Should I Exchange My Breast Implants?

In light of the news that some implants may cause a higher risk for ALCL, we have seen an increase in breast implant exchange procedure requests. The other reasons that Denver area breast augmentation patients consider exchanging their breast implants vary widely.  Some of the more common reasons patients consider a breast implant exchange include:

#1: Patients want to switch from a saline breast implant to a silicone gel breast implant

Silicone gel breast implants are the standard of care today and are now the most commonly used type of breast implant. In contrast to saline breast implants, silicone gel breast implants generally have a lower risk of rippling and contour irregularities, especially if the patient is thin and has less natural breast tissue coverage. Silicone gel breast implants are often softer and feel more natural than a saline breast implant. This is especially true if a saline breast implant is overfilled at the time of the original breast augmentation surgery.

This 28-year-old disliked the unnatural feel and shape of her saline breast implants. She also wanted more superior breast volume. Although her original breast augmentation surgery was performed elsewhere, she chose Broadway Plastic Surgery as the practice to have her 550 cc round saline implants exchanged for 565 cc Sientra textured round silicone gel implants. 

#2: Patients want to change the size of their breast implants to either a larger or smaller size

We do see Denver area patients who want to exchange their breast implants for larger, as well as patients who want smaller breast implants. The desire to change breast implant sizes often occurs after nursing or a weight gain or weight loss. Occasionally, the patient feels that a larger breast implant is no longer age appropriate. 

This 28-year-old patient disliked the size of her implants. She felt they were disproportionately large, and she noted asymmetry of the breast superior fullness. Her 550 cc silicone gel implants were replaced with 385 cc moderate plus smooth round Sientra silicone gel implants. The implant pockets were surgically modified to improve symmetry and positioning of the new smaller breast implants. Her original surgery was performed elsewhere but her implant replacement surgery was performed by Dr. Broadway at Broadway Plastic Surgery. 

#3: A patient may have damaged or ruptured their implant

Both saline breast implants and silicone gel breast implants have a lifetime guarantee from the manufacturer.  Depending upon the manufacturer, if a saline breast implant or a silicone gel breast implant fails within a 10 or 20-year timeframe, patients can be reimbursed for breast implant replacement surgery costs. Despite the guarantee, neither a silicone gel breast implant, nor a saline breast implant should be considered a lifetime device. Both saline breast implants and silicone gel breast implants can rupture, and every patient should be aware of that possibility. 

When a saline breast implant fails or ruptures, it usually deflates rapidly, and the patient will suddenly notice a dramatic change in breast volume.  Occasionally, the saline breast implant will leak slowly over an extended period of time. In this case, the patient may notice a slow change in breast size and subtle increase in rippling and wrinkling of her saline breast implant.

A silicone gel breast implant can also rupture, but it is more difficult to diagnose. Often a silicone gel breast implant rupture is diagnosed during a mammogram, ultrasound, or a MRI study as the physical exam is less reliable. A silicone gel breast implant rupture may be discovered as a hardening of the implant or as a displacement of the implant position. 

This 40-year old patient experienced a saline breast implant deflation with loss of right breast volume. The ruptured saline breast implant shell created a protruding fold that was visible and mildly uncomfortable. She elected to replace her saline breast implants with a textured 285 cc Sientra high-profile silicone gel breast implant. Only her replacement breast implant surgery was performed by Dr. Broadway at Broadway Plastic Surgery. 

#4: A patient’s breast implant might have developed a capsular contracture

A breast implant capsule is the tissue that naturally forms around the breast implant formed by the body in response to the presence of the breast implant. When the breast implant capsule becomes thickened and firm, the breast implant can feel hard and may also become distorted in shape.  Pain can result when a significant breast implant capsular contracture has occurred. 
Breast implant capsular contracture is one of the more common complications following breast implant surgery. A common cause of this condition is a bacterial biofilm on the surface of the implant. A ruptured breast implant can also cause the formation of a breast implant capsular contracture.

This 49-year-old patient disliked the asymmetry, size, and shape of her breast implants. She also felt that the breast implants were very hard.  Her breast implant capsule was removed (capsulectomy). Her partially deflated double lumen (saline surrounding gel) implants were replaced with Sientra 370 cc anatomically (tear drop) shaped textured silicone gel breast implants. Both of her new silicone gel breast implants were also repositioned to enhance her cleavage and superior breast fullness. Her original breast augmentation surgery was performed elsewhere. Her revision surgery was performed by Dr. Broadway at Broadway Plastic Surgery.

#5: A patient might have concerns about BIA-ALCL (Breast implant-associated anaplastic large cell lymphoma)

With the recent FDA recall of macro-textured implants, such as those manufactured by Allergan, many patients with this type of breast implant are concerned and might want to eliminate any risk by removing and or replacing their macro-textured breast implants. BIA-ALCL is not breast cancer. It is a form of non-Hodgkin’s lymphoma, found in in the breast implant capsule or fluid around the breast implant. Allergan textured breast implants have been removed from the market and are currently unavailable for breast augmentation. It is important to note that the risk for development of BIA-ALCL with an Allergan textured breast implant is currently estimated to be between 1/2500 and 1/3000. Due to these statistics, indicating a low risk for causing BIA-ALCL, the FDA is not currently recommending the removal of these breast implants. 

Because of a concern, many patients with Allergan textured breast implants elect to replace their breast implants with a smooth silicone gel breast implant or a textured breast implant from a different manufacturer.

This is 41-year-old with Allergan 425 cc macro-textured high-profile silicone gel breast implants. Because of her concerns about BIA-ALCL, she elected to exchange her breast implants for larger Sientra 470 cc smooth round implants. Her original surgery was performed elsewhere while her implant replacement surgery was performed by Dr. Broadway at Broadway Plastic Surgery. 

Are you interested in breast augmentation surgery or do you have any concerns about your breast implants? Contact our office to discuss your options. If you are from the Denver area, we encourage you to schedule an in-office consult. We also have many patients that live internationally as well as just outside of Colorado. Especially for patients that would have to travel to Denver we can provide an online virtual consult. Online or live, we offer a consultation utilizing computer generated images that simulate the results of surgery. These images can often help you define breast surgery goals and expectations while helping you visualize the aesthetic improvements that breast surgery can offer. Schedule your consultation today!