Breast implants are usually long lasting, but they are not considered lifetime devices. Removal, replacement and visits to the physician are commonly required. An implant can be taken out and not replaced, but the patient may experience dimpling, puckering, wrinkling or other cosmetic changes to the breasts.
Sometimes women decide years after having a breast augmentation procedure that they would prefer a larger or smaller implant. In other cases, women opted for saline implants before they could be assured of the safety of using silicone implants and are now considering making the switch. All of these options are available now, enabling women to get exactly the size, shape and fullness that she is seeking for her breasts.
Patients undergo breast implant removal and replacement for many different medical and aesthetic reasons. Any wrinkles, imbalances or folds a woman is experiencing can be corrected, as well as poor positioning of the implant. Oftentimes, the patient can benefit from the much wider variety of profiles, shapes, textures and sizes that are available today.
Breast implant removal and replacement surgery can achieve dramatic and beautiful results on its own as well as in conjunction with other cosmetic surgery or non-invasive procedures. We sometimes recommend combining an implant replacement surgery with other procedures such as a breast lift for more satisfying results. This is most commonly recommended to treat any sagging that has resulted from aging or pregnancy. During this combined procedure, some breast tissue is removed, the breast skin is tightened and lifted and a new implant is inserted.
In addition, a breast implant removal and replacement procedure may become necessary for some patients over time. There are short- and long-term complications specific to breast implants that all breast augmentation patients should be aware of, which can result in the need for another surgery. At some point in their lives, most augmentation patients will need follow-up surgery to replace their aging implants with new ones.
Capsular contracture is one of the most common problems caused by breast implants. This condition occurs when scar tissue around the implant hardens and begins to squeeze the implant. In addition to hardening of the breast tissue, capsular contracture can cause pain, rippling in the skin of the breast, movement of the breast implant and a distorted shape of the breast. Surgery may be needed to remove the scar tissue and to replace the implant.
Symmastia occurs when the breast implants meet at the middle of the chest. This is usually a result of the implants having been placed too close together (known as over-dissection of tissue in the cleaving area), which may have been done to enhance the patient’s cleavage. Symmastia is more common in thinner women because they have less tissue over the breastbone to keep the implants apart. The condition can be corrected by reattaching the fat and underlying tissue between the implants to the breastbone, as well as by replacing the implants with smaller ones.
The saline or silicone gel implant filling may leak out through an unsealed or damaged valve or through a rupture in the implant shell. A leakage may drain the implant immediately or over a longer period of time. Leaked saline is harmlessly absorbed by the body. Leaked silicone gel may remain within the capsule around the breast implant or may spread further. Because the filling is thicker, silicone gel implants are prone to “silent rupture,” where the patient may not realize her implant is leaking. For these reasons, it is important to undergo regular follow-up exams with a physician to check that the implants are intact.
Deflation can happen at any time after surgery to one or both implants. Causes of deflation include, but are not limited to, damage from surgical instruments, overfilling or underfilling of the breast implant, capsular contracture, trauma to the breast and normal wear and tear over time. Deflated breast implants require surgery for the removal and optional replacement of the implant.
Dissatisfaction with Results
As with any cosmetic surgery, the results of breast augmentation may not meet your expectations. Reasons for feeling dissatisfied may include implant size, scarring, wrinkling, asymmetry and implant displacement (shifting). These results can be minimized with pre-surgical counseling, careful surgical planning and correction with additional surgery to remove and replace the implants.
Talk to your doctor before you undergo breast augmentation to ensure that you have realistic expectations for your implants.