Revision surgery for saline bag implant rupture

There are cases of saline bag implant collapsing and leading to revision surgeries.
When the cohesive gel implant collapses, the volume is not completely lost. You might or might not feel that the shape of your breast changed a little. But if the saline bag implant collapses, you will be able to know right away as the volume shrinks a lot.



Usually the saline bag type does not tear off and leak. There would be a very small hole when the water leaks making the size shrink.

When we use the saline bag type implant in the breast augmentation surgery, we try to makin the incision spot very small therefore we fold up the implant, put it into the pocket, and then fill up the implant with the hose. Many think that the connecting part between the hose and the implant is where there is a leakage (Refer to image above)

We do not know exactly why the saline bag type collapses or gets damaged at all times.
I think that if there is not enough water at the time when you fill up the implant, then there is a high possibility of rupture.

Whatever the type of the implant it is, whether it is saline bag type or cohesive gel type, if the implant is folded and put into the body, there will be a lot of friction on the implant and this causes damage and leakage. This happens often if the saline bag type implant is not filled up properly.


The MRI shows wrinkled surface of the silicone gel type implant that is not filled up properly. ( Hammond, Aesthetic Breast Surgery, 2009, Saunders, Elsevier)


If this happens, there is a high possibility of capsular contracture.
So if there is a collapse or you need a revision surgery, one would have to cover up the initial pocket, find a new one for the new implant. If the first surgery was done below the pectoralis muscle, the revision would be donve above the pectoralis muscle, vice versa.

A completely new environment for the new implant would help avoid the development of capsular contracture!!





If a patient had ‘very bad shrinking’ experience of the saline bag type implant, then she would not want to use the saline bag type again.
Usually, she would want to use silicone gel filled implant. Both round and anatomical type would be possible to use. (Revision can be done by the the anatomical implant)

Saline bag type implant can be used in the first and revision surgery. This is not a bad thing. But this would be similar to getting non-incision method for double eyelid that results in the eyelid resulting in becoming loose. Then, you might want to get double eyelid surgery with incision to avoid this.



The reason why many people choose cohesive gel implant over the saline bag type is because of the sense of touch. You can know just by touching, how close a silicone gel can replicate a huamn skin. Everyone can know that cohesive gel is close to the skin and is not comparable.
Cohesive gel is a must in the revision surgery.

Is there a high possibility of complications such as capsular contracture when changing from saline bag type to the cohesive gel type? There is no accurate answer to this question. There is no accurate data. I think that if the doctor does the surgery accurately then there would not be any differences from the first surgery.
Whatever implant is use, the most important factor is how the doctor conducts the surgery.

The core choices that you need to make is that the pocket plane of the implant needs to be changed and the incision should be done on the inframammary fold. This would lead to harmless revision surgery.

Most patients who come in for breast augmentation focus on the size, implant type, and the incision part. They are not aware of the ‘plane’. The depth of the plane is most important factor in the breast agumentation surgery.

Today’s content was on the saline bag type implant users who used the implant before the cohesive gel implant was approved in 2007 and needed a revision surgery. If you have any questions, please leave them on the homepage or send me notes. I will get back to you.

Thanks a lot.