Explant (breast implant removal)

Women who opt for breast augmentation (breast enlargement) with implants may not be happy with the results for a number of reasons. The implant size, shape and/or placement may be problematic, or postsurgical complications, such as leaking, wrinkling, implant displacement, capsular contracture or symmastia (the implants drift together and meet in the middle of the chest), may have occurred. Although considered safe, revision surgery to correct problems with breast implants may be more complicated, cost more and take longer to recover from than the initial surgery.

Video courtesy of Dr. Rohrich of the Plastic and Reconstructive Surgery Journal. Tanna, Neil M.D., M.B.A.; Calobrace, M. Bradley M.D.; Clemens, Mark W. M.D.; Hammond, Dennis C. M.D.; Nahabedian, Maurice Y. M.D.; Rohrich, Rod J. M.D.; Zhang, Ben H. B.A.; Bregman, Dana M.D.; Perry, Adam D. M.D. Not All Breast Explants Are Equal: Contemporary Strategies in Breast Explantation Surgery, Plastic and Reconstructive Surgery: April 2021 - Volume 147 - Issue 4 - p 808-818
doi: 10.1097/PRS.0000000000007784

Reasons for Breast-Implant Revision Surgery

After undergoing breast augmentation with implants, women who become pregnant, or lose significant amounts of weight, may no longer be happy with how their breasts look, and decide to undergo revision surgery. Other reasons for breast implant revision surgery include those below.

Unhappiness with Size of Implants Chosen

Wanting a different implant size is the most common reason that a patient seeks revision surgery. A patient is advised to wait up to 1 year after the initial procedure before undergoing revision surgery; time is needed before swelling subsides and the implants settle, allowing for a true evaluation of the surgical outcome. Exceptions are when there is a pronounced asymmetry between the breasts, or the implant has leaked or ruptured.

During revision surgery, the incisions made during the initial surgery are often used to remove the implants and replace them with either larger or smaller ones. If larger implants are desired, the pockets in the breasts that hold the implants are made larger. If smaller implants are wanted, the pockets are made smaller using sutures; a mastopexy (breast lift) may also be performed.

Implants Are Leaking

Implants can leak because of age or defect to the inplant itself or injury to the breast. Whatever the reason, a leaking implant should be replaced as soon as possible. The incisions made during the initial surgery are often used when replacing the implant.

A leak to a saline implant is immediately noticeable; the implant deflates and the saline is absorbed by the body. When there is a leak in the types of silicone implants used today, because the silicone is designed to hold its shape, leaks are often only discovered during routine mammograms.

Implants Are Causing Pain or Other Complications

There is always a risk complications from a breast-implant procedure. They include wrinkling and rippling of the implant (usually a saline implant); capsular contracture (which can be painful), in which scar tissue forms around the implant, hardening the breast and changing its look and feel; and symmastia, in which the implants drift together and meet in the middle of the chest.

Even when breast-implant revision surgeries are successful, new implants are still subject to the same problems as the original implants.

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