Breast implant replacement

WHEN IS IT APPROPRIATE TO UNDERGO BREAST IMPLANT REPLACEMENT SURGERY?

Modern breast implants, used for breast reshaping operations, have an excellent quality, as they are made of a cohesive, i.e. compact gel, which guarantees absolute stability. Previously, implants consisted instead of a liquid gel that, in the event of a rupture of the medical device, resulted in a complete emptying of its contents. Although they last much longer than in the past, they are not indefinite, which is why it is necessary to undergo periodic checks in order to assess any problems of consistency (contracture), damage (rupture), infection of the implants or, finally, problems related to a disease of the mammary gland (breast cancer), for which a reoperation may be necessary.

PRE-SURGERY ASSESSMENT

In all women it is recommended to start breast cancer screening at 30-35 years of age by annual breast ultrasound, and from 40 years of age also by mammography. In women of any age who have breast implants, annual breast ultrasound is recommended to assess the condition of the implants. In cases where there is a suspicion of a breast disorder or an altered shape is detected, a breast ultrasound should be performed. The specialist will assess whether this will be sufficient or will prescribe a completion of the investigation up to MRI, which is the most suitable diagnostic examination to correctly assess the state of the implants in the presence of an ultrasound suspicion.

When a prosthesis rupture is suspected, it is important to consult your surgeon, if possible, or an experienced plastic surgeon in order to plan prosthesis replacement surgery.

THE BREAST IMPLANT REPLACEMENT

Implant replacement surgery, also called secondary or revision mastoplasty, is generally performed under general anaesthesia. In cases where the procedure is minimal, since only the implants need to be replaced and the patient's clinical picture is optimal, it can be performed under local anaesthesia with sedation, on an outpatient basis.
The duration of the procedure can vary from 30 minutes, in the simplest cases, up to 2 hours, if the procedure requires the removal of the capsule, change of plan and mastopexy.

The simplest technique is to replace the prosthesis using the same scar from the previous operation and can be performed when the same or increased volume is required. In cases where, on the other hand, the patient desires smaller implants, it is necessary to resize the pocket or remove the external skin around the areola (mastopexy, round block), or to operate with the classic 'inverted T' scar.

THE POST-OPERATIVE

Approximately 10 days after surgery, work activities can be resumed, if office work is involved, while for tasks requiring exertion with the arms, at least one month must pass. Furthermore, you may neither smoke nor expose your skin to the sun during this period, in order to facilitate wound healing.
Drains are not normally used, but if the operation is more investigative and the risk of bleeding greater, as after a capsulectomy, they may be necessary. Drains are usually removed after one day and a supportive bra will be worn, both day and night, for at least one month.

About two weeks after the operation, wound healing takes place and, as far as the absolute stabilisation of the result is concerned, this takes at least six months, since, initially, the appearance of the breasts is swollen and only between the sixth and twelfth month can the definitive result be outlined.

FAQ

Is breast implant replacement surgery permanent?

The operation is definitive. It should be borne in mind, however, that the results will vary depending on the patient's starting conditions. In cases where the patient's tissues prove to be particularly thin or damaged, due to significant weight loss or previous surgery, it may be useful to perform lipofilling surgery at a distance, which makes it possible to increase the thickness of the skin covering the prosthesis and restore harmonious contours to the breast. Unfortunately, nothing excludes, in cases of capsular contracture, that this phenomenon may recur.

What are the side effects and risks/complications?

In the early postoperative period, bruising and small bruises may occur. If there is a greater risk of postoperative bleeding, such as when a capsulectomy is performed, blood collection is prevented by the placement of drains.
Risks, on the other hand, may include altered nipple sensitivity, possible side reactions to anaesthesia, blood clots, or infections prevented by post-operative home antibiotic therapy. For this reason, as with any surgery, it is essential to always rely on professionals who are able to carry out an accurate pre-operative assessment and follow the surgeon's instructions post-operatively, especially with regard to lifestyle and reducing smoking, since cigarette consumption delays the healing process and increases the risk of complications.

What problems cannot be solved with breast implant replacement surgery?

Recurrent contractures require the removal of the implant. In some patients, albeit rarely, pain syndromes from sensory nerve injuries occur so that the presence of the implants is no longer bearable. At the same time, it may occur that in elderly patients the prostheses are perceived as a burden as a result of the anatomical change in their musculature.

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