Implant Replacement: Procedure Overview
- Some women with breast implants may need implants replaced years after the initial surgery. You may wish to replace your breast implants for reasons including:
- Hardening of the tissue around the implant and distortion of the breast (capsular contracture)
- Rupture or leakage of the implant
- Displacement of the implant into an abnormal position
- A desire to change the size of the implant
- Droopiness (ptosis) of the breast tissue overlying the implant
Sometimes replacing the implant alone may not completely correct the problem. At times other procedures, like removing the capsule around the implant or performing a breast lift or adjusting the implant pocket may be advisable.
Surgery and incisions - Surgery and incisions
- The surgery usually takes 1-2 hours to complete. If a breast lift is also performed an additional 60-90 minutes is required. Dr. Brown uses different types of implants and various procedures to insert the implants, depending on your desired results and anatomy. Dr. Brown will keep the incisions as minimal as possible, and the implants may be inserted in the armpit, the crease below the breast fold, or on the edge of the areola - the dark skin surrounding the nipple. The breast implant is placed in a pocket created either directly behind the breast tissue or underneath the pectoral muscle on the chest wall muscle. Each option has its own advantages and disadvantages, and Dr. Brown will discuss with you each procedure. Remember that if you are undergoing a combined breast lift-implant replacement, there will be additional scars related to the breast lift.
Dr. Brown performs most breast implant replacements in an outpatient setting or the in the office operating suite, under twilight or general anesthesia depending on your needs. He will discuss all options that are right for you during your consultation.
- In the initial consultation, Dr. Brown will begin by evaluating your health. Tell him if you smoke, and if you are taking any medications, vitamins, or other drugs, as these can affect the outcome of the surgery. Together, you will determine what size implants are best for you. In general, the larger the implant, the more unnatural it will appear. If your breasts are sagging, Dr. Brown may also recommend a breast lift. He will recommend specific procedures and implant types. Together you will decide which incisions and implants will give you the best result and also meet your expectations.
Preparing for surgery
- Tell Dr. Brown about any medical problems you have, and any problems you may have had with surgery in the past. A history of bleeding problems, nausea with surgery and high blood pressure are important to disclose to your surgeon, because these are risk factors for post-surgical bleeding. You will be told which medications to stop
and which to take before surgery. If you smoke, you will be asked to quit for a minimum of 4 weeks prior to surgery as well as 4 weeks after surgery. If you get sick or have any health issues in the days before surgery, please notify the office at once in case we have to postpone your operation.
Can I go home the day of the surgery?
- Yes, breast implant replacement can be done safely as an outpatient, and most patients will be able to go home the same day. Some patients may prefer to spend a night in the hospital if they have young children at home or live alone and do not have any help at home.
What about swelling and bruising?
- Swelling and bruising are normal signs of the healing process. Swelling peaks at about 48 hours, and then rapidly decreases. By the end of the first few weeks, 50% of the swelling is gone. During this early period, your breasts will appear larger than their final size due to the swelling. By 6-8 weeks, a majority of the swelling has diminished. By six months, almost all the swelling is gone. Any remaining swelling is almost not perceptible.
What restrictions are there?
- Generally, you can shower in 1-2 days after surgery, but you should not submerge incisions in the bath, hot-tub, or swimming pool for 2-3 weeks. The first day after surgery is usually spent lying in bed or sitting in a chair. Most patients then begin walking around the house the day after surgery. By the end of the first week, you will probably be ready to leave the house for short trips and light walks. Vigorous activities should not be performed until 6 weeks after surgery. Also, you shouldn't do any heavy lifting (over 10 pounds) during these 6 weeks.
These are only general guidelines, and Dr. Brown will give you more specific instructions at your consultation.
When can I travel?
- Traveling after surgery (air travel, long distance car trips, train rides, etc) should not be done before you have had your first postoperative visit. Typically, this occurs 5-7 days after surgery for suture removal. Patients who are at high risk for developing a blood clot should not travel until instructed by their surgeon. Short car trips under 60 minutes can be done before the first visit. A good rule of thumb is when you are off the stronger pain medication and can get up without assistance you are ready to go for a short drive. You should not drive the car yourself, however, until Dr. Brown gives you clearance for this.
What about mammograms?
- Routine screening mammograms should be continued after breast augmentation for women who are 40 years of age and older. If you are under 40 but are receiving annual mammograms because you are at high risk for breast cancer you should also continue to have annual screenings. While there is no evidence that breast implants cause breast cancer, they may change the way mammography is performed. When you request a routine mammogram, be sure to go to a radiology center where technicians are experienced in the special techniques required to obtain a reliable x-ray of the breast tissue. Scientific studies have not shown a higher risk of developing breast cancer or a lower survival rate from breast cancer in women who have breast implants.
What if I have a problem?
- When should I call the office? We always welcome calls from patients. If you have any concerns at any time, please feel free to contact our office
. If it is an emergency, the answering service is available 24 hours a day, including weekends and holidays.