Breast Implant Removal
Unhappy, pain, rupture, capsule, ripples
There is now a significant proportion of the female population who have undergone breast surgery with implants either for cosmetic reasons or in their breast reconstruction journey. Breast implants are better made than ever and now come with warranties from companies like Mentor and Polytech that cover issues like implant rupture or capsular contracture.
The rate of implant ruptures is thankfully now extremely low and I rarely see this problem in my practice even in implants that have been in for some time. Symptoms of an implant rupture are sudden change in shape or pain although it can happen with no symptoms at all. The first step is to arrange for an ultrasound scan and this will pick up the vast majority of issues. Usually it is possible to perform a simple exchange but if the rupture has been present for longer or if you suspect you have PIP implants then it may be necessary to perform removal of the scar around the implant, known as capsulectomy.
Rotation is another problem that can lead to the need for replacement of breast implants. This can only happen with shaped implants as round implants do not look different if they rotate, this is one of their key advantages. Sometimes it is possible to externally manipulate an implant back into position, especially if early in recovery, and then by resting it may allow the implant to settle into the correct position with no further issue but occasionally surgery is required either to swap the implant for a round one or to reduce the size of the pocket so that the implant fits snugly.
Sometimes patients just desire to go back to their natural size or to reduce the size of the implants after they lose weight. This is why it is important to be sure that you are at a stable weight when you have your surgery as the implants will not change in size the way your natural breasts do. If the implants have been large and in for some time then it may be necessary to perform un uplift (LINk to Mastopexy page ) or fat transfer to replace volume. Large implants that have been in for a long time can press against your natural breast tissue and cause it to thin out so after removal you will not go back to the same volume. This is why it is important to think carefully about the pros and cons of the size of implant you choose at your initial surgery.
Some patients who have implants in for a long time can develop ripples or knuckles that they can feel. These issues can sometime be improved by changing the type or shape of implant together with other procedures like fat grafting or removal of the capsule to prevent recurrence of the problem.
There are often different approaches and that is why your consultation is such an important part of your treatment. I will always provide you with all of the information you need and give you time to think it over. You should always have 2 consultations prior to making big decisions about how you wihs to proceed.
Mr Gerard Lambe MD, FRCS (Plast)
Consultant Plastic and Reconstructive Breast Surgeon
Christie Hospital NHS Trust