Having had over 10 years experience with the use of saline filled breast implants, we remain convinced that the results are as satisfying as with the older gel filled implants. The added safety is reassuring to patients who have the operation. They are comforted by the knowledge that if the implant should leak, the body will rapidly absorbed the salt water with minimal risk.
Although leakage is relatively infrequent, it is an ongoing problem that can occur at any stage following surgery. If leakage occurs, replacement is generally quite simple with low risk and little discomfort. Patients normally can return to normal activity within a day or so of the replacement procedure.
It is very important for patients to report any signs of leakage as soon as possible. If the implant begins to deflate, the scar tissue surrounding the implant will quickly begin to shrink. If this is allowed to occur, when the implant is finally replaced the pocket will be overly tight resulting in an unnatural firmness. If this happens, further corrective surgery may well be required and can result in the need for additional later operations after replacement.
While most patients do report leakage promptly, we recently had a patient who waited over a year before she chose to have the implants replaced. Unfortunately, by this time there was so much contracture of the capsule that there was barely room for the replacement implant. We have also had occasion to see several patients who failed to report evidence of leakage in a timely manner either because they were uncertain as to whether the implant was leaking or because they were reluctant to consider the need for replacement surgery. The net result was the same. These patients required additional work at the time of replacement increasing their risk and recovery time.
The lesson is clear. Patients with saline implants should immediately report any concerns of possible leakage to their surgeon. If the implant is leaking, prompt replacement is indicated. If this is carried out in a timely manner, the replacement surgery should be relatively simple and uncomplicated.