Implant replacement

WHO IS A GOOD CANDIDATE?

The FDA states that the lifespan of a breast implant, whether saline or silicone, is 10-15 years, so most breast augmentation patients will likely undergo another procedure at some point in their lives to either remove or replace their breast implants. Replacement is recommended in the case of a deflated saline implant, known rupture to a silicone implant, or implants that are more than 10-15 years old. It is also easy to resize to a smaller or larger implant during this procedure depending on the patient's preference. It is also possible to reshape the implant pocket to change the shape of the breast or position of where the implant sits.

THE PROCEDURE

Implant removal and replacement surgery is done under general anesthesia at an outpatient surgery center. Surgery typically takes under an hour. An incision is usually made in the scar from the original augmentation, the old implant is removed through here and the new one placed. This is typically along the inframammary fold or around the nipple. The capsule or scar tissue around the old implant is already established, but sometimes if the patient is going larger or wants to change how the new implant sits, some of the scar tissue is opened up or sutured to modify the walls of the scar capsule. If the patient has a ruptured silicone implant or has capsular contracture, sometimes the capsule or parts of it are removed as well. A new implant is then placed in the breast pocket and the incisions are closed with dissolvable sutures. After surgery the patient is wrapped in an ACE wrap and padding. Drains are usually not needed for this surgery.

IMPLANT TYPES

Both saline and silicone implants are commonly used, and both are FDA approved. In addition to the price difference (saline implants are less expensive), there are other important differences. Both have an outer shell made of silicone. Saline implants come deflated and are filled with sterile saline during your surgery. Silicone implants come pre-filled and with set sizes. Projection refers to how much the implants project forward from the body - moderate, high and extra high. We have sizers for each one to determine what the patient's goal look is. Silicone also comes in different levels of cohesivity and in textured and anatomic types. The most commonly used implants in our practice are smooth round silicone implants, and among this group, it is the patient's choice if they want regular gel, the most cohesive gel, or the hybrid type. Prices differ between each type, with a higher price for each level of extra cohesivity. The advantage of a more cohesive implant is less likelihood that if it ruptures, silicone gel can leak into the surrounding tissue. More cohesive implants also have less tendency to ripple, which is advantageous if a patient is very thin with very little breast tissue. The only difference in feel is that more cohesive implants can feel firmer.

RECOVERY

The pocket for the implants is already established so majority of patients find this less painful than their initial procedure. Avoid overhead reaching for 1 week and no lifting more than 5lbs. or high-end exercise for 4 weeks. Patients usually wear a sports bra 24/7 during this recovery period and may go back to wearing underwire bras 6 weeks after surgery. If larger implants are placed, it may take at least 3-6 months after surgery to see final results, as implants often will take some time to settle down as the skin stretches.