Silicone does not slosh like saline sometimes does. But saline is used today in two primary situations: concerns about cost (they are about half the cost of silicone) and because some patients are fearful of silicone and do not want to do post-op follow-up for silicone leakage. However, no scientific data supports this fear, but emotional responses are valid, and no woman should even consider putting any kind of implant into her body if she has fears about them.
With enough data to finally demonstrate the safety of silicone implants, in the fall of 2006 silicone implants once again became available. Since that time, a large number of women with saline implants have returned to Dr. Teitelbaum to have their implants replaced with silicone. Sometimes this is because the saline implant broke and deflated, thereby requiring a revision. Such patients will sometimes just replace the deflated side with another saline, some will replace both sides with saline, and some will replace both sides with silicone.
There are also patients who do not have broken saline implants who choose to change their implants to silicone for some combination of the following reasons: rippling, firmness, roundness, upper bulge, overall feel, sloshing, fear of a deflation at an inconvenient time that requires an unplanned revision, concern about the age of the implant, or wanting to change size. Weighing the benefits of improving these issues versus risk and cost vary with each patient, and Dr. Teitelbaum has had these discussions with hundreds of patients and can help you decide whether changing your saline implants out for silicone implants is something you want to do.
In general, if you are happy with everything about your breasts, Dr. Teitelbaum will discourage you from replacing your saline breast implants with silicone breast implants; he believes there should be another reason. Together, you and Dr. Teitelbaum can create a plan that best suits your needs and concerns.