Breast Implant Replacement (Breast Revision)
A large number of women have breast implants, and this has led to a dramatic increase in the number of women seeking breast implant replacement surgery (revision).
When undergoing the initial breast augmentation surgery, you may have been told to expect a replacement after ten years. Fortunately, this is not always the case. The FDA outlined in a 2011 report that only one in five patients require a revision procedure after ten years following their initial augmentation. This means that 80% of patients are doing fine with their current implants.
Why would I need replacement surgery?
Breast shape changes for many reasons. Over time, gravity, pregnancy and fluctuating weight can have dramatic effects on the shape of women’s breasts. Because implants increase the weight of the breasts these changes can be more pronounced in women with implants.
These changes can be corrected with a replacement of implants, or sometimes with a breast lift. Speak to your surgeon about your issues and show him what you like or dislike most. Then, you’re on track to having your breasts corrected.
If you don’t notice any cosmetic issues immediately, you’re on the path to becoming one of the 80% of women who don’t require an implant replacement over the coming decade.
However, even a flawlessly performed breast augmentation carries risk. In a small number of patients, medical complications can occur. These include:
- Development of capsular contracture
- Rupture or deflation
- Development of autoimmune issues or ‘breast implant illness’ symptoms
- Risk of developing ALCL cancer
What is capsular contracture?
Capsular contracture refers to when the implant becomes encapsulated in scar tissue, causing pain and deformity in the breast. When this occurs, your breast implants feel harder and can change position and/or shape. In this instance, a breast implant replacement (or removal) procedure can alleviate pain caused by the hardened tissue. If the implants have been removed due to capsular contracture, the implants may be placed in a different breast pocket (usually under the muscle) to prevent the recurrence of contracture.
Is rupture or deflation common?
Fortunately, the deflation or rupture of a breast implant is a rare occurrence and only affects a small amount of breast implants. Older breast implants have a much higher rate of rupture than the current ones on the market. This is because of the increased quality of implants made today. Today’s implants are extremely resistant to rupture due to the technological breakthrough of high-strength cohesive (HSC) silicone gel.
If your implant does rupture or leak, pain and further complications can arise. The best way to resolve this is with revisional surgery.
Will Medicare cover the cost of removal?
Most health insurance policies will cover the cost of breast implant removal when it meets the policy’s criteria for medical necessity. Medical necessity is defined as a leaking silicone breast implant or severe capsular contracture that causes breast hardness or pain.
What about if I suffer from breast implant illness symptoms?
Over time, some women develop medical symptoms that they believe are related to their breast implants. These health conditions include chronic fatigue, cognitive issues, and muscle pains. The FDA is yet to find evidence that breast implants are associated with these symptoms, despite that they are described by thousands of women with breast implants.
This, unfortunately, means there is no existing policy that will cover breast implant removal due to systemic illnesses caused by implants. If you feel that your body is reacting poorly to the implant, you should seek removal and not a replacement of the breast implant.
What is BIA-ALCL Cancer?
In 2011, the FDA announced that breast implants might cause a rare type of lymphoma called BIA-ALCL – Breast Implant-Associated Anaplastic Large Cell Lymphoma. This is a rare tumour that can occur in the scar tissue (capsule) surrounding breast implants.
Some women with concerns regarding the risk of this type of cancer often consider the removal of their implants or consider replacing their implant to one with a lower risk of this tumour developing. This cancer is associated with capsules of textured breast implants only, and not smooth ones.
What happens during Breast Implant Replacement surgery?
Dr Mark Doyle uses the En Bloc technique in which the breast implant and its surrounding scar tissue (capsule) are removed in one piece. Removing the breast capsule and implant together reduces the risk of any fluid or silicone surrounding the implant (but contained within the capsule) from leaking into your breast tissue.
After the implant and capsule have been removed, they will be replaced by the new implants. This may involve changing the position of the implants from on top of the muscle (sub-glandular) to beneath the muscle (sub-pectoral) or vice versa. From here, internal sutures are often used to help reshape the breasts and hold the new implants in place.
What is the recovery like?
Most patients leave the hospital on the day of their surgery. For the first 2 to 3 weeks you should take it easy, with no strenuous exercise or activity. After this time, you should be capable of returning to work. However, we recommend you wait another 3 weeks before recommencing exercise.
What are the risks of Breast Implant Replacement Surgery?
Like any major surgery, breast implant replacement surgery poses a risk of bleeding, infection and an adverse reaction to anaesthesia. Other potential complications will be discussed at your consultation, these include:
- Unfavourable scarring
- Poor healing of incisions
- Changes in nipple or breast sensation (temporary or permanent)
- Wrinkling of the skin over the implant
- Seroma (fluid accumulation under the skin or around the implant)
- Capsular contracture
- Implant leakage or rupture
Keep in mind there’s a lot to consider when deciding whether or not to undergo surgery. The most important decision you make is what surgeon you choose to operate on you. To ensure you’re in good hands, you must choose an ASAPS member. ASAPS members are fully qualified Specialist Plastic Surgeons from Australia and New Zealand who are Fellows of the Royal Australasian College of Surgeons (FRACS). Ask your surgeon about their qualifications. If you believe you are a suitable candidate for Breast Implant Replacement surgery, book your consultation appointment by calling 5598 0988 or email firstname.lastname@example.org.