Procedure After breast implant surgery, scar tissue (=capsule) surrounding the implant can cause discomfort and cosmetic 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 cosmetic 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) or over the muscle (=subglandular). Teardrop shaped implants look more natural but can rotate. Rough implants last longer (=less capsular contracture) but have a small cancer risk (BIA–ALCL). Implants under the muscle last longer (=less capsular contracture) and look more natural but surgery takes longer and causes more bruising. Breast implants last 10–15 years in average.
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.
If the overlying tissues have become lax, implant replacement can be combined with a breast lift to improve the shape and size.
I don’t use drains routinely. The wounds are repaired with sutures under the skin which don’t 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 Cosmetic, 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, Cosmetic imperfections (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, Anaplastic Large Cell Lymphoma (BIA ALCL), Rippling, 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 and serious risks are rare
Risk factors Smoking / contraception / flights within 6 weeks of surgery, overweight, high blood pressure, bleeding tendency, 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

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