SECOND BREAST AUGMENTATION – REMOVAL OF IMPLANTS
Patients having prosthesis will have to remove their implants in the long term.
The first reason concerns the security of the device. A period of 10 years is often chosen because it corresponds to the manufacturer’s warranty period.
Other reasons may be the cause of this change. One is aesthetic, indeed time goes by and breasts can lose their volume and the result is less harmonious.
The operation will rejuvenate the breast by reshaping the breasts. Sometimes it’s a loss of flexibility of the breasts, the occurrence of a shell phenomenon that changes the perception of the breast and can even distort its appearance giving it a round shape too.
Much more rarely, an implant rupture which the diagnosis is done during a breast biological assessment.
OPERATIVE PRINCIPLES
- 1. The change of implant of “security”
The surgical procedure is very simple. It always takes the same way first (sub mammary or hemi-areolar). If prosthesis were placed by axillary way, we always prefer a sub mammary way to use to make this change.
The implant is removed, the lodge can be redifined by increasing it if necessary to place a larger implant.
A new implant is then placed. The post-operative follow-ups of this gesture are generally much less painful than the initial ones.
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2. Change implant for capsular contracture (shell)
The technique is the same, contracture is treated by performing a capsulotomy (circular incision of the lodge of the prosthesis).
- 3. Change of implants due to rupture
When diagnosed early, rupture of the implant will cause no change in peri-prosthetic tissue. The gel of modern implants are cohesive, it remains fixed in the implant.
The operation will be to clean the lodge and to replace the implant.
In very exceptional cases, where the diagnosis is late (implants placed there 15 to 20 years ago ), it will be necessary to remove scar tissues that will be formed around the implant.
The intervention is longer, and the risk of post-operative hematoma will be significant.This is why we prefer in our practice to change implants systematically.
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4. Change of breast implants and plastic surgery areal (dermopexie areal)
In some patients, after 10 to 12 years old, pregnancies, aging or weight changes lead to sagging breasts.
The areola tends to slide down, altering the aesthetic result.
It is possible for us during the change of implants to replace the nipple-areola complex in a higher position. This will require the realization of a scar peri-areolar, which may be associated with a vertical scar subareolar but this only after 10 to 12 years.
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