any other plastic surgery procedure that I perform or to schedule a complimentary consultation, please contact my office at 480-451-3000.

Steven H. Turkeltaub, M.D. P.C.
Scottsdale and Phoenix, Arizona