Introduction to Breast Implants Removal & Replacement

With the ageing of implants, more women are electing to have their implants replaced with new ones or removed entirely. The removal and replacement of implants or removal of breast implants without replacement is a safe operation with few to no complications and a rapid recovery. The duration of the operation is around an hour or so. You can expect mild to little pain after the procedure.

For breast implant replacement, patients can choose to use either silicone gel or saline implants regardless of the type of implant that was originally inserted. The new breast implants are likely to be in the same area as in the previous breast implants. Breast implants can also be removed with very little to zero deformity.

As with any operation, safety and the recovery period are of concerns to most patients. The replacement & removal of breast implants is a safe surgery that is usually done under anaesthesia or sedation. The patient’s vital signs are monitored by the anesthesiologist.

A long-acting local anaesthesia is placed into the previous scar to make the recovery more comfortable. Once the breast implant pocket is exposed, bimanual examination (fingers on the outside are pressed against fingers in the pocket) is done to detect tumours.

Usually, the old breast implant is removed and a new one placed into the same pocket. Often no further manipulation of the pocket is needed.

Post Breast Implant Replacement Surgery

Once in the recovery room, patients are monitored by the recovery room nurse. There is usually very little pain from this surgery, and even the incision is comfortable because of the long-acting local anaesthetic that has been placed. Patients prone to nausea from anaesthesia usually do well because all patients receive a scopolamine patch behind the ear. Medication is available for those who struggle with nausea.

The surgery for replacement or removal of breast implants usually takes about an hour or less and the time in the recovery room is usually two hours prior to discharge. Vital signs continue to be monitored during this time by the nursing staff.

It is best to wear loose-fitting clothes for the return trip home. Patients are advised to rest after the surgery and because of the anaesthetic not to drive for the first 24 hours. A caregiver must be present for the first 24 hours which adds to the safety of the surgery.

Complications From Breast Implants Removal or Replacement

Complications from removing and replacing breast implants or simply removing breast implants are practically unheard of. For the most part, the original breast implant pocket is unchanged making this a fairly easy operation with little discomfort. When the original breast implant pocket needs to be altered, even this carries with it a few complications.

Incision for Replacement of Breast Implant Surgery

Usually, the breast implant replacement incision is at the original incision location. You can expect the healing to be in a similar fashion to the previous augmentation mammaplasty The most common incision is in the mammary fold. When the saline implant is replaced by a silicone implant, the incision needs to be extended.

Over vs. under the muscle

Augmentation mammaplasty may be done above or below the pectoralis major muscle (“over’s” and “under’s”) with the use of saline or gel-filled implants. The location and the type of implant has an effect on how the breast implants feel and look. There is generally no timeline when implants need to be replaced except for the older Mentor “low bleed” gel implants of the 1980s with shells that were manufactured too thinly.

Since the early 1980’s most breast implant surgery is performed in the under the muscle, subpectoral location. Augmentation mammaplasty performed this way has been shown to have fewer complications. There are less bleeding and less potential deformity from capsular contracture using what is medically known as the subpectoral approach for breast enlargement surgery.

Saline vs. silicone breast implants

It is easy to make an exchange from saline breast implants to silicone implants, as it is also easy to remove silicone breast implants and exchange these for saline implants. The placement of silicone gel implants requires a larger incision than saline implants, but here too the incision can be expected to heal well.

The incision for silicone breast implants is usually in the submammary fold. Most patients requesting removal and replacement of implants tend to choose the silicone implants because of the more natural appearance and feel of these breast implants.

Augmentation mammaplasty with saline breast implants

There is no specific duration as to how long saline implants will last. With time one can expect a certain amount of wear and tear especially when wrinkling of the implant can be felt which can create areas of weakness of the breast implant leading to leakage.

Generally, when a saline breast implant fails, the entire implant deflates, and the patient becomes aware that one side has become smaller than the other. It is unusual to have both sides fail at the same time and also unusual for a partial deflation. Deflation is more common if the implants are underfilled because wrinkles are more likely to form leading to failure. This is the primary reason I like to overfill implants. When a patient needs replacement of one breast implant, it is generally best to replace both implants at the same time.

Larger breast implants can be used to replace the original smaller breast implants. Generally, the tissues take up quite nicely and patients are more comfortable with the smaller implants. For any of the exchanges, saline or gel-filled implants can be placed.

More and more women are opting for the gel-filled breast implants. They most resemble normal breast tissue and usually, the implants cannot be felt. This is in contrast to saline breast implants which feel more like a water-filled balloon. Nevertheless, there is a high rate of satisfaction with either type of breast implant.