Breast Revision Surgery / Implant Removal

What is breast reconstruction?

Breast enlargement is a very popular cosmetic procedure among women around the world. Most women are extremely happy with the results of their breast augmentation surgery; however, some women may not be completely satisfied with the outcome or might wish to adjust the size.

There are also instances in which problems may arise following breast enlargement with implants. These include deflated or ruptured breast implants, capsular contracture, implant malposition or a combination of issues. Breast revision surgery is the removal or exchange of breast implants, which may sometimes be combined with a breast lift procedure.

Fast Facts:

Length of procedure: 1,5 – 3 hours depending on the type of procedure.
Type of anaesthesia: General anaesthetic.
Length of stay: Overnight
What to expect post-op: You may have difficulty lifting your arms above your shoulders in the first few days, and you will need to wear a supportive post-surgical bra for 6 weeks post-surgery.
Recovery time: You should be able to drive after ten days and return to work after approximately 1 week. Avoid strenuous activity for 1 month.
Results: Final results are seen after about 6 months and will persist, but may be affected by significant variations in weight, gravity, pregnancy and the natural ageing process.

Breast revision surgery or breast implant removal may be considered in the following circumstances:

  • A desire for larger (or smaller) breast size: Women who have previously had breast augmentation surgery, may after some time desire an increase in breast volume or cup size. This is a common reason for undergoing breast revision surgery. Some women may wish to decrease their breast size through implant removal or exchange for a smaller implant.
  • Breast Implant Rupture or Leak: Sometimes breast implants might leak or rupture. When this happens, they either need to be replaced or removed. A breast implant leak or rupture can occur as a result of the outer shell of the breast implant wearing down, tearing or breaking. When a silicone breast implant ruptures, it is often not noticed because there is no change in breast volume, size or shape. The rupture is often picked up on a routine mammogram or specific MRI or radiological evaluation in the event of a suspected rupture. When saline breast implants rupture, it is noticed immediately because the saline solution runs out of the silicone shell and is quickly absorbed by the body, resulting in a decrease in breast size. Breast revision surgery, allows the old leaking breast implant to be removed and replaced with a new one.
  • Capsular Contracture: When a breast implant is inserted, a thin pocket of scar tissue forms around it as part of the natural healing process; this pocket is called a capsule. The capsule may sometimes thicken and tighten around the implant leading to compression of the breast implant and the appearance of a distorted breast shape. The goal of breast revision surgery is to release the capsule (capsulotomy) or remove the capsule (capsulectomy) and to replace the breast implant with a new one (breast implant exchange), in order to help restore a more symmetric, attractive appearance and a youthful contour.
  • Breast Implant Malposition: Breast implant malposition is a situation that arises where there is a noticeable asymmetry of the breasts and their fullness. Both breast implants may have been placed either too high or too low on the chest wall, or the position may have shifted over time. Sometimes one breast implant appears to be at a different level than the other, or there might be a double-bubble deformity or one breast implant might have ‘flipped’. Sometimes breast implant malposition may be due to a pre-existing asymmetry of the breast position where one is higher than the other, or it might develop as a result of trauma.

    Breast revision surgery may be required to reposition one or both of the breast implants and/or repair any disrupted structures. The type of breast revision surgery will depend on the type of breast implant malposition at presentation.
  • ‘Old Implants’: Patients often ask if they need to replace their breast implants every 10 years. Previously, it was advised that patients should change their breast implants every 10- 15 years; however, this is not necessarily true, especially considering that newer generation breast implants are more robust. Breast implants only need to be exchanged if they are leaking, ruptured or causing other complications. Routine follow-up is important so that such complications can be picked up.
  • Breast Implant Illness: Breast Implant Illness, also known as Silicone Breast Implant Illness Syndrome, is an entity that currently has no clear definition or description. Breast implant illness is a term used by women with breast implants that self-identify and attribute a constellation of wide-ranging symptoms to their breast implants. These symptoms include fatigue, headaches, chronic pain, and a variety of neurological issues. It is a relatively rare condition given the number of women who have breast implants, but international literature suggests that up to half of the patients presenting with possible BII requesting explantation (removal) may experience an improvement of their symptoms.

    Silicone breast implants have been extensively studied with regard to their safety and associated outcomes, probably more so than any other medical device. Currently, the best available scientific literature does not show any conclusive or evidence-based studies or peer-reviewed data concerning this entity of “Breast/silicone implant illness", and at the time of this writing, the FDA does not recognise Breast Implant Illness as a diagnosis. Despite the lacking scientific evidence, as a plastic surgeon, Dr do Vale approaches such patients in a supportive manner because a substantial number may improve following surgical breast implant removal and capsulectomy.

Ultimately, the decision to obtain, keep, or remove breast implants is the choice of the patient. Dr do Vale will walk her through the process of surgery, the expected outcomes and all the risks and complications that could arise.

Recovery after Breast Revision Surgery:

Most patients will take about one week to recover before returning to work. It may take a few weeks for the incisions to fully heal and a good quality supportive post-surgical bra should be worn, day and night, during this period. No strenuous activity should be done during this time (approximately four to six weeks). Once the incisions have fully healed, you can resume your normal exercise routine. Dr do Vale will advise you on the most suitable scar management regimen to minimise the visibility of the scars.

For more information on Breast Revision Surgery or to find out if it’s the right procedure for you, request a consultation below or call 0109003999 to schedule your detailed consultation with Dr do Vale.