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Remove and Replace Breast Implants

remove-replaceThere are many reasons for wanting to remove and/or replace your breast implants:

  • Your original implants are leaking
  • Capsular contracture has caused breast deformity or hardening of the breast
  • Saline or liquid silicone implants needing replacement due to age of implants and possibility of rupture
  • Your needs have changed and you would like larger or smaller size implants
  • Your natural breast size has increased with age and you no longer need implants.

Most women chose to replace their implants, but occasionally circumstances change and the individual does not want, or need breast implants any longer. We offer a complimentary consultation with our Client Educators to help you understand your choices and what these mean to you financially. Feel free to contact us for more information.

In the meantime the following may help you to understand removing, or removing and replacing breast implants.

My implants are leaking

  • This may seem like it needs urgent attention, but it is not an emergency.
  • If your implants are saline, they will appear deflated but the saline leakage will cause no harm.
  • If your implants are liquid silicone, you may not be able to tell visually or even palpably. They do need to be replaced however as the silicone can migrate to local lymph nodes or you can get the formation of a siliconoma.
  • You will require an MRI to show that the implant is leaking. Your GP can organise for you to have this done before you see Dr McGovern
  • Call our rooms to make an appointment for a complimentary consultation with one of our patient educators and Dr McGovern.

My implant/s is going hard

  • This is known as capsular contracture.
  • Make an appointment to see Dr McGovern as soon as this is noticed.
  • If this occurs shortly after surgery (within 3 month) , it may be resolved with daily massage
  • If surgery is required you may decide to replace your implants if they are old
  • The latest technology implant – Motiva , may be recommended to reduce your risk of capsular contracture in the future.

I Don’t Want or Need My Breast Implants Anymore

If you have decided that you want your implants removed only:

  • Removing implants is a simple procedure performed under general anaesthetic in a hospital.
  • You may require a breast lift if you have a lot of spare skin.
  • You may need a breast reduction if you have lots of breast tissue and a low nipple position.

Will I have to pay for new implants?

  • Most implant manufacturers have some sort of warranty in the case of fault of the implant. You will need to know what type of implants you have.
  • If there is a problem with an implant and it is under warranty, the same implant will be replaced at no cost.
  • You will have other out of pocket costs associated though, eg hospital, anaesthetic and surgeons fees.
  • Ensure that the implant you chose has a warranty before you decide on surgery.
  • If you want to change the size of your implant or change the brand, you will have to pay for new implants

I want larger breast implants

  • If you are unhappy with the size of your implants, these can be changed surgically, but you will be charged full price for this and there are no rebates.

I want smaller breast implants

  • Again this can be done, but you will be charged for this and there are no rebates for changing the size of your impacts.
  • if you have had your implants for a short time ( 3- 12 months), and you think there was a gross mistake in the size you wanted and you received, you should talk to your surgeon about this and an arrangement should be able to be met.
  • Choosing a qualified plastic surgeon that does lots of breast implants initially avoids these types of problems

If you are wanting to remove your implants, or have a problem with your implants, please call our experienced staff. They will advise you of the best course of action and make an appointment for you to see Dr McGovern

surgeryAs with any surgical procedure, excessive bleeding following the operation may cause some swelling and pain. If excessive bleeding continues, another operation may be needed to control the bleeding and remove the accumulated blood. Polyurethane implants require the use of a drain to drain away excess fluid therefore avoiding the problem of excessive bleeding.

Less than 1% of women develop an infection around the implant. In most cases, the implant may need to be removed for several months until the infection clears. A new implant can then be inserted. This complication is rare provided you follow all the recommended guidelines.

Some women report that their nipples become oversensitive, under sensitive, or even numb. You may also notice small patches of numbness near your incisions. These symptoms usually disappear with time, but may be permanent in some patients.

There is no evidence that breast implants will affect fertility, pregnancy, or your ability to breast feed. If, however, you have breast fed a baby within a year before augmentation, you may produce milk for a few days after the surgery. This may cause some discomfort, but can be treated with prescribed medications, if persistent.

If a break occurs in a liquid silicone gel-filled implant, however, one of two things may occur. If the shell breaks but the scar capsule around the implant does not, you may not detect any change. If the scar also breaks or tears, especially following extreme pressure, silicone gel may move into the surrounding tissue. The gel may collect in the breast and cause a new scar to form around it, or it may move to a nearby area. There may be a change in the shape or firmness of the breast. Both type of breaks may require a second operation and replacement of the leaking implant. In some cases, it may not be possible to remove all the silicone gel in the breast tissue if rupture should occur.

In the case of cohesive gel implants, the manufacturers state the risks to be similar to liquid silicone gel. However, these same manufactures are continuing to face a legal witch-hunt, and so are guaranteeing nothing to anybody right now. The cohesive gel implants have been designed to solve this very problem of liquid silicone gel implant rupture, and appear at this early stage of follow up to have done so.

A few women with breast implants have reported symptoms similar to diseases of the immune system, such as scleroderma and other arthritis-like conditions. These symptoms may include joint pain or swelling, fever, fatigue, or breast pain. Research has found no link between silicone breast implants and the symptoms of what doctors refer to as “connective – tissue disorders,” with numerous large studies showing identical or lower than normal incidences of these diseases in women with breast implants.

Breast implants do not increase your risk of breast cancer, with studies showing augmented women to have only 43 – 47% of the normal risk for this killer disease. This presumably arises due to augmented ladies having less than half the normal amount of breast tissue, rather than to any protective effect of silicone!

While there is no evidence that breast implants cause breast cancer, they may change the way mammography is done to detect cancer. When you request a routine mammogram, be sure to go to a radiology centre where technicians are experienced in the special techniques required to get a reliable x-ray of a breast with an implant. Additional views will be required. Ultrasound examinations may be of benefit in some women with implants to detect breast lumps or to evaluate the implant.

While the majority of women do not experience these complications, you should discuss each of them with your plastic surgeon to make sure you understand the risks and consequences of the breast augmentation as these may have changed since your original surgery.

In your initial consultation, your surgeon will evaluate your breasts and explain which surgical techniques are most appropriate for you, based on the condition of your breasts, any noted capsular contracture, any suspected leaking, your original scars and skin tone and elasticity. If your breasts are sagging, he may also recommend a breast lift.(For more information on this procedure, click Breast Lift or Mastopexy).

Your surgeon will give you instructions to prepare for surgery, including guidelines on eating and drinking, smoking and taking or avoiding certain vitamins and medications .We also request that you prepare the incision site with topical antioxidants for at least 6 weeks prior to surgery. While making preparations, be sure to arrange for someone to drive you home after your surgery and to help you out for a few days, if needed.

Your surgeon performs removal and replacements in a dedicated operating theatre in one of our local hospitals. These are – Sunshine Coast Private Hospital, Sunshine Coast Day Surgery, and Caloundra Private Hospital. Most ladies choose day surgery. Occasionally, those with little support or little children at home choose to stay a day or two.
Breast implant removal and replacement is usually performed under general anesthesia, so you’ll sleep through the entire operation. Some surgeons may use local anesthesia, combined with a sedative, to make you drowsy. However significant discomfort during the procedure is then frequent. Your surgeon will recommend general anaesthesia.

Every effort will be made to ensure that the incision is placed so resulting scars will be as inconspicuous as possible. Working through the incision, your surgeon will lift your breast tissue and skin to locate the original implant, which is then removed. The new implant will either be placed in the same pocket, or a new pocket will be made, depending on the difference in size to the original and the placement of the new implant. This will either be directly behind the breast tissue or more commonly underneath your chest wall muscle (the pectoral muscle).

Putting the implants behind your chest muscle may reduce the potential for capsular contracture.

The implants are then centered beneath your nipples. To ensure accurate placement of implants and symmetry we will be sitting you up and adjusting implant position whilst you are under the anaesthetic.

Subpectoral implant placement may also interfere less with breast examination by mammogram than if the implant is placed directly behind the breast tissue. Placement behind the muscle however, may be more painful for a few days after surgery than placement directly under the breast tissue.

The surgery usually takes approximately one hour to one and a half hours to complete. Absorbable stitches are used to close the incisions, which will also be taped for greater support. A subpectoral stabilizer device will be applied over your breasts to help keep the implants still in their optimal position. This is essentially two velcro straps.

recoveryYou may also experience a burning sensation in your nipples for about two weeks, but this will subside as bruising fades. Your stitches will not need removal but the swelling in your breasts may take three to five weeks to disappear. You should not have new bras fitted or wear any bra for 6 weeks after surgery.

You should be able to return to work within a few days to a week after surgery, depending on the activity level required for your job. Follow your surgeon’s advice on when to begin exercises and normal activities. Your pectoral muscles will be sore when you contract or stretch them, for about one month. Your breasts will be sensitive to direct stimulation for two to three weeks, so you should avoid firm physical contact.

After that, breast contact is fine once your breasts are no longer tender, usually three to four weeks after surgery. Your scars will be firm and pink for at least six weeks. Then they may remain the same size for several months, or even appear to widen. After several months, your scars will begin to fade, although they will never disappear completely.

Routine mammograms should be continued after breast augmentation for women who are in the appropriate age groups, although the mammographic technician should use a special technique to assure that you get a reliable reading, as discussed earlier. (See All surgery carries some uncertainty and risk.)

For many women, the result of implant removal and replacement can be satisfying, even exhilarating, especially if capsular contracture or leaking of implants was the reason for the replacement. However, in some cases, the degree of capsular contracture may have impinged on the breast tissue itself leading to the possibility that some of your breast tissue will need to be removed along with the scar capsule. This may result in slight changes in breast shape even after replacement. Your surgeon will discuss all the parameters of your surgery and the specific changes to expect.

Your decision to have breast implant removal and replacement is a highly personal and possibly medically necessary one that not everyone will understand. The important thing is how you feel about it. If you’ve met your goals, then your surgery is a success.

If you have further questions, write them down and ask your surgeon and his friendly staff at your consultation.