Replacement of Breast Implants
About
Breast Implants should be changed when there is a definite safety concern or when you are no longer happy with the appearance.
The safety concern may be suspicion of ruptured implants. An ultrasound examination will either reassure that they are intact or confirm that there’s a problem and they need to be replaced.
Alternatively the appearance of your breasts might have deteriorated and you want this corrected. In the Gallery you’ll see pictures of common problems which I am asked to correct.
A ‘capsule’ is a layer of scar tissue around an implant which contracts, makes the implant feel hard, look round and often lifts it up too high. It can also be sore.
Implants can ‘drop down’ or ‘bottom out’ as years go by.
Implants can be placed ‘too high’ at the original operation or ‘too far apart’ producing a ‘gap’.
‘Rippling’ of an implant covering is sometimes seen under the skin if it is loose and thin.
The implants may have been ‘too big’.
Lastly the skin of the breast might be loose and ‘sagging’.
Understanding how these problems arise allows us to develop a strategy to produce good results.
Placing implants under the pectoral muscle reduces the chances of a capsule forming as well as implants dropping down. There is also more tissue coverage and implants are less visible.
Implant positioning ‘too far apart’ or ‘too high’ is a technical error at the time of surgery.
A false ‘round and overlarge’ appearance is a judgement issue concerning choice of implant shape and size.
The choice of implant make and construction can also further reduce the risk of rippling, capsule formation and drop. Experience has led me to a preferred implant which you can read about here.
Assessment
To make decisions about what to do, I ask some simple questions:
Should the implants be replaced or not? That boils down to two things:
Is there is a safety concern?
and if there is not
Will the result be sufficiently improved to make surgery worthwhile?
Then if surgery is to go ahead, more information is needed:
Will the new implants be the same size, smaller or larger than before?
Are the implants in the correct place? That’s the level on the chest and whether they are under the muscle or not.
Is the skin still tight or is it too loose?
The answers will guide the choice of new implant size, positioning and whether a breast uplift should be done at the same time.
Operation
It’s not just a matter of taking one implant out and putting another back in. ALL of the scar tissue capsule layer around the implant must be removed. If the implant was originally in front of the muscle, the position is changed in to “behind”. Then the implant is placed at the correct height and with the appropriate gap. If an uplift is needed this will be done as well after the space around the new implant is closed. Details of this are in the section Breast Uplift.
Recovery
You will need 14 days away from work. Your breasts will be very firm to start with and gradually soften. There’s no heavy lifting for two weeks and no high impact exercise until 8 weeks. There’s no need to wear special bras or supports, a crop top or stretchy sports top from about 10 days is simple and easy.
Gallery
Look at photographs of typical results for this procedure.
