Should You Consider A Breast implant revision?

Dr. Boudana understands that breast augmentation represents a considerable investment. Therefore, he wants patients to be reassured about the quality and lifespan of breast implants. There is a misconception that breast implants should be replaced every 10 years, when in fact women can theoretically live their entire lives with the same implants. In reality, breast implants should only be changed if there is a problem.

In addition, implant manufacturers are so confident in the longevity of their product that they offer a lifetime guarantee on implants. This means that in the rare case an implant ruptures, the manufacturer will provide a replacement implant at no charge.

You should also note that in the rare case of rupture, cohesive gel and saline implants are particularly safe. While implants used decades ago had higher risks of rupture, today’s implants are safer. If a rupture does occur, saline implants contain a saline solution that will be absorbed by the body, while the solid silicone in a cohesive gel implant will not leak.

There are several reasons to want to replace breast implants. With the high-quality of today’s breast implants and the stringent pre-marketing safety standards, patients usually want to replace implants for cosmetic reasons rather than because of rupture or deflation.

Fluctuations in weight, pregnancy, tissue aging, as well as gravity, can impact breast appearance. In this case, replacing implants and readjusting the capsule (capsulorraphy) may be required.

Sometimes, mastopexy (breast lift) is necessary to reposition the nipple and areola and lift the tissues, which can sag with time.

Some patients also choose to increase or decrease breast size after several years.

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Are you a good candidate for implant revision?

Though the need for breast implant revision surgery is rare when the original breast augmentation was performed by a well-trained and experienced surgeon, it can arise when a patient is unsatisfied with her results. Dr. Boudana’s goal is to create beautiful, natural-looking breasts with respect to your unique wishes, goals, and anatomy.

Complications that can be fixed with revision surgery include:
  • General dissatisfaction with breast augmentation results
  • Capsular contracture: This condition occurs when excessive scar tissue develops around the implants, causing the breasts to feel tight, firm, and uncomfortable and distorting their appearance
  • Implant rupture or leakage: Breast implants are designed to be durable and to stand up to lots of pressure, but they can occasionally break, leak, or rupture. In the case of saline implants, the harmless salt water filling is absorbed naturally by the body, but the affected breast is left with a deflated appearance. Today’s cohesive silicone implants do not lose their shape in the case of breakage, but they do need to be monitored with periodic MRI exams and require removal or replacement if they rupture.
  • Bottoming out: This occurs when an implant appears to migrate lower than its original placement due to stretching of the lower pole tissues, causing the implant to appear low and the nipple too high on the breast.
  • Implant malposition: This occurs when an implant migrates lower or off to one side than its original placement, causing the breasts to appear asymmetric or misshapen.
  • Rippling: When an implant ripples, it means that the surface texture of the implant is easily visible through the skin. Though rippling can happen with either saline or silicone implants, saline implants carry a slightly higher risk.
  • Asymmetry: This may be the result of pre-existing anatomic asymmetry or the result of misplacement at the time of the original surgery. In other cases, as time goes on, the weight of an implant can cause one breast to hang differently than the other.
  • Drooping: The breast tissues may droop over time due to aging, pregnancy, or weight change.
  • Saline to Silicone: Some women may wish to change their saline implants to silicone due to the more natural feel and appearance of silicone implants.
  • Size change: Some women may wish to change the size of their existing implants to better fit their wishes, goals, and anatomy.
  • Explantation: Some women may wish to have their breast implants removed/
  • Symmastia: This condition is also known as “uniboob,” when the breast implants appear to join in the midline. This may occur due to implant migration or misplacement at the time of the original procedure.

What are the procedure techniques and scars

Breast implant revision surgery (implant replacement) is usually done with an incision under the breast. The location of the incision will be discussed with Dr. Boudana during the consultation.

Anaesthesia and additional treatments

In some instances, breast implant replacement can be performed under local anaesthesia. For example, if the old implant is to be replaced with a larger one in a patient who does not require surgery or adjustments to the implant capsule or pocket, then local anaesthesia may be an option.

However, if a change in implant position is required, then the adjustment or modification of the pocket must be performed under general anaesthesia.

Additional procedures related to breast implant revision surgery may include capsulorraphy (raising the implant to obtain more contour), capsulectomy (removing the capsule around the implant), mastopexy (lifting the breast above the implant), or autologous fat injection (injecting fat around the implant to improve contour or shape).

These additional procedures will be discussed and proposed depending on your needs and expectations.

En bloc capsulectomy

En bloc capsulectomy is a procedure invented in France, which consists of removing the implant and the capsule at the same time (en bloc).

In practice, this procedure is rarely required, unless you have earlier-generation implants (made of liquid silicone) that have ruptured and where the silicone extrusion can be seen through medical imaging.

As today’s generation of implants are made of silicone gel, there is little risk that they will leak outside of the capsule.

En bloc capsulectomy is a highly precise procedure, requiring a surgeon experienced in the technique. Dr. Boudana has been performing this procedure for several years. He will be able to tell you whether you are a candidate for the surgery.

  • Anaesthesia:
    General/local
  • Duration:
    1 to 3 hours
  • Pain level:
    5/10
  • Recovery time:
    7 to 15 days
  • Resumption of physical activities:
    4 to 6 weeks

Why choose Dr. Boudana for your implant revision?

With close to a thousand successful breast revision surgeries under his belt, Dr. Boudana has developed a great deal of expertise in the field. He will be able to guide and advise you in achieving your goal.

Procedure details

Patients of Dr David Boudana can expect to be treated with a confidential and caring approach. Dr Boudana understands the importance of communication, and the consultation is an opportunity to establish your surgical goals. He may also offer additional or alternative treatments in some situations. The importance of a consultation with an expert, like Dr Boudana , cannot be understated, as there are many factors that should be considered prior to breast implant replacement surgery, including:

  • Shape and size of your breasts
  • Shape and size you desire
  • Your current breast implant type
  • Skin and breast tissue quality
  • Suitable placement of nipples and areolas

Once Dr Boudana fully understands your circumstances and your desires, he will be able to accurately determine the right technique.

The surgery is performed under general anaesthesia and lasts between 1 hour and 3 hours.

Following the operation, you will need someone to take you home and help and monitor you for the first 24 hours.

Once you are under anaesthesia, the skin of your breasts will be carefully cleaned with an antiseptic to prevent infection. This step is performed according to medical recommendations and standards. The procedure then begins with the removal of the implant with or without the capsule. For better visualization, the surgeon uses fibre optic instruments to create a lodge for the prosthesis.

The insertion of the new implant is done using the latest techniques, which have been proven to be effective in minimizing the risk of complications:

  • Protection of the nipples by an impermeable film preventing the spread of bacteria from the mammary glands;
  • Irrigation of the implant with an antibiotic or antiseptic solution before opening the implant package;
  • Washing of the prosthetic lodge with the antibiotic or antiseptic solution;
  • No touch technique: the implant is slipped into a specific pocket for insertion;
  • Multi-plane closure.
  • The use of an insertion pocket (Keller Funnel type) allows for a smaller incision, even for larger implants.

After the surgery, you will receive a personalized follow-up. Our nurses will also be available and will perform the first dressing change at our clinic, typically one week after surgery.

You will be given a postoperative instruction sheet when you are discharged as well as a prescription for pain medication.

All our follow-up appointments are free of charge for the first year after your surgery.

Results

Yes — a breast revision surgery can resolve whatever concerns that have developed from a woman’s original breast implants, whether from natural body changes or implant or surgical problems. Women can expect improved skin tone, less drooping and sagging, significantly improved breast shape, size and feel and better breast projection as discussed during their consultation.

Patients will have few if any additional scars since, wherever possible, Dr Boudana will use the original incision locations during surgery.

Results from a breast revision procedure can last many years, giving women the confidence and daily pleasure in their appearance they deserve.

Breast implant revision surgery
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** The photos and/or videos are not presented as a guarantee of result. The results may vary.
** Patients gave their consent for the publication of photos and/or videos.

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During your consultation, Dr. Boudana will take the time to address your specific goals and to discuss your treatment options. He will determine if you are a good candidate for implant revision surgery and review the results that can be realistically achieved. He will also help you determine which complementary procedures may benefit you the most.