General anaesthetic or local anaesthetic with sedation.
Breast implant replacement is a type of breast implant revision surgery that involves removing breast implants and replacing them with a new set. This procedure may be done to correct complications and/or in combination with other procedures, including capsulectomy and mastopexy (otherwise known as a breast lift). Implants can also be replaced to change the size or shape of the breasts if your tastes or preferences change.
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General anaesthetic or local anaesthetic with sedation.
Anyone with breast implants may wish to have them replaced for a variety of different reasons:
Over time, some may find they no longer like the look of their breast implants and want to have them replaced. They may wish to change the appearance of their breasts by:
Complications are other reasons that may lead to breast implant replacement surgery. Common complications include:
Some may wish to have their breast implants replaced due to the PIP implant scandal. This scandal refers to the use of implants containing an unapproved silicone gel. Many who have had these implants may wish to have them replaced with a safer implant that has a lower risk of rupture or leakage.
Breast implant replacement surgery is often done in combination with capsulectomy and mastopexy (breast lift) to correct complications and/or revise the shape of the breast.
Capsule contracture is a potential complication of breast implant surgery that involves a fibrous scar tissue capsule forming and contracting around the breast implant. This can cause pain as well as distort the breast.
A capsulectomy is a surgical procedure to remove this fibrous scar tissue capsule that forms around a breast implant.
A mastopexy is also known as a breast uplift procedure. A mastopexy involves removing excess skin and raising the nipple so that the breasts appear lifted and more youthful.
A breast implant replacement procedure is carried out to replace an old implant or to change the size/shape of a current one.
Breast implants may be replaced for a number of different reasons. Ideal candidates for a breast implant replacement procedure include those who have any of the following problems:
If any of these problems affect you then a breast implant replacement procedure may greatly improve the issue. Often, you may not be aware of the specific name of the problem you are experiencing but you may be unhappy with the visual result. Your surgeon will be happy to assess and examine your breasts so that they can advise you on the most suitable procedure.
As medicine develops, the outcomes for patients continue to improve. Nowadays, although they are not considered to last forever, breast implants are designed to be both long-lasting and safe.
Patients who may have had breast implants put in a long time ago may have been advised to get the breast implants replaced after a certain number of years. Your surgeon will be able to examine you during your consultation and give you advice on whether or not you need to get your implants replaced.
Not only do older implants sometimes need replacement, but the process of ageing and changes in your body may also change the aesthetics of your breast implants. Therefore, you may wish to have your implants replaced if, over time, the size and shape of your breasts have changed.
As mentioned, the aesthetics of your breast implants may change over time. As you age, you may find that the skin and breast tissue becomes less supported and starts to sag or droop. Additionally, changes in weight or the changes that occur in pregnancy can also alter the breast shape. All of these factors can contribute to the aesthetic of your breasts changing.
If you are no longer happy with the appearance of your breast, in terms of size, shape and lift, then you may be a suitable candidate for breast implant replacement. It is important that you speak honestly with your surgeon during your consultation and you discuss exactly what you would like to achieve with them. With this information, your surgeon will be able to advise you if what you want is possible, and how best to accomplish it.
"Foreign body" is a name given to anything that is not usually within the human body and is therefore recognized as ‘foreign’. A breast implant is, therefore, a foreign body as it is a new element that is introduced into the breast. When the body recognizes something as foreign surrounding tissue responds by forming a capsule around it. This occurs with a breast implant. The capsule is made up of fibrous tissue and it will surround the entire implant. This process is completely normal and expected following breast implant insertion. The process will be slightly different from person to person.
In those who form more scar tissue, the breasts may feel particularly hardened. In some cases, the capsule will form with muscular tissue involved. This muscular tissue is able to contract. When this occurs it is known as capsular contracture. This is a recognized complication of having a breast implant. Capsular contracture may cause problems because the contractions will alter the appearance of the breast implant. Therefore, the size and shape of the breast can become deformed. As well as this, the contractions themselves can be uncomfortable for the individual.
In order to treat capsular contracture, a surgical procedure called a capsulectomy is performed to remove the capsule. Therefore, a reason for having a breast implant replacement procedure can include experiencing the complication that is capsular contracture. The capsulectomy can be followed by an implant replacement procedure to restore the original size and shape that was desired.
Some women wish to have their breast implants replaced due to health concerns. This may be particularly true for those who received PIP implants. PIP implants were silicone breast implants that were found to contain an unapproved silicone gel. Once this fraudulent activity was discovered, it created a huge scandal and understandably caused a lot of fear in the women who had received the PIP implants.
PIP implants are known to be more prone to splitting and rupture than high-quality approved implants. All breast implants carry a risk of rupture, but PIP implants carry a much higher risk – there is up to a six times greater chance of rupture. If an implant ruptures it can be uncomfortable and require removal. However, there is no evidence which suggests that PIP implants are a serious danger to health. Despite this, it is understandable that many women with PIP implants wish to get them removed and replaced with high-quality approved implants.
PIP implants were made by a single company based in France and were largely used in private clinics for breast enlargement. Almost 50,000 women in the UK received these implants. Many will have had these removed since the scandal was uncovered, but many women still live with these implants with no impact on their general health. We would advise you to discuss this with your GP. If you are worried about the implants and would rather have new implants to replace them, a breast implant replacement procedure may be suitable for you.
You can find out if your implants are PIP implants by getting in contact with the clinic where you had the original operation. It is likely that you would have received a letter to tell you your implants are PIP implants if this is the case. Regardless of your decision to keep or change your PIP implants, it is useful to be aware of the signs of implant rupture. This includes:
Seek medical advice from your GP if you experience any of these symptoms or if you want further advice about your PIP implant.
There are a number of issues that a breast implant replacement procedure will not change:
As we age, it is natural for our skin to become less firm. This, therefore, may give the appearance of having more skin in the cleavage area or it can make the breasts appear to droop. Simply having an implant replacement procedure may not fix this problem. If having excess skin is of concern for you then you may wish to consider having a breast uplift to help remove the excess skin and reshape the breasts. This can be done in combination with a breast implant replacement and should be discussed with your surgeon.
Breast implant replacement will not be able to treat the size or shape of the nipple-areola complex. If you are looking to change the nipple or areola of the breast (the region surrounding the nipple), you should speak to your surgeon. They may suggest a nipple-areola complex reconstruction procedure instead.
A breast implant replacement procedure can last 1 to 4 hours depending on the technique your surgeon uses and whether or not another procedure is involved such as a breast lift or a capsulectomy. A breast implant replacement procedure involves the following steps:
Before having an operation, your surgeon needs to get your consent to do the procedure. This is important to ensure that you are fully aware of the risks and benefits of the operation. Gaining your consent means that you will have a thorough understanding of any complications that can happen during the surgery or afterward. Your surgeon will talk to you about the risks and benefits and make sure you understand everything completely. After this, they will ask you to sign the consent form. We recommend that you ask any questions that you may have before signing this form so that you are comfortable with the decision you are making.
Before having an implant replacement procedure, you will meet with an anaesthetist. Most replacement procedures will be done under a general anaesthetic. This means that you will not be aware of the surgery. A general anaesthetic is effectively like being asleep during the operation; not only will you be unaware of the surgery but you will also be unable to feel any pain.
Your anaesthetist will explain to you how your pain will be controlled during the operation. They will also tell you what to expect from different types of anaesthesia. Your anaesthetist will ask you questions about your medical health, previous exposure to general anaesthetic and any allergies that you may have. It is important that you provide your anaesthetist with information that is as accurate as possible. This helps to make sure you are safe when you are given the general anaesthetic.
Once you have been given your anaesthesia, your surgeon will then start the procedure. Replacing breast implants begins very similarly to breast implant removal as the original implants will need to be removed. The process of replacing the implant may be very simple if the new implant is similar in terms of size and shape. If, however, the new implant is significantly different from the original implant, the surgery may be more complex. This is because the implant sits within a capsule. The capsule will need to be altered in order to accommodate the new implant. If the new implant is larger than the previous implant then the capsule can be enlarged using small incisions. In some cases, however, the capsule can become calcified and hardened which makes it more difficult to alter. Your surgeon will discuss the options available if this is the case for you.
When a breast implant is put into the breast tissue, the body forms a capsule around the implant. This is a completely normal feature of having a breast implant. It is the way the body responds to anything foreign being inserted into the body. The capsule that forms is usually made up of fibrous tissue and the breast implants sit comfortably within these capsules.
The capsule that forms around an implant will be different in each individual. The capsule can, in some cases, contain a lot of scar tissue which can make the breasts feel hard. Sometimes muscular tissue can make up some of the capsule and this muscle can then contract. This is known as capsule contracture. If there is contracture of the capsule it can distort the appearance of the breast and change the shape of the implant. As well as this, it can cause a lot of discomfort and pain. In some instances, capsular contracture can even cause the breast implant to rupture. Capsular contracture is a recognized complication of having breast implants. Fortunately, treatment for this is available.
If you experience capsular contracture then a capsulectomy can be performed. This involves removing the capsule in which the implant sits. Each capsule will be different in terms of its strength and how much scar tissue has formed. The incisions that are made to remove the capsule will, therefore, vary from person to person. Once the capsule has been removed, a new implant can then be inserted back into the breast. The breast can then return to the shape intended by the implant, without the capsule contracting and distorting it.
Although it is possible to have a capsulectomy and a breast implant replacement procedure alone, you may also opt to have a breast uplift procedure in addition. This is because the contractions of the capsule can distort the breast tissue and this may weaken the fibrous ligaments that support the breast tissue. By having a breast uplift procedure following the new implant being inserted, a better aesthetic can be achieved. Again, this will involve the capsule being removed along with the old implant. A new implant can then be inserted into the breast tissue. Finally, any excess skin can be removed and the nipple can be placed higher up on the breast to ensure the breasts appear firm and lifted.
Once you have had the operation, you will return to the ward to recover. The medical team will monitor you during this time. They will want to keep an eye on your levels of pain and make sure you are comfortable. You may feel groggy or drowsy after the operation. This is because of the general anaesthetic that you will have.
Many patients may be able to go home on the day of the procedure, provided that they recover well after the operation. You will not be able to drive after the operation; this is because of the general anaesthetic and the discomfort that you will be in. Therefore we recommend you arrange for someone to take you home from the hospital. It is important that you follow your surgeon’s specific guidelines and timeframes regarding recovery.
You will meet your Medbelle surgeon for the first time for an initial consultation. This will usually last between 15 mins to one hour. During this meeting, your surgeon will talk to you about the size and shape of the implants that you can have, as well as the type of implants that can be used. Your surgeon will also want to discuss:
It is important to be aware that your surgeon will examine your breasts and any previous scars. If you are suffering from any complications due to your implants they may discuss these in more detail with you. Your surgeon may also wish to arrange additional tests such as an ultrasound or MRI of the breasts.
Your consultation is an important chance for you to find out more about a breast implant replacement procedure. Your surgeon is there to give you information about the procedure and to answer any questions you may have. You may want to try to make a note of your questions before you meet with your surgeon. That way, you can make sure you don’t forget to ask anything on the day of your consultation.
Most surgeons strongly recommend a two week “cooling off period” between your consultation and having a procedure. This is to make sure that you have had time to think everything through and know that this is the right choice for you at this time.
Before you consent to have a surgical procedure, it is important that you are educated and aware of all of the potential breast implant replacement risks and complications. If you smoke, have a high BMI or have any serious medical conditions it can increase the risk of complications occurring during and after surgery. Some of the potential breast implant replacement risks and complications include:
All surgery carries some general risks. These include:
This is the most common complication following breast implant surgery and is, in fact, a reason for having a breast implant replacement procedure. As previously described, a capsule of fibrous scar tissue forms around breast implants once they are inserted. This encapsulation occurs in all women. If, however, this capsule is particularly tough it can make the breast feel hardened. Additionally, if the capsule contains muscular tissue it can contract and can cause pain. The contractions can distort the shape of the breast implant which can then change the aesthetic of the breast.
Although this can be addressed with a capsulectomy procedure, it is important to note that having this form of breast implant revision does not remove the risk of future breast implants also having capsular contracture. Around 10% of women who have breast implants are thought to have problems with capsular contracture.
Many women will be happy with the cosmetic outcome of their implant replacement procedure. However, in some cases, they may wish they had kept their old implants in place. It is important that you think carefully about whether or not to have a revision for cosmetic reasons. Your surgeon will discuss the options available to you and help you to decide what is right for you. It may be useful to see before and after pictures of other breast implant replacement procedures that your surgeon has done. In addition, make sure you are open and honest with your surgeon about your expectations from surgery. This will help them tell you if what you want to achieve is possible.
In most cases, an implant replacement procedure will achieve the desired effect. However, some women may find that they are unhappy with the outcome or suffer from more complications. As a result, further revision surgery may be required. Choosing an experienced BAPRAS/BAAPS affiliated surgeon will help reduce this risk. Importantly, it is beneficial to share with your surgeon exactly what you are hoping to achieve so they can confirm whether your goals are realistic before the surgery.
If you are having a breast implant replacement, there is a risk that the new implant may rupture or leak. This is unlikely to occur as implants are now designed to be long-lasting, however, there is always the risk that the implant can fail. Rupture occurs when the implant splits open, leaking its contents. The contents are contained within the capsule that surrounds the breast implant. The contents, therefore, do not spill out into the breast tissue and beyond. Rupture is more likely to occur with a saline implant, however, silicone implants can also rupture. If a silicone implant ruptures, the contents do not leak out as rapidly and this is known as a “silent rupture”. Features to look out for in the case of implant rupture, include:
After an implant has ruptured or leaked, it requires removal. It can later be replaced with a new breast implant.
Over time, the breast tissue becomes less firm and can begin to droop downwards. This occurs in both natural breasts and those with implants. Larger implants will cause a greater amount of drooping. If you feel that your breasts are beginning to droop too much, this can be treated with surgery. In most cases, a breast uplift is performed to lift the breasts upwards and correct the effects of gravity.
This occurs when the breast implant pocket, the area in the breast where the implant is placed, becomes too loose. As a result, the breast tissue moves towards the armpits. This leads to a reduction or loss of cleavage. Some women will choose to have an implant revision to treat lateralisation. However, it remains to be a complication even with a new implant inserted. It is also more likely to occur in women with a small amount of natural breast tissue who then choose to have larger implants.
After having surgery, you may experience an altered sensation over the chest area. This will generally get better with time but can take up to several months. The most common symptoms include increased or reduced sensitivity around the surgical scar and nipples. In rare cases, nerve damage during surgery can cause permanent numbness.
A rare complication of breast implant replacement surgery involves damage to the blood vessels which supply the breast. If these vessels are damaged then there will be a lack of blood supply to the breast tissue and skin. This lack of blood supply can cause the tissue to die, also known as tissue necrosis. This process is much more common in smokers as smoking can cause damage to the inner lining of blood vessels. Diabetes and obesity also increase the risk.
Features of tissue necrosis include the skin turning a darker colour, and possibly turning black. Wounds can also develop. You may notice that your breasts feel lumpy, hard and painful. If you experience any of these symptoms you should get in touch with your surgeon as soon as possible. If the area of tissue necrosis is small it may heal by itself. However, if the area is larger then you may need further surgery to repair the wounded area of tissue.
BIA-ALCL stands for Breast Implant-Associated Anaplastic Large Cell Lymphoma. This is a rare type of lymph node cancer that has been associated with breast implants. It is a cancer of immune cells, not of the breast. Only a small number of cases have occurred worldwide and, as a result, the risk of BIA-ALCL is not clear. Estimates of its incidence vary from 1 in 4,000 to 1 in 300,000. Therefore, this lymphoma arising from breast implants is very rare.
Regardless of how rare BIA-ALCL is, it is important to be aware that the risk is still there. Additionally, knowing about the symptoms is very important. Signs of BIA-ALCL include swelling of the breast, a thickened mass in the breast and fluid collection around the implant. Treatment would include the removal of the implant and capsule as the cancer is usually well confined within the capsule itself. In some cases, chemotherapy would be required to treat cancer.
Most women experience some bruising and bleeding after surgery. This is to be expected following any procedure. However, sometimes this bruising and bleeding can be more severe. This usually happens soon after surgery, but can occur in the weeks afterward. You may notice symptoms such as the breast becoming very swollen and tight. If you experience these symptoms, you should contact your surgeon as soon as possible. You may need further surgery to treat the bleeding; if this is done promptly the outcome is usually very good.
All surgery carries a risk of infection. If you are affected, this will become apparent in the first two to three weeks after surgery. In most cases, the infection will be mild and can be treated with antibiotics. However, if you have any of the following symptoms, you should speak to your surgeon promptly:
Before going in to have your breast implant replacement surgery, there are a few things that you can do to prepare yourself. These tips will help you to have a smooth recovery with the best possible results. Here are some general breast implant replacement preparation tips:
After surgery, you are going to feel tired and will want to rest. Therefore, we suggest you do a big food shop the day before your procedure is scheduled for. This will help prevent you from having to go to the shops or carrying heavy bags when you are recovering. We recommend you get plenty of nutritious foods to help keep you healthy during your recovery period. You may also want to have some pre-cooked meals ready in the freezer. That way you won’t have to worry about cooking either!
In order to make more time for recovering from surgery, it is a good idea to get any household chores out the way. We suggest that you do any cleaning or chores such as laundry and taking out the bins the day before your operation or alternatively you can allocate these tasks to another household member. You may not have the energy to do these jobs for a few days after the surgery. Equally, stretching and lifting will be very painful initially, especially across your breasts.
Your chest will be sore after surgery so to prevent yourself from straining, it is a good idea to put cupboard items that you frequently use in easy to reach places. For example, put mugs and tea in low-down cupboards or on the kitchen counter.
After surgery, you may feel tired and need extra help looking after young children and pets. Therefore, you may want to ask friends or family to look after any young children or pets for the first week following surgery. This means you can focus your energy on getting better and hopefully be back on your feet quicker.
You may feel very sore and drowsy following your operation. Therefore, you will not be allowed to drive immediately afterward. It is essential that you arrange for transport to take you home safely after your operation. You may want to ask friends or family to help you with this. As always, it is important to follow your surgeon’s specific timeframes regarding when you can drive.
A healthy diet is important in ensuring a smooth recovery process. After the surgery, you should eat high-protein, low-sodium foods, including fresh fruits and vegetables. In addition, make sure to drink plenty of water and caffeine-free beverages. Avoid food and drink containing high amounts of sugars and salt during your recovery time. Alcohol should also be avoided as it can interact with any medications you may be taking in the recovery period. It can further add to the drowsiness you may feel as a result of the general anaesthetic.
After the operation, your breasts and chest area may feel tender and sore. It is, therefore, crucial that you wear clothing that is comfortable. We suggest that you wear items of clothing that zip or fasten from the front during the first few days post-surgery. This will help prevent you from having to strain or raise your arms above your head. In addition, you may want to wear slip-on shoes so that you don’t have to bend over to put them on.
Your surgeon may also advise you to wear a supportive bra for the first few weeks after the operation. These are special bras designed specifically for the post-surgical period to help support your breasts as they heal.
It takes time to recover after any surgical procedure. Knowing what to expect will help you to feel prepared for how things will be after the operation. Your surgeon will give you specific aftercare instructions which you should follow closely.
After the breast implant replacement operation, you will return to the ward to recover. During this time, the medical team will monitor you and make sure you are comfortable. If you have had a general anaesthetic, it may take some time for this to wear off. As a result, you may feel drowsy or sleepy. The medical team will regularly check up on you and make sure any symptoms such as pain or sickness are well controlled.
The length of time you will be required to stay in hospital will depend on how long the surgery took, any pre-existing medical conditions you may have or if there were any complications during or after the procedure. During your consultation, your surgeon will discuss when they expect you to return home. Often this is on the same day as surgery but some patients will spend up to two days in hospital after a breast implant replacement procedure.
You will not be able to drive for some time after the surgery due to the general anaesthetic and post-operative discomfort. It is important that you follow the specific instructions that your surgeon gives you about driving.
A follow-up appointment will be arranged for approximately 2 weeks after your operation. This appointment allows your surgeon to monitor your recovery and make sure that your incisions are healing well.
You will need to take some time off work to help you with your recovery. Each individual will feel different after the operation and some people may take longer to recover. In addition, different jobs are more physically demanding and may require more time off. During your consultation, your surgeon will be able to give you specific advice on how much time you will need to take off work.
After having a breast implant revision procedure, your breasts are likely to feel quite sensitive and sore. As a result, your surgeon may advise that you wear a supportive bra during the first 2-5 weeks after your breast implant removal procedure.
Your surgeon will give you specific instructions regarding showering and washing. You may not be able to have a shower or get the treatment area wet for several days after the procedure. Once you are able to shower again, it’s important to consider that you may find it more difficult to wash and you may need some help with this.
How soon you can return to exercise and activities will largely depend on how physically demanding they are. For the first three weeks, it is suggested that you avoid all sport and physical activities and focus solely on your recovery. It is important that you give your body time to heal and recover. During this initial recovery time, aerobic activities can cause swelling and slow down your progress and healing. After the third week, you may be able to do light physical activity, such as cycling. Once it has been six weeks since the operation, you should be able to resume your normal exercise and activities. Again, your surgeon will give you specific timeframes that you should follow.
After having your surgery, it is important that you follow your surgeon’s advice on how to care for the surgical wounds and any scars. This will help ensure the best possible cosmetic result from the operation. When it comes to scar care, your surgeon may recommend the following techniques to help reduce scarring:
It is important that you are aware that it may take some time for your breasts to fully settle and for you see the final results of your surgery.
If you are choosing to increase the size of your implants, your breasts may feel over-enlarged, tight and heavy. This occurs due to post-operative swelling and should resolve with time. Your breasts may also appear tight, too high or unnaturally round before they settle fully. In addition, your nipples may feel numb or overly sensitive for some time. Generally, after around 8-12 weeks following the operation, your body should have recovered to the extent that you can see the results of your breast removal surgery. However, it may take up to 2-9 months for this healing process to be fully complete. Your surgeon will be able to give you timeframes specific to your recovery.
It is important that you ask your surgeon any and all questions you have about your breast implant replacement procedure. Common breast implant replacement FAQs include the following:
Sometimes patients may be slightly unhappy with the results of implant surgery soon after the operation. This is because it takes time for the breast tissue to settle and the bruising and swelling to go down. It can take up to six months before you will be able to see the final results. Therefore, it is recommended that you wait at least six months after having implant surgery before making decisions about having a breast implant replacement procedure for cosmetic reasons.
Some women will not want to change the size of their breasts and may simply be unhappy with the shape or symmetry. As a result, replacement implants may not be needed. There are other surgical options available such as a breast uplift procedure. It is advised that you are clear with your surgeon about what you are hoping to achieve. Your surgeon can then provide you with advice as to whether new implants are needed or if other treatment options are possible.
In some cases, the breasts may appear to be dropping due to complications associated with the implants. If the implants are dropping downwards and pulling on the breast tissue, for example, then a replacement of the implants may resolve the problem. However, if the drooping is due to excess skin, or weakness of the breast tissue and fibrous ligaments, then other procedures may be more suitable. Your surgeon will discuss these procedures, such as a breast uplift surgery, during your consultation.
This is something that you should discuss with your surgeon at your initial consultation. Generally speaking, most women who have breast implants may still be able to breastfeed afterward. This is because certain surgical techniques won’t affect the ducts within the breast. Despite this, all surgical procedures come with their risks and there is always the potential for ducts to become damaged.
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