We know through experience that the decision to undergo breast implant replacement is generally preceded by a long decision making process. With this information we would like to help you with this process, by advising you about the procedure itself and the possibilities and risks involved in this operation. This advice, does not however, replace the need for an extensive personal consultation with your surgeon who will thoroughly address your specific questions.
When is a breast implant replacement necessary?
What is the aim of a breast implant replacement?
What do I have to consider before a breast implant replacement (pre-operative phase)?
What do I have to consider after a breast implant replacement (post-operative phase)?
When can I resume normal activities?
What are the possible risks with a breast implant replacement?
Which result can I expect after a breast implant replacement and what are the chances of success?
There are many different reasons that can make breast implant replacement necessary. A change of implant is necessary if there is distinct capsular fibrosis or if the implants have been in the chest for a very long time. Other reasons for replacement would be when a mammography shows a change in the outer layer or a rupture of the implant and there should also be an implant replacement when there is an infection or a danger of perforation.
Further indications are the wish of a different size implant or a subluxation (slipped implant).
The aim of a breast implant replacement is to exchange the existing silicone implant with a new one.
Procedure. In general, entry is made in the inframammary fold. If there is already a scar present from the previous operation then entry can be made through the same scar. Only in exceptional cases, are other approaches made via the axilla or areola.
If the capsular, which has developed around the implant, is highly advanced then it must be removed in part or as a whole during surgery. In some cases it is possible to remove the implant with the capsular together and in rare cases it maybe that the implant is removed separately to the capsular. It is also possible that during surgery the outer layer of the implant can be damaged.
The new implant can usually be placed in the same implant cavity, but in some cases the implant needs to be placed in a new cavity which can be either in front or behind the breast muscle.
In order to drain off any fluid and to significantly reduce the risk of capsular fibrosis a drain is inserted. Afterwards the incision is closed using fine stitches, dressed and then a compression bra is put on.
Additionally, in the case of sagging breasts, a breast uplift operation can be performed at the same time. Hereby, the amount of skin is reduced and the nipples placed in a higher position.
Types of implants: The breast implants used consist of a cohesive silicone filling that feels like natural breast tissue. The covering of the implant is also made of silicone, which either has a textured (rough) or a smooth surface. Furthermore, the implants differ through their various forms. There are three-dimensional anatomical implants, which have a teardrop shape as well as round implants in a variety of profiles and projections.
Type of anaesthesia. This procedure is usually carried out under general anaesthetic.
On the day of the operation please do not use any oily shower or bathing products but normal soap or shower gel and your skin should not be moisturised. Shaving of the armpit hair is necessary and after surgery, a special compression bra has to be worn, which can, prior to the operation be measured and fitted by us and then ordered for you. Information on general measures and the necessary preliminary examinations will be put together for you personally in a pamphlet which you will receive at your consultation.
For a few days after the procedure a dressing is to be worn, followed by a compression bra. Bruising, swelling or a feeling of tension regularly occurs after surgery but these changes should not worry you and should disappear within a few days. After the surgery the risk of thrombosis is higher and therefore it is necessary to take a thrombosis prophylaxis for the next 5 to 10 days. The drain is usually removed between the 2nd and 7th day after the operation and depending on the technique; the stitches can be removed between 7 and 14 days after surgery. Showering and bathing is only allowed once the stitches have been removed. A loss of sensation of the breasts and the nipples can be present for several weeks and usually returns to normal. A residual swelling can, to a lesser extent be present for several weeks.
Recovery. Exercises which may lead to vibrations in the breasts (e.g. horse riding, running, aerobics etc.) are possible, at the earliest, 6 weeks after surgery with the aid of a compression bra. Sports that involve the chest muscles may be done at the earliest 3 months after surgery. Heat from external sources (such as a sauna) should be avoided for 2 months and sunbathing and the use of tanning beds are only possible after the scars have completely healed and after all bruising has faded away.
No procedure is without risk. The general risks of surgery include the possibility of bleeding, thrombosis and infection. Specific risks associated with breast implant replacement include the possible displacement of the implant, the occurrence of capsular fibrosis and a change of sensation in the breast.
Enhancement of femininity. Through a breast implant replacement it is possible to achieve a natural and well formed breast which corresponds to a personal and distinct aesthetic feel. Depending on the initial situation breast implant replacement surgery can be a slightly bigger procedure than the first operation. The final result can be assessed after approximately 2-3 months.