Breast Implant Revision - Breast Implant Removal
Breast Implant Removal is usually the first step for Breast Implant Replacement, but sometimes immediately replacing the Breast Implant is unwise or undesired. Breast Implant Infection or Exposure is an indication for removing a Breast Implant and not immediately replacing it. The infected or exposed breast implant is removed and left out to allow time for the body to heal. This may be temporary, in anticipation of later replacing the Breast Implant, or permanent if there is no desire to replace the breast implants.
The decision to have Breast Augmentation is a personal one, as is Breast Implant Removal. There are times when a woman wants her Breast Implants permanently removed. If you no longer desire the fullness of Breast Augmentation, the Breast Implants can easily be removed. Your breasts may be stretched out by the implants, especially if the Breast Implants are large, and have been in place for a long time. Sometimes a Breast Lift may be indicated to remove the loose skin and sagging.
Breast Implants are sometimes temporarily removed during pregnancy to reduce volume and stretch of the breasts during lactation. The implants are also temporarily removed for specific types of adjuvant breast cancer treatments like brachytherapy and heated chemotherapy.
Breast Implant Removal without Breast Implant Replacement is rare; however, there are times when Breast Implant Removal is desired. The reasons for Breast Implant Removal vary widely. Sometimes a medical condition requires it, but often it is a voluntary decision, made after much thought and introspection. For example, breasts sometimes enlarge with age, making the additional volume of the Breast Implant no longer necessary. This is one reason why Breast Augmentation should be delayed until breast growth is stable, especially in younger patients. Here are a few of the more common scenarios:
While severe complications of Breast Implants are rare, Breast Implant Removal for serious complications associated with Breast Implant Infections and Breast Implant Exposure may require at least temporary removal of the Breast Implants. These types of complications are more common with Breast Reconstruction, because the normal anatomy and circulation are disrupted by the Breast Cancer curing mastectomy. Breast Implant removal itself is uncommon, but a significant percentage of explantations are for Breast Implant complications.
Breast Implants placed at a younger age need to last longer, but unlike the human body, Breast Implants do not change size or shape with time. In general, Breast Implants placed at a younger age tend to be larger. While the volume of an intact Breast Implant will remain constant, the breasts themselves may enlarge. This can be due to the natural changes that occur with aging, or breast enlargement may occur as a component of generalized weight gain. If the breast become too large, symptoms may develop, similar to those seen in women seeking Breast Reduction Surgery. While Breast Implant Replacement with smaller Breast Implants is often the best plan, in some cases, removing the Breast Implant entirely is the best option.
Another time when breasts enlarge is during pregnancy. It is important to mention, there is no contraindication to breast feeding after Breast Augmentation with all currently FDA approved Breast Implants. Breast feeding recommendations are the same as for women with and without Breast Implants. While not required, some women feel more comfortable having their Breast Implants Removed before becoming pregnant to decrease skin stretching. This may or may not help, and no large randomized studies are available on the subject.
Breast can also enlarge with menopause. Some women become uncomfortable with the size of there breasts at this time, and desire Breast Implant Removal. The combination of Breast Implant removal and a Breast Lift may be more desirable in this situation, as the breast skin loses some of its elasticity and ability to recoil at menopause. More information about Breast Implant Removal and Breast Lifts is available below.
Sometimes the desire to have larger breasts goes away. Many who present for Breast Implant Removal do not regret having Breast Augmentation, and explain that they are done enjoying their larger size, and simply want to be smaller again. Other times, Breast Augmentation just never feels right, and a small number of women frankly regret their decision to get Breast Implants in the first place. Fortunately, Breast Implants can be removed much more simply than they can be inserted.
Breast implants are often used for Breast Reconstruction. Unfortunately, as a group, Breast Reconstruction patients have more complications with Breast Implants than cosmetic Breast Augmentation patients. The injury from a mastectomy with Breast Reconstruction is much greater than the injury from creating a pocket for the Breast Implant as is done during a simple Breast Augmentation. Often, the treatment of breast cancer requires radiation to decrease the risk of local recurrence of the breast tumor. Radiation increases many of the risks associated with Breast Implants including: Capsular Contracture (hardening of the breasts), Breast Implant Deflation, Breast Implant Infections and Breast Implant Exposure.
Reconstructed breasts tend to sit higher on the chest. Breast Lifts are often performed on the opposite side to enhance symmetry. When Breast Implants become encapsulated, the implant may feel firm and rise up on the chest. This can cause discomfort and difficultly in finding suitable clothing to hide the asymmetry. Breast Reconstruction surgery can be revised to try to soften and lower the implant. In difficult cases, some patients will instead opt to have the reconstructive breast implant removed and wear an external prosthesis.
Removal of a Breast Implant is technically simple, and has a relatively short recovery period. No matter the reason the Breast Implant is removed, the loss of volume may cause sagging (breast ptosis). A Breast Lift may be necessary to enhance the breasts' aesthetics. Sometimes, removing breast implants is more challenging psychologically than physically. In these cases, counseling may be helpful. With careful preoperative consultation, and perioperative care, most patients will do well after Breast Implant Removal.
Sometimes removing the Breast Implant is not enough. Much in the same way that Breast Reduction Surgery both removes volume from and lifts the breast, removal of a Breast Implant may benefit from a Breast Lift concurrently. Breast Implant Removal does not only decrease the volume of the breast. It also removes support from the breast skin. The result can be a deflated, empty mass of breast skin. Removing a significant volume from the breast can lead to the combination of too much skin and too little support, better known as sagging.
The medical term for Breast Sagging is Breast Ptosis, and the solution for Breast Ptosis is the Breast Lift. A Breast Lift is not always necessary, nor desired. Breast Ptosis is a naturally occurring phenomena, and does not strictly require correction. Whether to have a Breast Lift after Breast Implant Removal, is something that needs to be discussed with a Board Certified Plastic Surgeon that you trust.
As a general rule, the removal of smaller Breast Implants from larger breasts with firm skin is not likely to require a Breast Lift. On the other hand, removal of large Breast Implants from small breasts with loose, inelastic skin is more likely to need a Breast Lift for optimal cosmetic results. Another common option is to remove the Breast Implants as the first stage. After the breasts have healed, in 6 to 12 months, the shape of the breasts can be reevaluated for the necessity of a Breast Lift as a second stage.
Saline Breast Implants provide a unique opportunity during Breast Implant Removal. Saline Breast Implants can be deflated in the office with a needle and a small amount of local anesthetic. While the deflated Breast Implants still need to be removed, deflating the implants allows you and your Board Certified Plastic Surgeon to preview the breasts' shape without a Breast Lift. This is normally done shortly before the Breast Implant Removal surgery is scheduled to minimize the risk of an infection. If left in place too long, the empty Breast Implant will fold unpredictably, and may cause irregularities in the breast shape, discomfort and erosion of the Breast Implant shell through the skin causing Breast Implant Exposure, a surgical emergency. Because of this, not all Plastic Surgeons are comfortable with this method of treatment.
The decision to have your Breast Implants removed is a personal one. To schedule a consultation appointment, call us at (925) 943-6353. We are conveniently located in the San Francisco East Bay Area city of Walnut Creek, California, across the street from John Muir Medical Center's Walnut Creek campus. Alternatively, you can contact us through the form available in the margin above.