| BEM | Breast Implant Exchange With Uplift |
|---|---|
| Procedure | After breast implant surgery, scar tissue forms around the implant (=capsular contracture), which can cause discomfort and aesthetic concerns. This natural process happens after about 10-15 years. If the overlying tissues have become lax, implant replacement combined with a breast lift can improve the shape and size. 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. A breast lift (=mastopexy) removes skin, reshapes the breast and lifts the nipple area. The improvement is mainly in the central and lower breast areas. The implant gives fullness to the upper breast. 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 | Anchor shaped: Around & below areola & in breast fold |
| Operation time | 3 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 cones, Skin penetration, Wound separation, Slough, Necrosis (Nipple / skin / fat), 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, Inability to breastfeed, 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, Unfavourable nipple shape / position, 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, Bra Enhancers, Implant Removal and mastopexy, Fat transfer instead of implant replacement, Implant exchange or removal without mastopexy |
Anstey Hall
Maris Lane
Cambridge
CB2 9LN
