Breast Implants Removal

Breast Implants Removal

Once a breast implant is placed, fibrous scar tissue forms around it, creating a tissue capsule. Your own body forms a protective capsule like this around any object it recognizes as foreign. The tissue capsule is usually soft or slightly firm, not noticeable, and helps to keep the implant in place. In some women and usually over a prolonged period of time, a tissue capsule forms that is unusually hard and dense. The capsule tightens around and squeezes the implant and can be very uncomfortable. This condition, called capsular contracture, can cause pain and distortion in the shape of the breast, and it can make the breast rise higher on the chest.

Mentor medical, the company that produce the implants that Stuart uses have a lifetime guarantee if the implant ruptures, but this does not cover the development of capsular contracture, which is the number one reason why breast implants require removal.

Do not ignore symptoms in your breasts and if you are unsure if the problem is within the breast tissue or the implant always seek advice from your GP. If you do develop problems with your breast implants regardless of whether Stuart has placed them or not he will be happy to see you and examine your breasts and advise you of the best way to treat the problem.

Currently if you are experiencing pain or discomfort in your breast implants the NHS will consider removing the implants as this is considered to be affecting your health and well-being but the NHS will not replace new breast implants. This is information is accurate currently (June 2020) but it is likely that this funding may be removed in future, so you must always be financially prepared to pay for the removal of the implants in the future.

Breast implants removed is an operation performed under a general anaesthetic and may require an overnight stay in hospital. An incision is made in the old scar in the breast crease and the implant and the surrounding capsule is examined. There are then various surgical options available dependent on the findings. It must be made clear that it is not always possible to remove the capsule “en bloc” and this can only be determined at the time of the surgery.

  • Capsulectomy: During a capsulectomy, Stuart will remove the existing implant and the surrounding tissue capsule.
  • Open capsulotomy: During an open capsulotomy, Stuart will attempt to cut open the tissue capsule around the implant by making small incisions and may also remove some of the capsule. The goal is for the capsule to pop open, giving the implant more room to move around. The goal is for the capsule to pop open, giving the implant more room to move around. Regardless of the surgical approach a sample of the capsule and the surrounding fluid will be taken and examined under the microscope to exclude the presence of Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL).

BIA -ALCL is a very rare type of lymphoma which appears to affect women with breast implants. It is not a breast cancer itself but can form on the capsule that surrounds the implant. The incidence is not exactly known but is thought to be between 1:20,000 to 1:60,000 and I have never seen in case in my practice. For further information regarding BIA-ALCL go to www.baaps.co.uk or www.bapras.co.uk

Following Breast Implant Removal

You would expect a 24 hour stay in hospital and you will have dressings over the wound, which should stay in place for 10 days by which time the wounds should be healed, the dressings can be removed and you commence showering and going about your day to day activities.

Once the implants have been removed you will of course have lost some volume. Unfortunately, the deforming force of the implant over the breast is not symmetrical and you may have lost some breast volume and have some thin tissue around where the implant has sat. However, this may not be symmetrical and it may be different on one side compared to the other. Some of these changes will be permanent.

Occasionally altered sensation to the nipple and lower part of the breast can occur and occasionally there can be some sensitivity. Usually the wounds heal well and keeping them clean and dry reduces the risk of common complications such as infection, bleeding and wound healing problems. It is unlikely you will develop a collection in your breast although this can occur immediately following surgery. Occasionally the capsule can seal off and tissue fluid can accumulate within the space of the capsule and this may require aspiration with a needle and syringe under ultrasound control. This would be unlikely but has occurred once or twice in my practice, but usually following aspiration the capsule then closes off.

It would be unlikely you would develop other problems with the blood supply to the breasts leading to either death of the breast tissue or nipple. This has significant consequences and can ultimately cause significant scaring with volume and contour defects within the breast. I would say this has never occurred in my practice but you should be aware of it, it is a recognised complication.

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