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Breast Implant Revision, Removal & Replacement

Breast > Breast Implant Revision, Removal & Replacement

Breast augmentation surgery (breast enlargement / breast enhancement) carries a certain amount of risks, as with other types of surgeries, such as anesthesia risks, post-operative bleeding (hematoma), infection, fluid accumulation (seroma), and pain. However, there are short- and long-term complications specific to breast implants that al patients who are considering breast implant surgery should be aware of. 

As with any cosmetic surgery, the results of breast augmentation may not meet your expectations or desired results. The reasons may include desired and actual breast size (too small, too large), scarring, wrinkling (seen or felt), asymmetry, and implant displacement (shifting of implant), deflation. These unsatisfactory results can be minimized with a comprehensive pre-operative consultation, good communication with the operating Plastic Surgeon, careful surgical planning and execution of the surgical plan. Most important, choosing the appropriate size implant. Discuss all the options available to you with Dr. Shureih before you undergo breast augmentation.

Because breast implants are prone to these and other complications as well as simple wear and tear over time, it is important that all breast augmentation patients be followed on a yearly basis by the operating Plastic Surgeon to ensure that their breasts are healthy, and the implants are in good general condition.

For some patients this may mean yearly mammogram or when indicated an MRI of the breast, to ensure good BREAST HEALTH. This includes physical examination as well. Dr. Shureih makes sure to follow his patients with breast implants on a yearly basis. We never discharge our breast implant patients.

If you have any question regarding your implants or are dissatisfied or your concerns are brushed away by your physician, please do not hesitate to call us for a confidential consultation.

The most common reasons for revision surgery after breast augmentation is :

Size of the breast :

Disappointment with the breast size after breast augmentation is caused by poor communication between the surgeon and the patient. Understanding the patient expectations. Patients requesting specific size implant regardless of body shape and breast measurement. Implants should be chosen based on the breast measurements.

Capsular Contracture :

All implants will form a capsule (SCAR) around the breast implant. A certain percentage of patients will progress so that the capsule around the implant becomes tight, capsular contracture. About 5-10% of all implants will develop capsular contracture. This is the nature of the biologic behavior of the interaction of the body and the implant. Capsular contracture is characterized by pain, hardness of the implant; displaced implant. There is no definite known cause for the formation of capsular contracture. There is no medical treatment that can prevent or treat capsular contracture. Surgery remains the only treatment, surgical release of the capsule (Capsulotomy) or sometimes complete removal of the capsule (capsulectomy).

Implant Displacement :

Implants can be displaced in any direction. Lateral, medial, superior, and inferior.  The cause could be due to capsular contracture, too large of an implant, surgical violation of normal boundaries of the breast, Trauma and Weak tissue holding power.

Treatment is surgical. This will include reshaping the pocket with sutures, capsular repair, and the use of acellular matrix to support the repair. These procedures are difficult and require expertise and can be expensive. (Acellular matrix is expensive).

Capsular Contracture :

Disappointment with the breast size after breast augmentation is caused by poor communication between the surgeon and the patient. Understanding the patient expectations. Patients requesting specific size implant regardless of body shape and breast measurement. Implants should be chosen based on the breast measurements.

Deflation of Saline Implant, leakage of silicone implant :

Saline implants can deflate, and the saline inside will leak out. The breast will become suddenly or gradually smaller. The implant edges can become more palpable.

Silicone implants can leak due to failure of the shell, as a result of wear and tear. Silicone implant leak can be contained within the capsule (intra-capsular). Or there could also be a tear in the capsule and the silicone will leak out to the breast tissue (Extra-capsular).

Leaking implants are not normal and should be removed, with or without replacement which is a decision for the patient to explore with the surgeon.

Infection :

Any infection that involves the breast implant should be treated by removal of the implant and capsulectomy. Intravenous antibiotics for few days and continue oral antibiotics. Implants can be replaced no less than 6 months after complete healing.

Bleeding :

Once the diagnosis of bleeding in the breast is made, the treatment is surgical evacuation of the blood and stopping the bleeding points. Then replace the implants.