One of the commonest operations performed by plastic surgeons today is breast explant surgery. This refers to the removal of breast implants. Many different types of breast implants have been used in Australia over the last 50 years and there are many reasons why women request breast explant surgery.
A consultation with a plastic surgeon is necessary to determine whether your implants should be removed and what, if any, surgery is required to reconstruct your breasts.
The more information that is available, the better the advice that can be provided. Your surgeon would like to know details about your breast implant:
• Who is the manufacturer?
• Is the implant silicone or saline filled?
• Is the implant wall smooth or textured?
• Is the implant in front or behind the pectoral muscle?
• Have you had any problems due to the implant e.g. rippling, malposition, asymmetry or hardening due to fibrous encapsulation of the implant?
• Do you have pain or swelling?
• Do you have symptoms of “Breast Implant Illness” including fatigue, allergies, muscle aches, joint pains, hair loss?
• Have you had a breast ultrasound (or even better an MRI) to determine whether the implant has ruptured and whether there is evidence of silicone leakage?
Smooth-walled saline implants placed behind the muscle usually have a lifespan of well over 20 years and do not need to be replaced unless they become symptomatic or harmlessly deflate.
Silicone implants all deteriorate over time. They gradually ooze silicone until ultimately the wall breaks down and the implant ruptures.
Textured silicone implants, especially when placed behind the pectoral muscle, are prone to rupture due to shearing forces.
Textured implants, especially those with a macro texture, have been associated with the development of ALCL (Anaplastic Large Cell Lymphoma), which is an indolent neoplastic disease of the capsule surrounding the implant. It presents usually as acute swelling of the breast and is diagnosed by the finding of certain cells on aspiration of the fluid.
Note that The Chief Medical Officer has advised that “All silicone gel implants are considered high risk medical devices”.
Once the decision has been made to remove your breast implants, then you must decide whether any further reconstructive surgery is required.
For some women, removing the implants alone is all that is required, as there is sufficient breast tissue to provide a reasonable breast size.
For others, additional volume may be desired and this can be best achieved by using your own fat as a fat graft.
For very large volumes another implant may be required. In these cases we would favour a smooth-walled saline implant inserted under the muscle because of its unsurpassed safety record.
A fat graft (known as Autologous Fat Transfer) involves harvesting fat from the hips, thighs or abdomen and, following preparation, grafting the fat directly into the fat of your breast tissue to augment your breast. At Avenue Plastic Surgery we have 5 years’ experience with this procedure and our special techniques ensure graft survival and adequate volume augmentation after only 1 procedure.
Some women have experienced significant sagging of their breasts and in this situation a breast lift is required. A breast lift is a very powerful method of reconstruction as it tightens the breast skin and moves the existing breast tissue and nipple upwards to provide a more youthful looking breast. Fat Transfer is often used to augment the results of a breast lift with fat being placed especially in the cleavage and upper pole.
Breast explant surgery is a specialised area of plastic surgery so it is important to ensure that your chosen specialist is familiar with the procedure and all the associated options. At Avenue Plastic Surgery we have extensive experience in guiding women through their decision process and performing the surgery as a Day Case. Our patients benefit from our exclusive Fat Graft Growth Program and our Silicone Detox Program. Please contact us for further information.
Breast Explant and reconstruction by Autologous Fat Transfer