If an intact silicone implant needs to be removed or replaced and has not leaked the procedure is straightforward and similar to saline implant removal.
Using existing incisions the implant(s) can be removed, the pocket inspected, the capsule evaluated and the incisions closed again. It’s a quick outpatient procedure with a short recovery time.
If the implant is known to have leaked and/or there is a capsular contracture present the procedure is more involved. We can still utilize the existing incisions but usually need to extend them. We want to remove not only the implant but the capsule around it and this requires better access.
Our goal is to remove the implant, silicone, and the tissues that have been affected. In cases with significant tissue reaction, we will perform an “en-bloc” removal, taking out the implant and capsule as a single unit.
We always send a portion or the entire capsule to pathology for examination in all cases. These cases take longer and may have a longer recovery.
After the removal step, patients have several options:
- Leave the implants out. – This is the simplest but may leave the breasts looking small or deflated. Lowest cost, fastest recovery.
- Place new implants. – This will restore the breasts to their preoperative appearance. New silicone or saline implants can be placed.
- Perform a breast lift, with or without implants. – These can be more extensive procedures depending on the amount of breast tissue available and the amount of deflation or droop that has occurred over the years.
- Leave the implants out, decide later. – If you’re unsure about whether to proceed with new implants or a lift after removal you can simply have them removed, allow adequate time for the breast skin to contract, and then assess the final result. If you’re satisfied with the appearance, you’re done. If you then desire a breast lift or want new implants placed we can then move forward when you’re ready. Of course, it means another operation but allows you to be sure of your decision.
We have seen patients make all of these choices and have helped guide them through the decision process. Final desired appearance, recovery time, cost issues and other factors can all influence these decisions.
These consultations and the operations that follow can be challenging but we enjoy taking on these potentially complex cases.
Next: Insurance and implant warranties
