Conversion Of Saline to Silicone Implants
FACTORS TO CONSIDER
Many patients who have had saline implants placed over the last 10 to 15 years are now presenting for replacement of their implants with silicone gel. Several factors should be discussed with the patient upon this conversion to a completely different product.
1. Silicone implants in general, at least in my opinion, appear smaller in the body than saline implants. Saline implants have a similar affect to a water balloon, especially as they become narrower with more projection as in high profile implants and show more projection than silicone gel implants of the same size when placed behind the muscle. As a result, patients who desire to have the same projection or volume in size should consider going with a larger silicone gel implant in order to compensate for this specific factor. For example, patients who may present with a ruptured 390 cc smooth moderate profile saline placed 10 years ago may desire to have a larger 475 cc high profile silicone gel implant in order to regain fullness, but have a similar width. High profile implants are narrower than their counterpart moderate profiles and thereby compensation in order to regain diameter should be examined by the plastic surgeon on the Mentor or Allergan chart, looking at base diameter specifically.
2. Projection. Silicone implants in general do not project as well as saline implants and this is generally the case in patients who are used to having more fullness with their salt water implants that convert to silicone. These patients may not be satisfied with their silicone gel replacement and fullness and therefore once again high profile or at least moderate plus silicone gel implants should be used rather than the moderate profile style 10 gel and also increase in the volume of the bag should compensate for this reduction of AP projection associated with silicone gel.
3. There are new style 45 extra high profile gels presenting to the market in 2011. These will be useful for patients who desire a little less natural, but more upper pole fullness or possibly those who are having severe rippling and visibility with their saline implants, the rounder implants just by the law of physics, the less visibility and rippling an implant will have. The extra style 45 high profile Allergan gels may great reduce rippling and visibility in these patients who are quite thin, ectomorphic build, who have minimal breast tissue or those who ripple severely with moderate profile saline or textured implants; however, these patients may have a little less unnatural upper pole fullness and more of a rounded upper ledge.