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Removal and replacement of breast implants

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Removal of breast implants is a repeated surgical operation for removal of previously installed breast implants which is done for a number of reasons both esthetical as well as by medical indications. This operation can be done at the same time with replacement with implants of new generation or breast lift.

Even if in 10-20 years after installation of breast endoprosthesis the patient feels herself good and is happy about shape of the breast and regularly undergoes all necessary examinations and all indicators are normal, there is no reason to remove or replace implants. However, regretfully, there are cases when such operation is necessary.

Reasons for removal:

  1. Esthetical. The patient may be unhappy about the size or shape of her “new” breast. Often girls come with a request “I want larger”. Also, shape of mammal glands may change as a result of pregnancy, period of lactation, substantial weight changes, decline overtime under force of gravity (ptosis of breast)

  2. Complications in the form of capsular contraction, persistent seromas

  3. Rupture of implant (injury, traffic accident, damage of endoprosthesis at installation)

  4. Flipping, displacement, etc.

Replacement of polyurethane implants installed by another doctor with Polytech 320 anatomical polyurethane implants

Photo: Replacement of polyurethane implants installed by another doctor with Polytech 320 anatomical polyurethane implants

Contraindications and the list of necessary tests and examinations is the same as for breast augmentation surgery.

How the operation is done

Operation for removal or replacement of breast implants is done under general anesthesia and lasts from 1 to 2 hours depending on the necessary scope of work.

Incision is done on the old cicatrix and removal of the prosthetic and fibrous tissue (capsule) surrounding it is done through it. If operation is done comprehensively with lifting, other incisions of tissues might be necessary.

In most women, capsule is a superfine membrane of connecting tissue paving perimeter around the implant. In case of capsular contraction, is resembles a bag with wall thickness from 0.5 mm to 1 cm. Here, the bag is contracting thus deforming an implant and breast.

replacement of implant from round-shaped with anatomical one

Photo: replacement of implant from round-shaped with anatomical one


 

Removal implants

Methods of removal of implants:

  1. 1. At the same time with capsular bag “en bloc” (is only done in case of presence of capsule and capsular contraction which happens in minority of patients).

  2. With no capsule (when there is no capsule and capsular contraction, this is a situation in the majority of patients). In a normal case, I do not observe a capsular bag but rather a barrier layer consisting of microns which looks like a whitish transparent plaque on the endoprosthesis.

  3. With fragments of capsule. For example, capsule may be only on the lower pole of the implant and be absent on the upper one or vice versa. Sometimes there is a double capsule at the bottom and no capsule on the top. In addition, the surgeon may intentionally leave fragments or the entire capsule for further plasty as additional tissue for the better esthetic effect.

Replacement of implants

Operation for removal of old implants and installation of new ones in their place is called re-endoprosthetics.

One-time removal of old implants and installation of new ones is possible in case when operation is done for a reason other than inflammation or infection. Otherwise, it is recommended to wait for recovery and do a repeated operation.

Replacement of implants (re-endoprosthetics)

Photo: Replacement of implants (re-endoprosthetics)

New endoprosthesis is installed into the pocket formed after the old ones. If it is necessary to install implants of a larger volume, the doctor increases the pocked accordingly.

If the implants were removed for the reason of complications (capsular contracture, seromas) – I strongly recommend implants with polyurethane cover for endoprosthetics as they give the minimal risk of such complications.

Rehabilitation period

  • The patient has to stay at least 1 day in the hospital after plastic surgery for removal of endoprosthesis
  • Moderate pain in the area of breast may be of concern first. Feeling of discomfort is possible in the first days due to tension of skin as a result of edema of soft tissues.
  • It is recommended to wear compression garments for better restoration of tissues, reduction of edema and minimization of postoperative complications.
  • One can return back to work in 7-14 days.
  • One should exclude heavy physical loads for 1 month.

It is necessary to observe all recommendations given by the doctor for reduction of probability of complications.

Specificities of rehabilitation and recommendations for re-endoprosthetics are the same as for mammoplasty.

Questions and answers

How the breast will appear after removal of implants?

Appearance of breast after removal of implants is largely affected by method of removal. “En bloc” removal with no one-time installation of implants always causes gross defects. Unlike this, preservation of capsule practically does not change natural shape of breast as scarring is minimal. The doctor defines the best way to do the operation depending on situation.

How one can detect rupture of the implant?

With the help of such examinations as: sonogram of mammal glands, mammography and MRI with contrast. MRI with contrast is the most reliable way of examination of mammal gland and implants. Gross rupture may also be detected by palpation by the doctor during examination.

Is it necessary to remove Allergan implants due to their withdrawal from the market?

In this case, I agree with recommendations of FDA (Food and Drug Administration of USA) which does not recommend removal of prohibited implants Allergan Biocell due to extremely low risk of lymphoma (BIA-ALCL).

However, if wearing Allergan implants (or any other ones) is associated with seromas, capsular contraction – replacement is necessary. If everything is nice and no complications are observed, there is no point to disturb implants.

Prices for removal / replacement of implants (Kyiv, Ukraine)

Procedure Price*
Removal of implants (cost depends on complexity of situation) 1000 - 4000 euro
Replacement of implants (cost of new implants and compression garments included):  
  • uncomplicated
5200 euro
  • complicated by capsular contraction or rupture of implant
6000 euro

*Price includes all costs: surgery, anesthesia, hospitalization (ward, meals, wifi, medication, dressings), inspections

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