| BIE | Exchange Of Breast Implants |
|---|---|
| Procedure | After breast implant surgery, scar tissue (=capsule) surrounding the implant can cause discomfort and aesthetic concerns. This natural process happens after about 10-15 years. Women over 50 or women with a strong family history of breast cancer should have a breast cancer screen prior to aesthetic surgery. Breast implants come in different volumes and projections (=profiles), can be round or teardrop-shaped (=anatomical / contoured), have a rough (=textured) or smooth surface and can be placed under the muscle (=dual plane / submuscular / subpectoral) or over the muscle (=subglandular / subfacial). Teardrop shaped implants look more natural but can rotate. Rough and smooth implants have a small cancer risk (BIA-ALCL, BIA-SCC). In rough implants this risk is higher, but they last longer with less capsular contracture, a more stable position and less "bottoming out". Implants under the muscle develop less capsular contracture and look more natural shortly after surgery, can but can result in a wider cleavage, a "breast animation deformity" or a "waterfall deformity" over time. Implants over the muscle can make the breasts droopier and be more visible under the skin. Breast implants last 10-15 years in average. To find the desired size, implant sizers can be used in clinic and the rice test can be used at home (= fill the mid-portions of old tights with a measured volume of rice, tie the ends, and conform these to the breasts in a bra – adjust volume as per preference). This can only determine the size difference if larger implants are required. Exchange surgery (=Implant replacement, exchange mammaplasty or mammoplasty) often requires the scar to be extended. The breast implant is removed with the surrounding scar tissue (=capsulectomy) where possible. The surgery is more complex than the original insertion of the implants. Histology testing of the capsule is mandatory in all suspicious cases and should be considered by patients in all other cases (Please let your surgeon know if you prefer testing). If the overlying tissues have become lax, implant replacement can be combined with a breast lift to improve the shape and size. I do not use drains routinely. The wounds are repaired with sutures under the skin which do not require removal and dissolve within four months. A support garment following surgery is recommended. |
| Scars | 5 - 10cm |
| Operation time | 2.5 hours |
| Anaesthesia | General |
| Hospital Stay | Day Surgery > (Overnight) |
| Benefits | Aesthetic, Psychological, Functional, Symptomatic |
| Risks | Bleeding, Infection, Scar problems (stretched, thick, abnormal pigmentation, red, retracted etc.), Skin discoloration, Skin penetration, Wound separation, Slough, Necrosis, Pain, Nerve injury (Numbness, weakness), Bruising, Swelling, Overcorrection, Undercorrection, Asymmetry, Remaining stretch marks, Recurrent redundancy / droopiness, Aesthetic imperfections (E.g. Waterfall deformity, breast animation deformity, bottoming out, wide cleavage, misplacement etc. Higher risk after subsequent pregnancies / weight changes / menopause), Seroma, Shoulder problems, Pneumothorax, Lung injury, Capsular contracture, Implant rupture or leak, silicone granuloma, lymphadenitis / displacement / rotation / extrusion, Rippling, In most patients, breast implants do not cause medical disease but there is a small risk of developing cancer (e.g. BIA-ALCL or BIA-SCC) and other not yet known diseases in future, Contour irregularities, Need for further surgery (including implant removal), Allergic reaction, Chest infection, Heart attack, Stroke, Blood clots in legs & lungs. N.B. Most complications are unlikely. Serious risks or death are rare |
| Risk factors | Smoking / contraception / flights within 6 weeks of surgery, overweight, high blood pressure, bleeding tendency (Stop herbal products or supplements for two weeks before surgery), diabetes |
| Optimising factors | Diet rich in Vitamin C and protein, plenty of fluids, fresh air, scar massage, sun protection, support garments, breast band and massage (only if advised by me) |
| Discomfort | 1 - 2 weeks |
| Bruising | 2 - 3 weeks |
| Recovery | Light activities 2 weeks, Driving 3 weeks, Physical work / sports / sex 6 weeks, Unrestricted 3 months |
| Acceptable appearance | 2 - 4 weeks for most patients (This is subjective) |
| Final result | 6 - 18 months |
| Alternatives | No Surgery, Garments, Implant removal only, Implant exchange with lift |
Anstey Hall
Maris Lane
Cambridge
CB2 9LN
