Mammoplasty, a widespread breast enlargement operation nowadays, has become a “salvation” for many women who consider small breast size to be relatively unattractive or not in keeping with the proportions of their body.

To get an overview of this operation, a consultation with an experienced surgeon can take up to three hours. The question of whether it is necessary to change implants after mammoplasty interests every woman who comes for a consultation with a surgeon.

If we compare the implants of today and those that were produced 15 years ago, the difference in terms of quality is significantly different. The assortment of the latter was predominantly in a round shape, with a smooth shell. The composition of the implants was also different, and their wear life was much shorter than modern ones.

Mammoplasty is the most popular operation among women, therefore, leading clinics around the world paid the greatest attention to it. So, already at the present time, thanks to research, implants can have a lifelong service life. But, unfortunately, not everything is so simple, and there are still some nuances to replacing implants.

The main reasons for replacing implants after mammoplasty:

• Fibrous capsular contracture.
• Sagging skin in the chest area, which is affected by age-related factors.
• Aesthetic wishes for changing the size and shape of the breast.
• Rupture and leakage of implants.
• Installation of low-quality breast implants from unscrupulous specialists.
• Any inflammatory processes in the area of ​​the mammary glands.

Any secondary intervention necessarily involves a certain degree of risk to the body. Clinical examination, mammography, breast ultrasound, ECG and many other tests will give a clear picture for repeated implant replacement.

Natural changes in the mammary glands after mammography are caused by stretching of the ligaments and tissues. This can occur after sudden weight loss or, conversely, excess weight, after breastfeeding and many age-related factors. It should be noted that all these frequent problems that force women to undergo surgery again can be caused by the location and weight of the implant, that is, if it was large and installed under the gland, and not “under the muscle,” then the likelihood of sagging mammary glands there will be more.

Fibrous capsular contracture

Despite the vast and practical experience in performing mammoplasty, medicine is powerless to protect the protective function of the human body. Fibrous capsular contracture is the formation of dense fibrous tissue around the implant, which over time can cause discomfort and significant pain. As mentioned above, this is a protective mechanism of our body. There are some statistical arguments and studies by surgeons regarding the formation of fibrous tissue, or rather, if, then its prevention.

It is possible to avoid fibrous capsular contracture under the following conditions:

• Installation of the implant not under the gland, but partially or completely under the muscle.
• Textured surface of the implant (not smooth, but a “rough” circle).

In fact, there is no consensus. Some surgeons prove the opposite. Most likely, an individual approach by an experienced specialist to the constitution of a woman’s body minimizes the appearance of fibrous capsular contracture.

Most often, re-endoprosthetics becomes the patient’s personal wish. But you should consider factors that are best avoided:

1. Spinal problems. The implants themselves are heavy; for example, increasing breast size to size 4 can cause complications on the spine.
2. Breast enlargement by three to four sizes in one mammogram. In the future, deformation of the mammary glands may occur, as well as overstretching of ligaments and tissues.
3. Implant adjustment caused by a sudden change in weight, often caused by a woman's pregnancy.

How to replace breast implants step by step

Depending on what problem the woman came with, the operation to replace implants can last one to two hours.

The anesthesiologist, after making sure that the patient is in good health, can perform general or local anesthesia, which depends on the technical nuances of the operation.

The duration of the operation may be longer if the woman only wants to remove the implants. In this case, additional adjustments are made to the shape, symmetry, and tightening of ligaments and soft tissues.

How is breast implant replacement performed? Complete re-endoprosthetics can be divided into three stages.

1. First of all, the surgeon removes the old implants. Makes incisions following the scar left from the first operation. This may be a line under the mammary glands (submammary) or the armpit. One of the most popular is an operation performed along the nipple areola line. This case leaves behind visually invisible scars. This replacement option solves the problem of ptosis (possible prolapse of the mammary glands in the future). Women who want to enlarge their breasts by more than two sizes can also hope for good results. In this case, it is important to choose an experienced specialist who practices this technique. After the incision is made, the implants are removed.
2. Then, complete or partial removal of the fibrous contracture capsule is performed (capsulotomy). Most often, these tissues adapt to a new foreign object (in this case, an implant). But in its severe form, it is necessary to completely remove the resulting contracture.
3. At the third stage of the operation, the plastic surgeon installs new endoprostheses. If the patient only needs to replace the implants with new ones, then he installs them in the old place. In another case, for example, with an increase in breast volume, it is necessary to create a new space for additional volume of the mammary glands. At this stage, if necessary, they are tightened.

1. After removing old implants, the area after them should become denser. For this process, women are recommended to wear special compression garments for a certain period; this usually takes no more than a month. The use of underwear does not allow filling the implant site with physiological fluid. The same recommendations are given when replacing endoprostheses.
2. It is prohibited to visit baths, saunas, take hot baths and visit the solarium.
3. Limit or exclude any physical exercise in the first month.
4. Intimate life is not allowed without the approval of the attending physician.

By following all the recommendations and listening to the advice of an experienced specialist, your physiological changes will not be noticeable in the future. Soon you will get used to the changes and will be content with the new external changes.

A perfect body is the dream of many women, which plastic surgery can make come true. Breast enlargement and breast augmentation are in particular demand, making it possible to create pleasant roundness where nature has spared them.

The greatest interest is in mammoplasty using silicone implants. But, despite the significant improvement in prostheses and, as a consequence, the results of the operation, women in some cases may need to restore breast contours and replace old implants with new ones. Most often, repeated surgery is required for:

• capsular contracture;
• infectious processes;
• displacement;
• implant ruptures;
• omission, etc.

Mammary fibrosis or capsular contracture

A frequent complication leading to the need for surgical correction after surgery is the separation of a foreign body by connective tissue formations. When the tissue becomes denser, it causes a woman to feel discomfort and pressure; it is also possible to change the shape of the breast and develop asymmetry of the mammary glands.

The complication occurs in the first year after surgery and rarely occurs thereafter. When a small lump forms, the fibrous tissue is excised to release the implant and restore the natural contours of the bust. If the compaction is pronounced and the woman experiences severe discomfort, the fibrous capsule is completely removed, the old implant is removed and a new one is installed.

The main method of preventing mammary fibrosis is the strict implementation of all the surgeon’s recommendations during the rehabilitation period. If a lump is detected and pain appears, you should immediately consult a doctor to prevent further complications.

Prosthesis rupture and gel leakage

Modern technologies for manufacturing silicone inserts have minimized the risk of damage to the implant and leakage of contents. But under severe mechanical stress (for example, a knife wound), it is almost impossible to avoid gel leakage.

If you suspect a rupture of the prosthesis, you should immediately contact a surgeon to remove and replace the silicone insert. Signs of damage include pain and changes in the shape of the mammary glands.

Other reasons for replacing implants

Other complications leading to the need for repeat breast surgery include:

• development of an inflammatory or infectious process that occurs within a month after mammoplasty;
• duration of surgical intervention with the installation of fragile, heavy types of prostheses;
• physiological changes in the body (loss of skin elasticity during the aging process, leading to sagging, loss of attractive appearance of the breasts);
• significant changes in weight;
• loss of shape, volume, appearance of pronounced asymmetry after pregnancy or completion of breastfeeding.

In each of these cases, it is possible to restore the beautiful contours of the bust by performing surgical correction with removal and replacement of old implants.

When should breast surgery not be performed?

In some cases, surgical intervention can pose a risk to a woman's health. The operation is prohibited in the following cases:

• oncological neoplasm in the breast. After complete cure of the disease, it is possible to restore the normal appearance of the mammary glands with silicone implants;
• pregnancy. The stress on a woman’s body during mammoplasty can pose a threat to the child’s health;
• lactation. Correcting the shape of the mammary glands during this period not only harms the woman’s health, but also leads to distorted results after the end of the lactation period;
• exacerbation of a chronic disease, immunodeficiency conditions that increase the risk of complications.

If there are contraindications, you can turn to changes in body contours.

Recovery after mammoplasty

After any surgical intervention, the body needs time to recover. After the first breast augmentation surgery, rehabilitation takes a long period, requiring constant monitoring by the attending physician.

Removing and replacing old silicone inserts with new ones is less painful, but also requires strict adherence to medical instructions during the recovery period. When placing the implant into the formed bed, only short-term swelling and small hematomas occur. But when changing the location of the prosthesis, the body needs more time to adapt.

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Breast revision (breast implant replacement)

Breast implant surgery, which usually involves the displacement and/or replacement of saline or silicone breast implants, is performed to change not only the size of your breasts, but also the appearance of your breasts beyond your original breast augmentation vision. The final goal of the operation is to restore the natural youthful shape of the bust.

The content of the article:

When is breast revision necessary?

If there has been prolapse of saline implants or damage to silicone implants detected during X-ray and MRI studies.
If you want to change your implant/breast size.
If scar tissue has hardened around the implant (capsular contracture) or your breast implants have changed position.
If your breast tissue has changed as a result of skin stretching during weight loss/gain.

Related procedures

Many women who decide to undergo breast revision also consider breast augmentation, breast lift, breast reduction and liposuction.

Analysis

pros
You can restore youth to your bust shape.
You can increase or decrease your breast size.
You can improve the natural symmetry of your breasts.

Minuses
Under the influence of gravity and inevitable aging, the shape of the breast and its size may eventually change.
The initial weight of the implants greatly influences its further appearance over time.
Your surgeon will need medical records of previous breast surgery.

So, these are the main pros and cons in deciding to undergo breast revision surgery. If you would like to know important aspects of surgery specific to your situation, consult your plastic surgeon.

Implant replacement: photos before and after the procedure

Are you a suitable candidate for breast revision surgery?

Even if your first breast surgery was well planned and beautifully performed, changes can occur over time.

Below are some common indications for revision breast surgery:

You are healthy.
You don't smoke.
Do you want to increase or decrease the size of your breasts?
You want to correct breast asymmetry.
You want to get rid of problems that have arisen with your implants and/or the mammary glands around them.
Pregnancy and/or breastfeeding have changed the appearance of the implants.
Weight loss or gain has a negative impact on the appearance of your breast implants.
You should have had a breast lift after your initial augmentation but didn't.
You are dissatisfied with the results of your previous surgery due to poor placement of implants or other aesthetic problems.
You want to remove your breast implants permanently.

If your overall health is good, you have a positive attitude and are realistic about the future result, then most likely you are suitable for this procedure.

About the progress of your operation

How is the breast revision procedure performed?

The type of breast implant removal and replacement surgery your surgeon will perform depends on why your breasts need to be re-enhanced.

Changing the implant size: If you decide to change the size of your implants, then your surgeon will likely make an incision along the old scar to remove and replace the implants. If you want larger implants, your surgeon will need to enlarge the “pocket,” or space in your breast, to accommodate the larger implant. If you want smaller implants, your doctor may surgically use sutures to reduce the existing pocket to the size needed for a smaller implant. A breast lift can also be performed at the same time.

The occurrence of capsular contracture (tissue and implant compaction): Your doctor will most likely use the old scar to remove the hardened tissue and the implant. He or she will then replace it with a new implant.

Palpation of the implant: When the edges of the breast saline implants are very noticeable and palpable, your surgeon will use the original grafting incision to remove the implants or reposition them. Other methods are also possible by using a different type of implant, or placing the new implant in a different breast pocket that has thicker muscle tissue, or using additional muscle tissue to cover the edges of the implant.

Incorrect implant position: Sometimes the implant pockets are formed too far apart or too close together, causing the breasts to look unsightly. To correct this, your surgeon will use the initial incision to reconstruct the pocket by moving the required amount of tissue around the implant into the appropriate position using sutures. Your surgeon may need additional tissue to reinforce the resulting implant pocket, so an acellular dermal matrix technique is used to provide additional support.

Implant removal: If your implants are too large and cause your skin to stretch, your surgeon may recommend a breast lift along with implant removal, although implant removal alone may be sufficient. To remove implants, the primary scar is almost always used to install them. It is also quite common for the lining or “capsule” around the implant to be removed to allow the sutures to heal quickly.

Changing the position of the nipple and areola: If it is necessary to tighten your nipple and areola (the dark part of the skin around the nipples), additional incisions are made. A circular incision along the contour of the areola is used in cases of slight elevation. If it is necessary to significantly move the nipple and areola upward, it is most rational to simultaneously use two incisions: around the areola and a vertical incision down from the areola to the fold under the breast. In cases where it is necessary to remove a significant part of the breast (for example, in women who have lost a lot of weight), an additional third incision may be required in a horizontal direction along the contour of the natural fold under the breast. If a nipple lift is necessary, you can leave the nipples and areola themselves attached to the main tissues of the breast, thereby maintaining sensitivity and the possibility of future breastfeeding.

The goal of your plastic surgeon and the entire clinic staff is to achieve the most beautiful and natural appearance of your breasts, as well as to make the entire surgical process as easy as possible and, if possible, create optimal comfort.

What implant options are there?

Established contact with your plastic surgeon is the key to success in achieving your goal. Your task is to describe your aesthetic preferences as clearly as possible so that the doctor can offer appropriate options. During your consultation, you and your surgeon should address the following issues:

1. What type of implant will be used?

Breast implants filled with saline (sterile salt water). They can be pre-filled with the required volume of solution or filled during surgery, thereby providing a slight change in the size of the implant.
Breast implants filled with silicone, soft and elastic gel of different shapes and sizes. All silicone implants are pre-filled with gel, so large incisions may be required for implantation.
Breast implants filled with cross-linked silicone gel, also known as “gummy bear” or “permanent” implants. These implants are made from a thick gel made from bonded silicone molecules, making the implants slightly thicker and harder than regular implants. This allows them to retain their shape longer. They have been approved by the Food and Drug Administration for use in the US since 2013, and have been available in most other countries since 1992.

2. Will your implants be located in front of or behind the pectoralis major muscle?

Placing the implant behind the pectoral muscle (the muscle behind your breasts) means there is less interference with mammograms or feeding your baby. Your surgeon will tell you the pros and cons of both options.
3. What size will your implants be?
4. Will you also need a breast lift?
5. Will you need general anesthesia or intravenous sedation?
What will my scars look like after breast revision surgery?
The initial incision is almost always used for both replacement and removal of implants. However, if you need a breast lift, repositioning the nipple and areola, the scarring may be different (see How is breast revision performed?).

Preparation for the procedure

How to prepare for breast revision surgery?

Your surgeon will provide detailed instructions on preoperative preparation, answer all your questions, take a complete history and perform a physical examination to determine your physical readiness for surgery. In some cases, a mammogram may be necessary before surgery.

Before surgery, your surgeon will give the following instructions:

Avoid taking aspirin, certain anti-inflammatory medications, and herbal medications that may cause increased bleeding.
To promote better scar healing, stop smoking at least six weeks before surgery.
Regardless of the type of surgery, it is important to hydrate before and after surgery for continued safe recovery.
Reduce your consumption of alcoholic beverages to 2-3 times a week.
If your surgery is planned to be an outpatient procedure, be sure to arrange for someone to take you home after surgery and stay with you for the next two days unless you and your surgeon have decided on other post-op recovery options. (see How will the recovery and healing process proceed after breast revision?)
Before surgery, stock your refrigerator with high-protein, low-sodium foods, including prepared meals, fresh fruits and vegetables, and plenty of caffeinated drinks and plain water. During the postoperative period, avoid eating foods and drinks containing salt.
During the rehabilitation period, you will not be able to move your arms freely, so make sure that all the things you need during recovery are stored in an accessible place without the need to reach or bend over them (high shelves or very low cabinets).
Prepare a large number of different films or pre-recorded programs, as well as novels and magazines. If possible, install a radio connection on your bed and put a remote control for the TV.
Ensure ongoing communication is available throughout the recovery period outlined by your surgeon. This is very important for your recovery. If you have children under five years old, make arrangements with someone who can take care of them during this period. For the first two weeks, you should not lift, move, wash or clean anything.
Spend your rest and sleep time lying on your back at an incline of 25-45 degrees in the first postoperative days and until the swelling subsides. You can achieve the required inclination using an inclined pillow or while relaxing in a rocking chair.
Avoid hot showers, hot tubs and saunas for two to three weeks.
Decide what you will wear for the first few days, choose clothes that have zips down the front. Wear ballet flats or slip-on shoes to avoid having to bend over.
Typically, breast revision surgery is performed on an outpatient basis. Arrange for someone to take you home after surgery and stay for at least the first night.

What to expect on the day of breast revision surgery?

Breast revision surgery can be performed in a public hospital, private clinic or specialized institution. Your surgeon will inform you about the duration of the operation depending on the details of the surgical plan.

You may be advised to bathe with antibacterial soap before surgery.
Do not wear any make-up products, including nail polish, lotions, perfumes or other cosmetics.
Wear or bring soft, comfortable, loose-front clothing that you will wear after surgery, including shoes that can be put on quickly and easily.
Take only essential items with you (passport, insurance policy, cell phone, etc.), leave other things at home, such as jewelry.
All medications are administered for your comfort during surgery.
Typically, general anesthesia is used during breast revision surgery, although in some cases local anesthesia or intravenous sedation may be used.
To ensure your safety during surgery, your well-being will be monitored by various devices to monitor your heart function, blood pressure, pulse and the amount of oxygen circulating in your blood.
Your plastic surgeon will adhere to the surgical plan discussed with you prior to surgery.
Once the surgery has begun, the surgeon may decide to use concomitant techniques or modify the technique to ensure the best outcome. The main thing is that you feel comfortable and trust your doctor to make these decisions.
After surgery, long elastic bandages (a bandage) will be wrapped around your breasts or a surgical bra will be worn. Drainage tubes may also be attached to your breasts.
Once your surgery is complete, you will be transferred to a rehabilitation unit where you will continue to be monitored closely.
When you are ready, you can return home with the help of a friend or family member.

Before you go home, you (or whoever is caring for you) should be sure that you can clean the drain yourself.
You will likely be allowed to go home after a short observation period unless you and your plastic surgeon have decided otherwise about your post-op recovery period.

Aftercare and recovery

You should discuss with your doctor how long it will take for you to return to your normal lifestyle, activities and work. Also after surgery, you and your caregiver will receive detailed instructions about the recovery period, including information about:
Drain pipes, if installed
Symptoms you will experience
Possible signs of complications

Immediately after breast revision

Your post-operative discomfort and recovery period will be similar to that of your first breast augmentation surgery. On the day of surgery, you will need to get up and walk around. You will need to do this for several days in a row until you return to more normal activities after surgery. Getting up and moving around is very important for your recovery. The degree and duration of discomfort depends largely on the size and location of the implants, and may include pain, stiffness, swelling, bruising and itching.

As the anesthesia wears off, pain may occur. If the pain is very severe and prolonged, consult a doctor. There will also be some slight redness and swelling after surgery. Check with your doctor to see if your pain, redness, and swelling are normal or if complications may occur.

Time to regain shape after repeated breast correction

It is extremely important that you follow all instructions for your care provided by your surgeon. These include: wearing compression garments at all times, taking care of your drainage, taking antibiotics if needed, and the amount and type of activity that is safe for you. Your surgeon will also provide detailed instructions about the normal symptoms you should experience and any possible signs of complications. It is important to understand that the duration of the recovery period directly depends on the person.

Breast lift procedures are performed in combination with implant removal, and the rehabilitation period increases. If your implants have been completely removed, your recovery period will likely be short and with minimal discomfort. Avoid strenuous physical activity for at least the first two weeks after surgery. After this period, you should be very gentle with your breasts for at least the next month. Your plastic surgeon will give you clear guidelines and limits regarding physical activity.

First week

During this week, you should sleep so that your head and shoulders are higher than the rest of your body, then swelling in the chest area will go away better. You can use regular pillows, an inclined pillow, or sleep in a large chair.
Your plastic surgeon will likely allow you to shower 1-3 days after surgery, but you will need to avoid soaking in a bathtub or hot tub for at least 4 weeks after surgery.
Depending on your plastic surgeon's discretion, your bandages may be removed within a few days of surgery.
If drains are installed, you cannot shower for at least a day after they are removed, which usually happens after three days.
You may be advised to wear a compression bra during the initial healing period to prevent fluid accumulation, control swelling, and keep the implants in position during the initial recovery period.
If non-self-absorbable sutures were used, they will be removed within a week.
At the initial stage, there may be some change in skin color and swelling, but this will go away after you have fully recovered.

In 2-6 weeks

The remaining swelling will resolve within a month. You can usually return to work after breast revision within 7-10 days, depending on the type of surgery you had.
If you choose larger implants, you may feel some tension in the skin around your breasts as your body adjusts to the new size.

Longer period

The final shrinkage of new breast implants occurs after several weeks or months. There may be changes in sensation, tingling or numbness around the scar, but this should go away within a few weeks or months.

How long will the results last?

Unless you undergo significant changes in weight or become pregnant, your new breast shape will remain in its original form after surgery for a long time. However, gravity and the effects of aging will eventually change breast size. The weight of the implant also affects the appearance of changes in your breasts over time. The results of repeated breast correction are long-term. However, you can visit your doctor periodically to ensure that your implants do not pose any health risks and to rule out possible complications.

To ensure safety and the most beautiful and healthy outcome, it is important to visit your plastic surgeon's office as recommended for an evaluation and whenever you notice any changes. Do not hesitate to contact your surgeon if you have any questions or concerns.

Among the many questions that patients ask me during breast augmentation consultations, one question always appears:

“Will it be necessary to change the implants?”

The question is quite clear - you invest in yourself, in your appearance, and the duration of such investments is important to you.

Here's what you should know:

Aging of implants

Of course, breast augmentation implants, like any other device, whether medical (for example, a kneecap prosthesis) or non-medical (a TV or the tires of your car) wear out. Implants produced 10-20 years ago, according to manufacturers, had a wear rate of up to 5% per year, and if at the initial stage this was quite a bit, then over time the risk of their destruction or rupture rapidly increased.

The service life of implants depends on many reasons, such as the body’s reaction to a foreign object, the type of implant, and its location. Some patients still “wear” implants that were released more than 30 years ago and have absolutely no problems. But in general, previous generation implants required replacement on average 6-14 years after surgery.

Modern implants have a significantly lower percentage of wear, which has allowed implant manufacturers from leading companies to give them a lifetime warranty.

But, despite the fact that modern implants are virtually wear-free, according to statistics, about 20% of patients who have undergone breast augmentation turn to the surgeon with a request to replace the implant after some time.

What are the reasons for this? Here are some facts:

Aesthetic preferences

Sometimes patients turn to the surgeon with a request to replace the implant solely for aesthetic reasons - they want to change their size or shape.

If these are not the first months after the operation, when the swelling has not yet gone down and/or the implants have not yet descended or “slung” into place, most likely the surgeon will refuse you - the breasts have not yet taken their final shape and it is too early to draw any conclusions.

Age-related changes

Another reason that makes women think about replacing implants is age-related changes, breastfeeding, gaining excess weight or, conversely, losing weight. As a result, the volume of the soft tissue of the breast changes, the skin loses its elasticity, and the ligaments (Cooper's ligaments) that support the breast weaken and stretch. All this leads to sagging, or, as surgeons say, “ptosis” of the breast.
These are natural processes and they do not depend on whether you have implants or not.

However, if the implant is placed under a gland rather than a muscle, and it is large, its weight can accelerate unwanted breast changes. There is no exact information, but it is believed that implants with a volume of more than 400-500 ml contribute to this to one degree or another.

An implant installed under the pectoral muscle, on the contrary, is a kind of support, supports the breast tissue and helps to reduce their stretching. But it is not a panacea for natural age-related changes.

As the condition of the tissue deteriorates, the shape of the breast also deteriorates. In this case, the shape of the breast can take the form of a “two-story tower”, where the first floor formed by the implant has an excellent shape, but above it the “roof” has slipped and is “nodding.” If this aesthetic issue bothers you, it should be corrected. In general, clothing covers it well, and if you're happy with the look of your breasts in a bra, you can do nothing.

Otherwise, a breast lift (mastopexy) is the solution. If by this time enough time has passed since the breast augmentation (more than five years), then a reasonable approach is to place new implants at the same time.

Complications

Another reason for the need to replace an implant is capsular contracture. This is not a surgeon’s mistake and cannot even be considered a complication in the truest sense of the word. The growth of connective tissue around a foreign object (fibrous capsule) is a natural reaction of the body.

If the capsule around the implant is soft, elastic and the shape of the breast has not changed, then most likely you are not even aware of its existence. (1st degree contracture)

The stiffer shape of the capsule is slightly tender for the patient, but the shape of the breast is not changed, and you most likely will not want to have surgery in this case. (2nd degree)

But if the contracture progresses, the breast becomes hard and changes shape, reoperation is necessary.

* * *
I understand that it is not very pleasant to learn that you may have to undergo breast re-surgery in the future. Some patients initially have tissue that is quite weak or prone to loss of elasticity and, most likely, implant replacement will be necessary.
During consultations, I always focus on these facts so that patients can weigh the pros and cons.

Finally, to reassure patients who have read this article, I want to assure that most women are absolutely satisfied with the result of the operation. With the right decision about the size of the implant and the method of placing it, you can get an excellent, long-lasting result.

Cost of mammoplasty

• In the price list of the clinic’s services you can see the current cost of breast surgery.
• View all prices for plastic surgery services.

The best option is selected during a face-to-face consultation,
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Let's be honest. They cannot remain in the body forever. Sooner or later they break. This article will talk about silicone implants and the danger that women around the world expose themselves to. The statistics on this matter are very eloquent and scary: 50% of implants rupture within 10 years after surgery. Women who wear silicone in their breasts for 15 to 20 years increase their risk of rupture by up to 90%.

What are doctors afraid of?

Board-certified plastic surgeon Dr. Ed Melmed says filler leakage can't be controlled. Doctors cannot know how the material will behave in the body and where it will spread.

Statistics on the number of operations

Every year, in the United States alone, about 300,000 women and girls get breast implants. If you take into account similar operations around the world, the numbers are even more impressive. It is believed that every year from 5 to 10 million beauties resort to this method of figure correction.

Women are generally not informed about the dangers before surgery. At an appointment with a plastic surgeon, they will never be told about a potential health threat. On the contrary, most doctors in clinics tell patients that this procedure is safe, and if there are any health risks, they are minimal. That’s why women go under the knife so easily, because they, in fact, don’t suspect anything. However, this is not the case when you should remain silent about the consequences.

Evidence collected from real stories

If you want to know what the true dangers of breast augmentation surgery are, ask affected women. There are thousands of true and terrifying stories around the world of debilitating autoimmune disorders and other physical problems. Please take into account the information we provide below. If you, your friends or relatives are thinking about breast augmentation surgery, just familiarize them with this information. Your life, as well as the lives of those you know, may entirely depend on this knowledge.

Clients provide employees of plastic surgery clinics with a comfortable old age. Most often, women aged about 30 years old come to us for breast correction. Many of the patients have already given birth to children, and their mammary glands after pregnancy and breastfeeding have lost their previous shape and elasticity. Another part of women has complexes about their small size. Breast implants seem to be the only salvation.

The first danger when visiting a plastic surgeon is to look for a cheaper alternative. It is no secret that high-quality material is expensive, and many private clinics are fighting for potential clients. This is why advice appears about alternative, more affordable options. Not a single doctor will say that there are no permanent implants on the modern market. Any of the options on the market are prone to filler leakage. Some of them include brine valves, which after some time of “use” can turn black and become moldy. Ultimately, a woman’s body is doomed to put up with systemic fungal problems.

Beauties are confident that large breasts provide many advantages in the battle for a potential partner, for family happiness and well-being. They go to the clinic and hope for their dream to come true. No plastic surgeon will debunk these expectations. He will not talk about severe autoimmune disorders that lead to a wheelchair, arthritis, fibromyalgia, chronic fatigue and other ailments.

The international organization FDA is now openly mentioning the problems associated with breast implants. This service has existed on the international plastic surgery market for more than 40 years. And all this time, the FDA never officially granted its approval.

The loudest scandal

At the end of the 90s, perhaps the loudest scandal associated with this area thundered throughout the world. The lawsuit, which involved 450,000 women in the United States, received extensive media coverage. This famous case was brought against Dow Corning, the world's largest manufacturer of silicone implants.

The company has never admitted that its products are hazardous to health. However, the court ordered huge monetary compensation to be paid to the victims. It is known that in the 70s of the last century, Dow Corning implants had a very thin outer shell and a high probability of material leakage. Some women paid for their dream of having beautiful breasts with their lives while they waited for the court verdict.

In the case against the monopoly company, some more terrible details came to light. It turns out that Dow Corning employees knew that their products were toxic, but hid this information from the public for as long as they could. Such a scandal is far from an isolated incident. Recent lawsuits include the infamous case brought against the French manufacturer PIP, whose implants contained toxic chemicals prohibited for human use.

Animal experiments

Scientists are eager to shed light on the behavior of leaked silicone in the body and are conducting experiments on animals. Thus, 80% of rats whose bodies were injected with silicone subsequently developed tumors. These figures were so stunning that the international organization FDA immediately rushed to call them erroneous.

Silicone implants are back on the market

Some time ago, silicone was no longer used as a filler for breast implants. And now it is conquering the international market again. Several manufacturing companies, which were sued for a total of $3.7 billion, have returned to their usual line of business. Moreover, no long-term studies have been carried out on the products they produce. It is worth noting that data regarding the safety of products from Dow Corning, Baxter Healthcare Corporation and Bristol-Myers Scribb have not been confirmed. This means that women again have no guarantees.

When a woman decides to undergo breast augmentation and correction surgery, she is concerned about many issues related to implants. After all, they should become part of her body. One of the most common questions is whether implants need to be changed after.

Do I need to change implants after mammoplasty: warranty and durability...

As the experience of surgeons shows, many women feel great even with old models of implants that were installed about 30 years ago. However, at that time technology had not yet reached modern heights and could not guarantee the complete wear resistance of such products. Today, many manufacturers offer implants with a lifetime warranty. Such products do not require replacement at all due to wear. Therefore, when asked by patients whether it is necessary to change implants after mammoplasty, plastic surgeons can confidently answer “no”.

Do I need to change implants after mammoplasty: reasons for replacing implants...

However, there are exceptional reasons for which it is still necessary to install new implants. Such reasons include:

• The desire of the patient herself to again change the shape or size of the breast;
• Deterioration in breast shape as a result of strong changes in weight and body proportions due to age, hormonal fluctuations, etc. With age, the body of any person changes according to a program independent of him. Heredity and health status play a big role in this. Therefore, not all women manage to maintain the breast shape created by the surgeon in ideal condition throughout their lives. With repeated corrective plastic surgery, the doctor can perform a breast lift and replace old implants with new ones. In addition, the new implant will be selected taking into account the changed proportions of the figure, skin tone, etc.
• Damage to the implant. Modern products for breast enlargement are particularly durable, so damage to their integrity is usually possible only as a result of a puncture.
• Progressive development of a fibrous capsule around the implant. The problem is related to the reaction of body tissues to a foreign object, which is breast implants. In some people, such an individual reaction may be too strong and a hard capsule of fibrous tissue will form around the implant, which can even deform the breast. This complication is very rare, but if it occurs, the implant will have to be replaced.

In these cases, the answer to the question whether implants need to be changed after

Women who have undergone augmentation mammoplasty at least once in their lives have a question: what is the wear rate of implants and do they need to be changed at all?

But there are also statistics in which patients are satisfied with the result and do not resort to repeat mammoplasty, even after the specified period of time.

a brief description of

The endoprostheses that were produced about 10-20 years ago had a 7-8% wear rate, and manufacturers could not give a 100% guarantee that the implant would not rupture or its integrity would not be compromised.

At the moment, modern prostheses have a significantly lower wear rate, which allows leading manufacturing companies to provide a lifetime warranty on their products.

A breast prosthesis is a medical product that is made from high-quality biocompatible material, for installation under the skin or mammary gland, in order to simulate a woman’s bust and increase its size.

The first breast prostheses were filled with fats, liquid paraffin and various other fillers. They were injected into the thickness of the mammary gland.

The first breast augmentation operations were performed at the end of the 19th century, but such operations did not bring the desired result and led to serious complications.

Since 1944, the production of a prosthesis in the form of a closed shell made of silicone filled with sodium chloride or gel began.

And from this moment the real evolution of breast prostheses begins and their shape, structure, fillers and types improve every year.

Conventionally, the types of breast prostheses can be divided into several generations:

• The first generation of prostheses were made from a tear-shaped silicone shell, which was filled with a viscous silicone gel. A septum was installed at the back to prevent the implant from moving;
• the second generation of implans became softer and the gel became lighter. Second-generation breast prostheses were also produced in double-sided form and consisted of a silicone prosthesis inside a saline one;
• the third and fourth generations of implants were coated with an elastomer to prevent the gel from sweating through the shell. In the fourth generation, different forms of prostheses with various coatings were also already being produced;
• Fifth generation prostheses consist of a cohesive gel. It is a soft gel and has the ability to mimic living breast tissue. This gel also has “memory” and, in case of any deformation, returns to the shape specified during the production process.

Video: How the operation works

Kinds

Modern breast implants have two types:

1. silicone;
2. saline.

Silicone dentures consist of a silicone filler, the viscosity of which may vary between manufacturers. Breast, silicone implants are pleasant to the touch and do not differ from female breasts.

Such prostheses are suitable for women with small breasts; they do not wrinkle and look very natural. But silicone prostheses are very expensive, and in the event of a rupture, it is difficult to detect the leakage site.

Saline endoprostheses consist of regular saline or sodium chloride solution. This solution is pumped in after the prosthesis is installed, during the operation.

Such prostheses are much cheaper than silicone ones and much safer. In the event of a rupture of the saline prosthesis, it is easy to detect the location of the leak and a saline solution will enter the body, which does not cause harm to the body.

Also, when describing the types of endoprostheses, you should pay attention to the following characteristics:

• form;
• size;
• coating.

The shape of the prosthesis can be:

1. round;
2. anatomical (drop-shaped);
3. anatomical with a high profile.

The size of the prosthesis is:

1. fixed. This size does not have a valve and the volume of the prosthesis cannot be changed;
2. adjustable. With this size, the prosthesis has a valve through which saline solution can be injected;

The coating or surface may be:

1. smooth;
2. textured. Textured dentures are uneven and have fibers on their surface;
3. with a spongy surface structure. The connective tissue grows into the spongy structure of the shell and will allow the prosthesis to be fixed in one place.

Indications for change

Changing implants is called – re-endoprosthetics of the mammary glands.

Indications for changing breast implants may be as follows:

• aesthetic dissatisfaction after breast augmentation surgery;
• correction of changes in the appearance of the breasts, which are associated with breastfeeding, pregnancy and age-related changes;
• the patient’s desire to enlarge her breasts 3-4 sizes larger than before;

Also, indications for breast replacement may include complications after the first augmentation mammoplasty, these include:

Do I need to change implants after mammoplasty?

Prostheses for breast enlargement, like any other devices not only of a medical nature, wear out.

The service life of breast endoprostheses depends on many factors, such as the body’s reaction to a foreign object, the quality of the implant, and its location.

The frequency of replacement depends on the implant material and the skill of the surgeon.

Is it possible to plan a pregnancy after breast augmentation?

It is possible to plan a pregnancy after augmentation mammoplasty. Breast augmentation does not affect the development of the fetus and is safe.

Research conducted in this area has proven that neither silicone nor saline prostheses have a negative effect on the fetus.

The only thing that awaits a woman after childbirth is sagging breasts. This is due to the enlargement of the mammary glands and to return to their previous shape, mammoplasty in the form of a breast lift will be required.

But performing augmentation mammoplasty during pregnancy is strictly prohibited, since the operation is performed under anesthesia, which has a detrimental effect during fetal development.

Whatever method and access for installation is chosen, this should not affect breastfeeding of the child.

The most complete feeding process will be if during the operation the implant is placed in the armpit. In this case, the mammary glands are not affected and the lactation process will not be disrupted.

If the areolas are affected during the operation, it is important to know even before performing augmentation mammoplasty, how the feeding period will proceed and discuss this point with the plastic surgeon.

In order to avoid complications such as mastitis due to the presence of prostheses, you need to choose the right feeding technique and regularly do special massage.

Photo: Before and after surgery

How does the replacement work?

The process of carrying out the procedure for replacing breast prostheses can be divided into two stages:

1. preparation for the event;
2. implant removal procedure;

Preparation includes:

• the doctor's consultation;
• examination of the patient;
• consultation with a mammologist;
• performing mammography.

• take herbal medications;
• drink alcohol and smoke;

During the operation, the doctor makes appropriate incisions that can be performed:

• along the edges of the nipple areola;
• in the armpit;
• under the mammary gland.

The operation to replace dentures is performed under general anesthesia and lasts from one to two hours.

Complete re-endoprosthetics includes three stages:

1. removal of old implants. The surgeon makes an incision along the scar line and removes the old prosthesis through it;
2. capsulotomy. A fibrous capsule always forms around the prosthesis; it depends on how large it is. Sometimes, during capsulotomy, partial removal of fibrous seals is required; in case of serious complications, complete removal of the contracture is required;
3. installation of new prostheses. Basically, implants are installed in an already formed old bed, but if the patient wants to enlarge her breasts even more, the surgeon will need to form a new “pocket” for the endoprosthesis.

After removal and installation of breast prostheses, the skin pocket must become denser and in order to speed up this process and prevent it from filling with physiological fluids, patients must wear compression garments for a month after the operation.

The final recovery after re-endoprosthetics takes several months, during which it is prohibited to visit:

1. saunas;
2. solariums;
3. take hot baths;
4. sunbathing in the sun.

Active physical activity is prohibited until the tissues have completely healed.

Dangers of repeat surgery

Of course, both with the first and repeated augmentation mammoplasty there is a risk of complications.

And if during the first operation to enlarge the mammary glands there were no complications or problems, then during the second operation the risk of complications doubles.

As with the first operation, the following complications may occur:

• capsular contracture;
• hematoma;
• seroma;
• wound infection;
• formation of keloids and hypertrophic scars;
• temperature after mammoplasty;
• implant rupture;
• deformation of the endoprosthesis;
• displacement of the prosthesis;
• double fold or double bubble effect;
• calcification;
• allergic reaction to the endoprosthesis;
• symmastia – fusion of two breasts.

It is also worth knowing that augmentation mammoplasty is performed under anesthesia, so not only complications related to the breast area, but also diseases of the cardiovascular system and gastrointestinal tract may occur.

Prevention of complications

In order to reduce the risk of complications, it is necessary to carry out the following preventive measures:

• choice of doctor. When choosing a doctor, it is necessary to proceed not from cost-saving methods, but from the number of operations performed in this area, professionalism and experience;
• follow all recommendations of the plastic surgeon;
• take broad-spectrum antibiotics to prevent infections from entering the postoperative wound and the appearance of fever;
• choose endoprostheses from well-known manufacturers. When choosing implants, you can consult with a plastic surgeon, and also pay attention to patient reviews of companies that produce these products;
• wear compression garments after surgery. But it is necessary to purchase such underwear before the operation.

Factors affecting wear

The first factor that affects the aging of implants is:

• age-related changes;
• gaining excess weight or losing weight;
• lactation.

As a result, the volume of the mammary glands changes, the skin loses its elasticity and the ligaments that support the breasts are stretched.

In many cases, there is a risk of implant leakage and rupture, which also applies to implant aging factors. This may be due to some household injuries to the chest and poor quality choice of endoprosthesis.

Every woman who wants to seek the help of a plastic surgeon should familiarize herself with the following statistics:

• 30% of patients complain of rupture and leakage of the prosthesis;
• 40% of women are dissatisfied with the results of plastic surgery and resort to re-endoprosthetics;
• 50% of patients consult a plastic surgeon for complications within 3 years;
• 10% of women who had mammoplasty using silicone implants develop cancer;
• even if no complications arise, after 5-10 years the dentures need to be changed because they wear out.

Finally, I would like to reassure women and add that most women who have undergone augmentation mammoplasty are satisfied with the result.

With the right choice of prosthesis and method of its installation, you can get a good and long-lasting result, in which there is no need to change implants after mammoplasty.

Are implants safe and after how many years should they be replaced?
Will there be scars and scars?
Is breastfeeding possible with silicone breasts?

Because of these and many other questions, a woman is afraid to fulfill her dream of having beautiful and firm breasts. This article will dispel all doubts and tell the whole truth about implants.

Evolution of implants

Still at the end 19th century attempts at breast augmentation began. Liquid paraffin, glass beads, oils and other foreign bodies were injected into the chest. But all these operations were not successful: foreign objects did not take root, went beyond the mammary glands, and were rejected from the body.

IN 1960 In the 1980s, the first silicone implant was created, which was a capsule with thick walls, although it looked unnatural and leaked easily.

1968 year gave the world an implant with a physical solution, thanks to which the body did not reject the capsules. But the main drawback of the invention was the thin walls, which often led to rupture; in addition, the chest with saline solution clearly gurgled when walking.

IN 1970 year, the second generation of silicone implants appears. But the walls of the capsules become even thinner. 95% of women receive no know-how, but only disappointment after endoprosthetics: almost all implants crack within the first 12 years.

1980 year gives the world the third generation of silicone implants. The walls of the capsules become much stronger, and the filler becomes thicker. And most importantly, statistics related to complications after the first two models are rapidly falling.

IN 1990 In 2009, a safer model was developed, but it has not yet received recognition: implants with viscous jelly-like silicone, which does not leak when the capsule ruptures.

1992 year - silicone implants are banned in the USA, and implants with saline solution are again used for breast enlargement.

IN 2006 year, after years of controversy and debate, the United States re-authorizes the use of silicone implants.

To date Breast augmentation is one of the most popular plastic surgeries in the world, along with rhinoplasty and facelift. According to statistics, in the United States over the past 5 years, the number of women who have decided to undergo endoprosthetics has increased by approximately 40% - this is about 350,000 women. Every day, surgeons performed up to 1000 operations a day! In Russia, the numbers are much lower, and in 2012 the number of patients was 22,000. This may be due to the small number of professional surgeons in our country.

1. The size of the implants does not correspond to standard breast sizes (A, B, C...). It is measured in milliliters and varies in volume. The smallest implants are a 90 ml capsule, the largest are 740 ml. The most popular are 200 ml implants, which increase breast size by 1.5 sizes, as well as 300 and 400 ml.
2. Today there are 2 forms of implants: round and teardrop-shaped (anatomical). The former make the breasts look sexy, the latter look more natural.
3. The surfaces of the implant are also distinguished – smooth or rough (textured).
4. A distinctive feature of modern implants is that they are practically eternal.

Preparing for surgery and choosing implants

The choice of the implant, its shape, size and surface is carried out by the surgeon together with the patient at a preliminary in-person consultation. The following issues are also discussed:

Features of the operation;
-possible complications and rehabilitation period;
-place of the incision (through the inframammary fold, through the nipple areola, through the armpit).
For convenience, a “try-on” of external implants is carried out, which allows the patient to evaluate the final result.

In addition to the face-to-face consultation, the patient must undergo a number of standard studies:
-ECG;
-consultation with a mammologist and anesthesiologist;
-Ultrasound;
-blood chemistry;
-tests for HIV, AIDS and hepatitis B and C.

Temporary contraindications

Due to colds, fever, menstruation, the operation is postponed for some time. Also, no later than a month before surgery, the patient should not smoke.

Surgery and rehabilitation period

The patient is put under general anesthesia and operated on for 40 minutes to 2 hours. The surgeon inserts the implant under the pectoralis major muscle, so women do not have problems during lactation. Most often, endoprosthesis replacement is performed through the armpit - this technique is minimally invasive and allows you to avoid scars.

After the operation, the patient remains in bed for a day. Every few days the dressing is changed, and on the 10th day the stitches are removed. The swelling goes away within 2-3 weeks. For two months, a woman must constantly wear a holding bra with wide straps to avoid the appearance of stretch marks; sexual life is also limited, sports, heavy lifting, hot baths and smoking are excluded.

Possible complications with breast augmentation

Leading surgeon at Frau Klinik Egorova M.V. comments on problematic issues:

Implant rupture: “Modern implants are practically eternal, but there are situations in which rupture is possible: car accidents, falls, injections and other types of injuries. Although the thick composition of the silicone implant will not leak, a repeat operation will be necessary.”

Hematomas: “After surgery, blood usually accumulates under the skin for 24 hours. The body can only cope with small hematomas on its own, but larger ones do not resolve and require opening to remove the accumulated fluid.”

Decreased nipple sensitivity: “About 5-7% of women after endoprosthetics lose nipple sensitivity, the situation may not change even within 5 years.”

Rare complications: “Breast augmentation is still an operation, not an aesthetic procedure, so in rare cases complications (infectious diseases, suppuration) are possible. If complications arise, the implant is removed, and after six months the endoprosthetics is repeated.”

The final result mainly depends on the professionalism of the plastic surgeon, but also on the natural size of the breast and other physiological characteristics.

Replacing breast implants is not necessary if a woman is satisfied with the aesthetic appearance of her breasts and mammography does not reveal any abnormalities. Replacement of implants is carried out for medical reasons as a result of complications after the initial operation, as well as due to dissatisfaction with the appearance of silicone breasts. What are the advantages and disadvantages of breast replacement, existing technologies for replacing breast implants, and the features of replacement, as well as the cost of this procedure, you will learn about this today from our article.

Reasons why implants are replaced

Aesthetic reasons:

• Breast asymmetry, incorrectly selected implants during primary plastic surgery;
• Wrinkling, protrusion, the appearance of folds under the mammary glands, the “double breast” effect;
• Dissatisfaction with the appearance of the breasts as a result of pregnancy and breastfeeding, sudden weight loss or ptosis due to age-related changes in the body;
• Dissatisfaction with breast size, desire to increase by 1-2 sizes.

Medical reasons:

• Constrictive fibrosis (capsular contracture). The implant becomes overgrown with scar tissue, causing the breast to become denser and painful when pressed;
• Endoprosthesis rupture, gel (saline) leakage. As a result, swelling and inflammation of the mammary glands and pain develop;
• Poorly manufactured endoprostheses. Asymmetry develops, the integrity of the shell is disrupted;
• Ill-formed pocket. When the implant is located under the soft tissue of the mammary glands, the likelihood of developing capsular contracture increases than when it is located behind the pectoralis major muscle;
• Sagging of the mammary glands;
• Development of synmastia. As a result of the installation of wide-based implants in thin women with thin skin, the interbreast space gradually disappears, and the mammary glands grow together;
• The development of inflammatory processes, bleeding, the introduction of staphylococcal infections, the formation of hematomas.

Advantages and disadvantages of breast replacement

Breast implant replacement has the following benefits:

• Aesthetic appearance of the breast;
• Correction of asymmetries that arise over time;
• Increase or decrease in the size of the mammary glands.

The disadvantages of revision mammoplasty include gradual ptosis of the mammary glands. Under the influence of the weight of silicone implants, ptosis develops. It is also affected by skin aging, loss of elasticity and firmness.

Breast implant replacement technology

Reendoprosthetics surgery is carried out in several stages:

• Removal of existing implants. Removal takes place by making an incision along a previously made incision;
• Removing the capsule formed around each implant. The contracture capsule is removed completely when there is severe scarring of the surrounding tissue. If there are no complications, it is partially removed;
• Prosthetics of new implants. New breast implants are placed in an existing pocket;
• Stitching.

Surgery lasts on average 120 minutes under general anesthesia. If correction of asymmetry, increase in breast size, etc. is necessary, then the operation takes longer.

The rehabilitation period lasts longer than with primary plastic surgery, approximately 3-4 months. For faster implantation, it is necessary to wear supportive underwear with fixation.

Features of implant replacement

The surgery will differ from the original repair depending on the reason for the replacement.

• Features of replacing implants due to changes in the size of the mammary glands:

Firstly, after removing the old implants, the doctor expands (reduces) the pocket. If your breast size decreases, it is necessary to perform a skin tightening. Secondly, in order to enlarge the mammary glands by four sizes or more, it is necessary to carry out re-endoprosthetics in two stages - increasing the size of the implants by no more than two sizes in one operation. Thus, the chest will not be deformed, there will be no stretch marks on the skin, and the load on the spine will not be too sharp.

• Features of replacing implants due to their shrinkage:

In this case, only implants with a gel structure and a textured surface are installed, since a smooth surface does not guarantee re-wrinkling. Implants are placed not under the soft tissue of the mammary glands, but under the large muscle.

• Features of replacing implants due to asymmetry (displacement):

One of the dentures is displaced as a result of excessive growth of fibrous tissue. In this case, after replacement, a breast lift is necessary.

To prevent the implant from moving again, a dermal matrix is ​​inserted to support it. It consists of a complex of collagen and elastin.

• Features of replacing implants due to synmastia:

After removing the implants, the doctor works to reduce the size of the pockets. In complicated cases, the mesh is sutured and sutures are placed inside the pocket to prevent rupture of the inner part of the interthoracic space. Only after these manipulations are new implants of a smaller size (smaller width and projection) installed so that they do not touch the internal sutures.
The rehabilitation process in this case lasts at least 6 months.

Price

The cost of replacing breast implants consists of two components: the cost of removing old implants and the cost of installing new ones. In addition, you need to know whether one or both endoprostheses will be replaced, whether it is necessary to carry out work to remove complications, whether it is necessary to perform a breast lift, etc.

The average cost is as follows:

• The average price of implants ranges from 40 to 70 thousand rubles;
• The average price for work on removing old implants is 90 thousand rubles;
• The average price for work to remove complications is 57 thousand rubles;
• The average price of a breast lift is 120 thousand rubles;
• The average price for re-endoprosthetics is 140 thousand rubles.