Breast implant removal is a repeat surgery to remove previously inserted breast implants, which is performed for a number of reasons, both aesthetic and medical. This surgery can be performed simultaneously with replacement with new-generation implants (repeat mammoplasty) or a breast lift.
If even 10 to 20 years after the insertion of breast endoprosthesis the patient feels well, is satisfied with the shape of her breasts, undergoes the necessary examinations on a regular basis and all indicators are normal, there is no reason to remove or change the implants. But, unfortunately, there are cases in which such a surgery is necessary.
Reasons for removal:
1. Aesthetic. The patient may be unhappy about the size or shape of her “new” breast. Often young women come with a request “I want larger breasts”. Also, the 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 contracture, persistent seroma (read more about complications after mammoplasty here).
3. Rupture of the implant (injuries, traffic accidents, damage to the endoprostheses during insertion)
Flipping, displacement, etc.
Implant removal methods:
- Simultaneously with capsular bag “en bloc” (is only performed in the presence of capsule and capsular contraction which happens in the minority of patients);
- Without a capsule (in the absence of capsule and capsular contraction, which is a typical situation in the majority of patients). In a normal case, I do not see a capsular bag but a barrier layer consisting of microns which looks like a whitish transparent plaque on the endoprostheses;
- With capsule fragments. For example, a 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 plastic surgery as additional tissue for the best aesthetic effect.
Replacement of implants
The surgery for the removal of old implants and insertion of new ones in their place is called re-endoprosthetics or re-mammoplasty.
It is possible to remove old implants and insert new ones simultaneously when the surgery is performed for a reason other than inflammation or infection. Otherwise, it is recommended to wait for recovery and then perform a repeat surgery.
New endoprostheses are inserted into the pocket formed after the old ones. If it is necessary to insert implants of a larger volume, the doctor enlarges the pocket accordingly.
If the implants were removed because of complications (capsular contracture, seromas), I strongly recommend inserting implants with polyurethane cover for re-endoprosthetics, as they give the minimal risk of such side effects.
Rehabilitation period
- The patient must stay at least one day in hospital after plastic surgery for the removal of endoprosthesis.
- At first, the patient may feel moderate pain in the breast area. During the first days, the patient may feel discomfort due to the tension of skin as a result of edema of soft tissues.
- It is recommended to wear compression garments for a month for better restoration of tissues, reduction of edema and minimisation of postoperative complications.
- You can return back to work in 7 to 14 days.
- Heavy physical activity should be excluded for one month.
To reduce the likelihood of complications, you need to observe all doctor’s recommendations.
Specificities of rehabilitation and recommendations for re-endoprosthetics are the same as for mammoplasty.