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Brexplant

Wednesday, September 25, 2019

A new word for breast implant explant surgery!

This week I operated on 2 women who had breast implants inserted 20 years ago.  The first lady had her textured implants inserted in front of the muscle and needed to have them removed because of breast pain.  The pain was due to the development of thick fibrous capsules around the implants.  An en-bloc removal was performed of the capsule and the implant.

The following photograph shows the appearance of the heavily calcified capsule and an implant.

It is known that implants placed in front of the muscle are prone to a much higher degree of encapsulation.  This is believed to be due to the fact that the implants are in contact with the breast tissue, allowing bacteria from the breast to grow around the implant and stimulate the development of thick capsules.  In some women, these bacteria can trigger a disease called Anaplasitc Large Cell Lymphoma (ALCL) although fortunately this was not the case for this woman.

 

My second patient had smooth-walled silicone implants inserted behind the muscle.  In her case the proplem was that an ultrasound examination showed that the left implant was leaking.  This was found to be case during surgery when an intact right implant was removed but the left implant had totally disintegrated.  In this case the implants were surrounded by only a very thin capsule.  This is usually the case when implants are placed behind the muscle as the muscle protects the implants from the overlying breast so that bacteria from the breast glands do not have access to the implant where they could stimulate development of a thick capsule.

In both cases implant volume was restored by autologous fat transfer.  This involved harvesting fat from the abdomen and thighs and, following preparation, carefully grafting it into the breasts.

Fat grafting is now established as an all natural way to restore volume following removal of breast implants, or Brexplant surgery.

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