The surgery will be more complicated than the original placement, as scar tissue forms after most surgical procedures. If you choose smaller implants, the area surrounding the new implant will need to be tightened, and skin may need to be lifted. An increase in breast size will require the surgical creation of a larger pocket to accommodate the bigger implant. You may also choose to try a different type of implant. Some women decide that saline implants feel less natural than they expected, and opt for surgery to swap saline for a silicone gel variety. Other women may have health or safety concerns about silicone gel implants, and choose saline for their breast revision procedure.