Every patient who undergoes breast prosthesis placement must be aware of a reality of which she is often unaware: it is almost certain that at some point in her life she will have to undergo breast surgery to replace her implants.
What are the reasons for reoperation?
- Prosthesis rupture
Breast implants, like practically any prosthesis implanted in the body, suffer a progressive deterioration that can lead to implant rupture. If a titanium prosthesis needs to be replaced… what makes you think that a prosthesis made of silicone and subjected to constant movement and friction will last forever?
There is no brand of prosthesis on the market that guarantees the impossibility of breakage, and hiding this reality from the patient is irresponsible, a lack of truthful information and fraud. There is no obligation to change the implants every certain period of time. Revisions and imaging studies should be performed to detect the rupture. When the rupture has occurred, the replacement surgery will be scheduled. According to some publications, up to 10% of the implants are broken 10 years after their placement, although there are different data and studies on this subject.
In most cases the rupture does not have any serious effect, as the silicone is contained inside the collagen capsule that the body has manufactured around the implant. Usually the patient does not notice any changes with the rupture of the implant, and it is usually a casual finding when a radiological exploration is performed. That is, many women have their implants ruptured without being aware of it or notice any effect or change in their aesthetics.
- Capsular contracture
The capsule that the body makes around the prosthesis is usually soft and flexible, and its presence is not noticeable to the touch. In some cases (approximately 1-2% of our patients), the capsule is too thick and firm, resulting in a breast that is deformed, uncomfortable, too round or too hard to the touch. This is known as capsular contracture. In such cases, implant replacement surgery is necessary. We always recommend complete removal of the capsule (capsulectomy) and replacement of the prostheses, even if they are not broken.
Implant replacement for esthetic reasons
It may be necessary a prosthesis replacement to obtain a better result in terms of an increase or decrease in size; or at the same time that we perform a breast remodeling because the years have passed and you want to improve the aesthetics (with its changes in weight, maternity or aging of the tissue).
Implant replacement surgery considerations
- Scars: when possible, the intervention is performed through the existing scars. If the intervention is used to lift a sagging breast or it is necessary to tighten the skin, it is normal that scars are necessary around the entire areola, and even vertically or in the submammary fold. The important thing is a good result, with an aesthetically satisfactory breast.
- The size of the new implants: it is common that the new implants are slightly larger than the initial ones. This does not mean a larger breast, but it compensates for the loss of volume that occurs with the capsulectomy and the atrophy that the breast tissue suffers over the years.
- Are there any guarantees that cover the costs? Most manufacturers supply implants free of charge when a rupture has occurred. The ruptured implant is sent to the manufacturer for study. There are insurance companies that allow you to take out specific insurance to cover ruptures or contractures in the first years, which allows you to cover part of the costs of anesthesia or surgery.
- Is surgery easier than the first time? Absolutely NO. The replacement of implants requires a precise surgery, with the extraction of the prosthesis avoiding that any free silicone remains in the tissue, and manipulating the covering tissues (muscle, fascia and skin) so that the breast retains a proper shape, thickness and feel.
If you have breast implants or plan to undergo surgery
If you are young, it is almost certain that your implants will be changed, perform imaging studies ultrasound – Mammography – MRI under the supervision of a specialist in plastic, aesthetic and reconstructive surgery and be wary of professionals who promise you “eternal” implants.
The replacement of breast prostheses should be performed by specialists with extensive experience in complex breast surgeries involving the simultaneous performance of several techniques in the same intervention (capsulectomy, mastopexy and various breast plasties).