Breast Implant Replacement

Breast implants may be replaced for many reasons, but the patient has already decided that she wants to retain volume with implants.

The old implants may not be retaining a proper shape, be leaking or be too small or too large. Perhaps unluckily you need to remove implants that could do harm such as the ill fated PIP implants. (we never used these at the Cadogan Clinic).

Do you need to remove implants just because they have been there for 10 years or more? The answer is no. If you are happy with the appearance and they cause no trouble, then why fix it? However if you need to have some other procedure on the breasts after 10 years with implants, then you may take the opportunity to save yourself the possible trouble of another operation down the line.

You have a few decisions to make. What size do want to end up? Work out the consequences with the surgeon. It may not just be the implant volume as the shape will influence the appearance. Perhaps the breast tissue needs to be reduced or added to by fat grafting (fat transfer).

Breast tissue drooping around an implant looks peculiar. Perhaps the skin has stretched with age, pregnancy or weight loss. In this case, there is the choice of a larger implant, probably with a different shape or reduction of the skin ,tightened by a mastopexy (breast Lift). Think about the scars.

The other cause of breast deformity is the development of a capsule around the implant.This is something to be dealt with.

 All implants are walled off from the surrounding breat tissue, but with 2-10% of patients this wall becomes thickened with fibrous tissue, which contracts like a scar. There are degrees of contracture (Baker scale). With severerer contracure the breast becomes uncomfortable and the shape changes. Usually the implant rises up and appears as swelling above the nipple and the breast tissue hanging below (double bubble), but if the implant slips to th e bottom of a long breast it becomes a ‘cricket ball in a sock’.

Treatment of a capsule may be to release the tension by making relieving cuts in th capsule (capsulotomy). The very severe capsule will need patial removal of the capsule (capsulectomy).

The surgeon will usually suggest a different type of implant such as the polyurethane covered implant (Polytech), which has a much lower tendency to stimulate capsule formation.

There is plenty to work out with your sympathetic Cadogan Clinic Surgeon.

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Image of MR BRYAN MAYOU, FOUNDER

Of course, we use the very latest technology. But our real skill is in knowing how and when to use it to suit each individual patient.

MR BRYAN MAYOU, FOUNDER

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