Breast Implant Replacement
Breast implants can last forever, but may not. While most patients with breast implants
do well for many years, situations can arise where secondary procedures may be needed
to help reach a more ideal aesthetic appearance. The appearance of an augmented
breast depends upon the position of the implant relative to the patient's own breast
tissue. Aesthetic changes can result from a descent of breast tissue relative to
an implant, either from the effect of gravity or capsular changes that may elevate
the implant position directly. Alternatively, breast implants may, on occasion,
ultimately settle into a position lower than originally intended following initial
placement. Adjustment of the breast implant or breast tissue position may be needed
in combination in a given patient.
Increased firmness, or capsular contracture, can occur due to changes in the scar
capsule that forms around a breast implant. In the case of silicone gel implants,
such a situation can call for an MRI evaluation to determine whether the implant
has ruptured. Rupture of a saline implant is more readily apparent. In this situation,
a procedure to divide, release, or remove the implant capsule may be needed with
possible implant removal or replacement.
Aesthetic goals of a patient may change over time. A patient may decide that a particular
breast size or shape that was important earlier in life may be different from her
present goals or wishes. This can be the case in the early or late postoperative
periods following breast enhancement.
These are the most common situations that we see in patients who consider secondary
breast implant procedures. The best answers for a given patient are discussed and
pursued on a very personal and individual basis. We have many options to help improve
the outcomes for these patients that can include silicone gel or saline implant
removal with or without replacement, though a lift is often needed if the implants
are not replaced. The latest in breast implant technology allows us to offer a wide
range of options, that can include choices of implant shape (round vs. anatomic,
or teardrop), surface (smooth vs. textured), profile, or projection (high profile,
moderate plus profile, moderate profile), and filler material (silicone gel vs.
saline). Breast lift can also play an important role in helping to reposition breast
tissue at the time of implant replacement and thus achieve an optimal aesthetic
outcome in these patients.
Secondary breast enhancement is usually performed under general anesthesia on an
outpatient basis. Most patients are asked to refrain from vigorous physical activity
for about one week, and can resume most normal activities soon thereafter.
What follows are examples of patients who have allowed us to share their preoperative
and postoperative photographs with you. These are examples of typical outcomes,
but may not represent your preoperative situation or postoperative result.