Procedures

Breast Implant Removal & Replacement Melbourne

Overview

With hundreds of thousands of women having had silicone breast implants  inserted over the last 50 years, removal of old and sometimes leaking silicone breast implants has become a common procedure. Many surgeons recommend that silicone breast implants be replaced every 10 years.

Some women choose to have their implants removed and replaced earlier if they have developed signs of silicone leakage, if the breasts have become hard due to fibrous capsular contracture or simply because they are not happy with their size – either too big or too small. Some women dislike the look of their breasts as silicone implants may be situated too high and look fake!

What are my options?

If you decide to have your implants removed, our breast surgeons can offer you a number of excellent options:

1. Implant removal without replacement Some women decide simply to have their old implants removed and for nothing more to be done. It’s important to note that the natural breast tissue would have been compressed by the implant and the ribs of the chest wall are usually indented due to pressure of the implant. Therefore, it may take some time before your breasts return to their normal size.

2. Implant removal and replacement Some women (including those who previously had very small breasts) choose to have their implants replaced following removal. In this case, we recommend a saline implant placed behind the pectoral muscle. The current generation of saline filled implants are extremely soft and long-lasting. This procedure can be performed at the same time as your implant removal and offers an excellent result with maximum safety. The greatest advantage of saline implants is that they give you peace of mind. Indeed, there is no doubt that saline implants are safer than traditional silicone implants.

At Avenue Plastic Surgery, we have inserted over 4000 saline implants over the last 20 years and have had only 4 unexplained leaks during this period. We therefore feel that it is reasonable to advise women to expect their saline breast implants to last at least 20 years.

3. Implant removal and augmentation via fat transfer Thanks to our expertise in breast surgery, we are now also able to offer our breast implant removal patients re-augmentation via fat transfer. Fat from other areas of your body (such as your hips, thighs and abdomen) can be harvested using a special form of liposuction and then, after preparation, injected into your breasts. Most women are able to achieve a 1-2 cup size increase, depending on the amount of fat available. Fat transfer is a wonderful, natural way both to enhance your bust and to lose excess fat from unwanted areas!

Leaking Implants and Capsular Contracture – how we can help

All silicone breast implants have a limited lifespan – the risk of rupture increases over time, with an estimated 10-15% rupturing by 10 years. A rupture may be present without any clinical signs of symptom – MRI is the best imaging method to detect rupture.

In the case of rupture, it is essential to have your leaking implants removed. The aim of surgery is to remove the implant and as much of the original silicone as possible. If the silicone has spread to other parts of the body such as the lymph glands in the arm pits, then a decision must be made as to whether further surgery to remove these glands is required. Sometimes a scar tissue capsule develops around the implant. This capsular can thicken, harden and even calcify.  In these cases, it may also be necessary to remove the capsule.

Total Capsulectomy

When and how is it done?

All breast implants become surrounded by a capsule of scar tissue, which is manufactured by the body and designed to form a barrier between the tissues of the body and the actual implant.  This capsule of scar tissue is often very thin and the implant slides around inside the capsule providing a natural looking movement to the breasts.  Occasionally however the capsule can become thickened and even calcified i.e. hard clumps of calcium tissue form inside the capsule.  This is usually seen when the implant is located in front of the muscle and when the implants have been in place for a long period of time.

In cases where the capsule is severely thickened (and perhaps also calcified) it may be advisable to remove the capsule at the time of implant removal.

The following photographs show one such thickened and calcified capsule being removed.

The first photograph shows the capsule as it looks from the outside.  A small incision has been made into the wall of the capsule and the silicone implant can be seen protruding from within.

The implant is then left in place while the capsule is dissected away from the surrounding breast tissue.  At about the halfway mark the implant is usually removed and traction applied to the capsule to allow it to be dissected free and removed.

Once the capsule has been removed it can be opened so that the extensive formation of calcium crystals can be clearly seen.

Some women are believed to suffer from “Breast Implant Associated Illness”.  This refers to symptoms such as muscle aches and pains, joint aches and pains, rashes, allergic conditions, hair loss, fatigue etc. that is believed, but not proven, to be caused by silicone breast implants.  It is possible that the silicone released by the implants can act as an adjuvant and trigger Auto Immune Disease.  For women who believe that they are suffering from this condition, it is understandable that they would like to have a total capsulectomy procedure.  It is important to realise however that if the implant is located behind the muscle the back wall of the capsule may be intensely adherent to the underlying rib cage and this may make removal of the entire capsule a risky procedure.

We have seen many women who have had severe breast deformities following total capsulectomy. For these women scar revision including Fat Grafting is often required.

In some cases, it may be advantageous to retain a thin non diseased capsule as it provides structural support for breast reconstruction, implant insertion or fat grafting.

At Avenue Plastic Surgery we have extensive experience in managing breast implant capsules and their problems.

*Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.