In a perfect world, your breast implants would last for the rest of your life. Unfortunately, very few things in life last forever, and breast implants are no exception. Like most other medical devices, breast implants eventually wear out over time and will need to be replaced. The good news is that modern advances in breast implant technology allow you to enjoy your beautiful breast augmentation results for a very long time.
If you feel that it is time to replace your breast implants, it is important to work with a plastic surgeon who has extensive experience performing breast implant revision/replacement procedures. There are significant differences between an initial breast augmentation procedure and a revision procedure, and your surgeon must have the skill set to handle the unique challenges associated with breast implant replacement. However, in your initial investigation you may have called to other offices and found that there are many other surgeons, even Board Certified, that do not like to work on patients with previous implants unless they did the original surgery. There are several reasons for this. Many times, revision breast surgery can be the most challenging because of changes in scar tissue, native breast tissue or in the implant itself. Records can be lost and so there is no information to go on when planning the next surgery. Some patients have had a series of bad luck or bad outcomes that make them very anxious and hesitant to seek out help. And financially too, patients have already spent money on their breasts and now feel somewhat unnerved at the thought of having to now spend more! For all of these reasons, it is crucial to find a surgeon who performs these types of procedures on an almost daily basis! As with almost all medical specialties, making the correct diagnosis is critical. Without it, the correct solution is merely a guess and Dr. Corey relies on years of experience and volume to make that all-so-important diagnosis.
Scottsdale breast surgeon Dr. John Corey is board-certified by the American Board of Plastic Surgery and has more than two decades of experience performing breast implant revision and replacement procedures. The best way to learn about your implant replacement options is to speak with him in person. It helps as well to bring in as much information as you can from your previous surgeries. Please call 480-767-7700 or contact John J. Corey, MD online to schedule a consultation. We welcome breast implant revision patients from Phoenix, Chandler, and all surrounding areas of Arizona.
Common Reasons for Breast Implant Revision/Replacement
Dr. Corey usually sees changes in one of 3 areas that may lead to a Breast Implant revision. First, it may be the implant that needs replacing. Second, it may be the surrounding capsule of the body's own scar tissue that needs adjustment. And lastly, it may be the breast tissue that has changed and is in need of lifting or tightening. It may be one of these things or it can be all three!!!
Regarding implants, breast implant technology is always evolving and improving. As a result, we expect to see a continued increase in the lifespan of breast implants over the next few years. Currently, it is common for breast implants to last 15 years or more. However, there are a variety of reasons why you may choose to replace your breast implants, including:
- Breast implant rupture – Saline breast implants deflate when they rupture, which can cause breast asymmetry. Because most of the time with these types of implants, when they deflate...they REALLY deflate and essentially disappear. When this happens, the surrounding capsule of scar tissue starts to shrink down as well and can become more difficult to surgically manage and lead to a more difficult recovery. Dr. Corey will work to schedule your appointment quickly so that you can restore your appearance as soon as possible. A rupture will not be as noticeable with silicone breast implants since they do not deflate. Therefore, Dr. Corey recommends going for an MRI periodically to ensure your silicone implant hasn't ruptured. Unllike with saline implants, there usually is not the "urgency" that we see with saline. When some of the older type of silicone implants (1970's and early 1980's) are ruptured, Dr. Corey is well versed at the removal of this less cohesive and more "syrupy" type of silicone gel.
- Desire for a different style or size of implant – This is one of the most common reasons for implant replacement. Many women eventually desire a change in implant size, either up or down and maybe even a change in the shape of their breasts, which many times can be achieved with just a change in breast implant. Many women had breast implants placed back when saline filled implants were the only option available to them and now, years later they are beginning to see wrinkling or rippling from their saline implants. They may now want to change to a silicone product to help reduce this, using one of the many form stable products.
CAPSULE / SCAR TISSUE
The capsule is simply a sac of your own scar tissue that your body forms when it recognizes that this breast implant is not you! Think of it as a ziplock bag that completely surrounds your implant. Most of the time, this is a very thin, smooth and soft structure that again, is made from your own body and is NOT part of the implant. But changes can happen that are noticed by the patient and at times, it is this change in the capsule of tissue that can be the most challenging and difficult to correct.
- Capsular contracture – Some patients develop a contraction in this tissue that can become very noticeable or painful. The breast can become very hard, making the simple act of hugging uncomfortable or awkward. Often times, the capsule can be softened by a procedure that makes cuts in the wall of the capsule, called capsulotomy and allows it to soften or stretch back out. In severe cases, mere cuts in the capsule are not enough and complete removal is required, called casulectomy, and this is a much more aggressive form of treatment.
- Capsule malposition – In this instance, the capsule is not necessarily hard but is just holding the implant in a position that is not giving the breast the optimum shape. The implant can be held too high, too wide, too low, or in the case of symastia, too close together and there are different treatments for these as well. Capsulotomy can be one way to get an implant to move but one of the more difficult things to treat is when a capsule is holding the implant too low. It can be a challenge to get an implant to go against gravity and stay uphill. A procedure called capsulorrhaphy can be used in most cases to suture the capsule closed in the area where we do not want the implant to be. Dr. Corey believes that strict compliance is essential in getting the desired outcome and that can be up to 12 weeks in a particular supportive bra and activity restrictions as well. At other times a tissue matrix needs to be brought in such as Strattice or SERI which acts like a hammock of support.
- Sagging or drooping over time – Most women are satisfied with their initial breast augmentation results, but over time you may develop issues such as sagging which can change the way your breasts look. Your capsule may be holding the implant in a great position but instead, your own natural breast tissue has dropped off the end of the implant, giving a very low and droopy look to your nipple. It is the corrective lifting of the tissue where Dr. Corey relies heavily on hybrid techniques learned during his training both in the United States and Brazil.
If you begin to experience any pain or discomfort around your breast implants or if you notice undesirable changes in appearance of your implanted breasts, we encourage you to call our Scottsdale plastic surgery center to schedule a consultation with our Dr. Corey and learn more about your breast implant revision and replacement options.
There are a number of reasons you may wish to consider breast implant revision surgery. Aesthetic imperfections are certainly among the top motivating factors, but so too are issues of comfort and health. While rare, breast augmentation complications can occur on occasion. Unfortunately we are seeing some of these complications as we see more and more non- Plastic Surgery Board Certified physicians performing aesthetic surgery without the proper training and experience. In many States, it is not illegal for ANY type of physician to perform cosmetic surgical procedures in the confines of their own office or clinic. Many of these practitioners only have a few operations that they feel comfortable with and then try and apply them to every situation. This approach can lead to patient's being very dissatisfied with their result and even worse, a surgical complication. You may want to consider breast implant replacement if you experience one of the following complications:
If you begin to experience any pain or discomfort around your breast implants or if you notice changes to their appearance, we encourage you to call our Scottsdale plastic surgery center to schedule a consultation with our Dr. Corey and learn more about your breast implant revision and replacement options.
Saline Breast Implant Removal without Invasive Surgery
Dr. Corey removes saline breast implants with local anesthesia alone, at our state-of-the-art plastic surgery practice. General anesthesia and the operating room are unnecessary. Saline fluid is easily drained from these breast implants, which makes their removal simple and painless. You also avoid the expense of undergoing surgery.
Breast Implant Revision Candidates
To be a good candidate for breast augmentation revision surgery, you must be in generally good health. As with your initial breast implant placement, good health includes being a nonsmoker. If you are a smoker, you will need to quit at least six weeks in advance of your procedure.
In addition to being a healthy nonsmoker, good candidates for breast implant revision should be:
- Prepared for a surgical procedure
- Able to take time off for recovery
- Willing to follow Dr. Corey’s pre and postoperative instructions
- Aware of all potential risks and complications
Dr. Corey will take time during your breast revision consultation to answer any questions you may have about the procedure including recovery time and surgical preparation. He will also discuss your desires and goals, and help you better understand what this procedure can help you accomplish. If you are not a good candidate for revision surgery, Dr. Corey will be happy to provide you with alternative options or work with you to determine what will be necessary to increase your chances of a successful and rewarding procedure.