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Breast Implant Removal

Breast > Breast Implant Revision, Removal & Replacement

EXPLANTATION 

Breast implants are available for both breast enhancement and breast reconstruction. Saline breast implants are made of a silicone rubber shell filled with saline (salt water). Silicone breast implants are made of a silicone rubber shell and is filled with silicone gel.  The gel is now made of a thicker gel of varying degree.

A woman considering breast augmentation to enhance the size of the breast and

feel more proportionate, fit better in clothes and feel better about herself and body image.  This is a very personal decision, and no one has the right to critique that decision. The patient should be informed in great details of all the medical facts available about the chosen implant. Information should include the potential risks, complications long and short term. Patients should be informed of potential need for future surgery, and the fact that the patient is fully responsible for the cost of any further surgery.

Breast implants are the most studied medical devices in the United States. Those studies were reviewed by the FDA and the FDA has approved their general use in 2006. If the patient has any concerns regarding breast implant safety then they should not undergo the surgery.

At the same time we should not politicize and pass moral judgments on a woman’s breast and what should and should not be done. It is a very personal decision.

Breast Implant removal ( EXPLANTATION).

Breast implants removal could be for various reasons :

1: A medical reason
2: A personal reason

Medical reasons may include infection, capsular contracture, pain ,  exposure of implant, leakage or failure of implant.


Explantation may be requested by the patient for personal reasons. Repeated need for surgical corrections, concerns about the health and safety, or any other personal reason.


The surgical procedure is done under heavy sedation with local anesthesia supplement, or may be done under complete general anesthesia.


The procedure can take 2-4 hours. When contemplating explantation of breast implant without replacement then whenever possible an enblock explantation should be considered to prevent spillage or contamination of silicone outside the breast implant capsule, Although rare, leaving the capsule in may lead to fluid accumulation in the capsule pocket.  This will require more operative time, expertise and expense. In the case of the implant positioned under the muscle, the posterior leaflet of the capsule leys on the ribs, and care not to perforate the chest wall for the sake of complete capsule removal orenblock removal of the implant.

It is very difficult to predict the ultimate result and shape of the breast after breast implant removal. The shape of the breast would depend on many factors :

The position of the implant, the size of the implant, the amount of skin stretch or loss of skin elasticity, Loss of breast tissue and the length of time the implant has been in.

The breast size may be smaller than the original size due to loss of breast tissue and in rare occasions bigger because of increase in the size of the breast with time or weight gain.

The breast may drop, because of loss of volume, loss of skin elasticity, and stretch of skin. Deformity of the breast may occur because of scar adhesion. The scar may be longer than the original scar if an enblock removal of implant and capsule is required.

Some women may opt for a smaller implant replacement to minimize the deformity of explantation. This will require manipulation of the larger pocket or change of the position of the implant.

Sagging breast or potentially sagging of the breast may require a breast lift procedure to enhance the shape of the breast after breast implant removal or sizing down to a smaller implant.

One should not ignore the potential psychological impact on the woman after breast implant removal and the changes in body image. Depression is common and may require professional help before and after the breast implant removal.

THE PROCEDURE

Enblock breast implant removal requires a longer incision. An infra-mammary incision is the most direct approach and causes the least trauma to the breast tissue and fat in the breast. Pre-existing Periareolar incision can be used. Only the capsule and the implant should be removed with minimal amount of surrounding tissue. The use of Harmonic Scalpel minimizes trauma to the surrounding tissue.

The capsule should be sent for pathological examination.

 

When total capsule removal is done, a drain is used to minimize fluid and blood accumulation.

RISKS AND COMPLICATIONS

Any surgical procedure carries a certain amount of risk and complications.

Infection, bleeding, hematoma, seroma, breast deformity, the need for further surgery, scarring, pain and psychological trauma.

The decision for surgery should be taken with great care and understanding of the procedure, the complications , the cost of the surgery and the cost of any further surgery for complication and undesired results.

For further information contact Dr. Shureih at 410-243-3035

Email: sshureih@msn.com

Website: www.cosmeticsurgeryforme.com