There are a variety of reasons for breast implant exchange:

• Changing tastes — After her initial implants, years have passed and the patient may want to increase or decrease her implant size.
• New options — Implants continue to evolve. Today’s silicone implants have a much more cohesive gel. Plus, the outer shells are more reliable. Options such as the INSPIRA ® Round Gel implant increase fullness by 75 percent.
• Leakage — Implants can rupture. While reliability is increasing, this can be particularly true with older implants.
• Different shape — The patient may want to place the implant beneath the pectoral muscle instead of atop it. She may opt to change the projection. She may change from round implants to teardrop-shaped implants.
• Capsular contracture — When an implant is placed in its breast pocket, scar tissue forms. This is normal. But sometimes, excessive scar tissue can form and tighten around the implant causing it to become hard, deformed, and painful.
• Asymmetry — Issues with asymmetry could have become exacerbated with time.
• Wrinkling/rippling — In some cases there isn’t enough breast tissue to fully cover the implant and rippling can be seen on the surface. This is more often the case with saline implants.
• Type — The patient may opt to replace older saline implants with new silicone implants that are thought to feel much more like natural breast tissue. Or she may opt for gummy bear implants.

Breast implants have been thoroughly researched by the FDA and other institutions and they have not found a connection between implants and health issues. Still, earlier implants are more prone to leakage than today’s models. Also, the silicone gel used in older implants was much thinner than today’s more cohesive gels, which are more akin to the consistency of gelatin. So, while there aren’t any “bad” implants, exchanging your implants for new implants or a different type of implant can be a good idea.

The vast majority of patients opt to have their implants exchanged for new implants. They may change the size, projection, type, or even change the position. Rarely do women opt to completely remove their implants. However, if this is your choice, it can also be done, but the procedure will usually also require a breast lift to remove stretched skin and breast tissue that will sag if not lifted. The breasts will be much smaller after implant removal, even with a breast lift.

Dr. Saltz often can use your original incisions for implant removal and replacement. If you opt for larger implants, he simply enlarges the breast pocket holding the implant. If there has been capsular contracture, he will remove the hardened capsule (scar tissue) along with the implant before placing the new implants. Where there has been rippling, changing the implant type may solve the problem, or placing the implants in a different breast pocket with more muscle coverage may be needed.

If you opt to move the implant placement from atop the pectoral muscle to beneath the muscle, this is a somewhat more involved procedure.

Recovery from this surgery is not difficult; it is normally easier than the initial augmentation surgery. Most women can return to work in just two to three days, and swelling and bruising resolve quickly. However, if Dr. Saltz performs a breast lift along with your implant exchange, your recovery will be more in line with that of a breast lift procedure.

This surgery is not complicated and is usually performed without any major problems. Of course, all surgical procedures have some risk of problems such as infection, bleeding, reaction to anesthesia, changes in sensation and such. Dr. Saltz will discuss these possible risks with you during your consultation.