Most women who see a plastic surgeon and express a desire to enlarge their breasts do not even suspect that implants are not installed for life, and over time they will need re-endoprosthetics. Indeed, breast prostheses have a service life, after which they wear out.
How long can you wear breast implants , and when should you refuse to replace them? We will try to answer these and other questions, having the professional opinion of the majority of authoritative specialists in the field of breast plastic surgery.
The scary phrase “capsular contracture.” Do I need to remove the implant?
— Any implant, no matter what safe materials it is made from, is a foreign body for the body. And this is a normal protective reaction of the body when a capsule forms around a foreign material. If the capsule formed around the implant is thin and elastic and does not deform the tissue, then this is considered the postoperative norm. If, even after the end of the postoperative period, the breast tissue is painful, hardened, or asymmetry or deformation has appeared over the years, then such a pathological process, called capsular contracture , requires treatment.
Often we are talking about repeat surgery. The reasons for the formation of denser capsular contracture are different: it is impossible to predict in advance what kind of capsule will form around the implant. Today, medical technologies are developing rapidly, and implantation is practiced in various industries. These include plastic and reconstructive medicine (breast, nose, chin implants), cardiac surgery (stents, vascular prostheses, artificial heart valves), orthopedics (artificial joints, intervertebral discs, vertebrae, metal structures), and dentistry (dental implants). Important: the formation of a fibrous capsule is not only a problem with breast implants. This is a problem of interaction between the body and a foreign body, and is typical for absolutely any implant.
Of course, when there is a problem, you need to think about how to solve it. But when there is a high-quality implant, when there are no objective reasons for treatment or removal of the implant, then there is no point in succumbing to general hysteria. The fact is that modern implants are quite inert and the risk of such complications is minimized.
Possible complications
Repeated surgery is no more dangerous than the first, but may cause some complications. Possible negative consequences of re-endoprosthetics include:
- formation of hematomas;
- formation of contractures;
- development of infections;
- the appearance of keloid scars;
- development of a double fold;
- fusion of mammary glands.
All negative consequences can be neutralized if you contact a competent specialist. Doctors at the Bust Clinic will select the best options for prostheses from high-quality modern materials, which can help reduce the risk of allergic reactions and other side effects.
How often does a seroma form after surgery and is it necessary to remove the implants?
— Seroma is an abnormal accumulation of serous fluid, sometimes developing after plastic surgery. It is considered a rare complication of mammoplasty. Seroma usually resolves on its own within a few weeks. Safe implants provide minimal risk of such a complication. Another problem that is often discussed in the media is anaplastic large cell lymphoma (BIA-ALCL). The formation of lymphoma is also influenced by various factors - both health status and what implants the clinic uses.
Doctors do not deny that seromas and lymphomas are possible. In my practice, only once was there a suspicion that the patient, due to the nature of her complaints, might have a complication in the form of lymphoma. After removing the implants, we did a histochemical examination. But the presence of ALCL was not confirmed! Here you need to think more about the quality of the implants installed and how skillfully the operation was performed. Lifestyle is important, because problems can provoke other diseases of the body.
One size does not fit all
For some women, choosing an implant size is akin to choosing a bikini or bra. However, this is fundamentally wrong. Before recommending a particular size for a woman, a plastic surgeon takes into account several different factors - skin elasticity, volume of glandular tissue, breast size, chest volume, and finally, the age and even height of the patient.
So, for example, for some women the ideal would be to increase the volume by one or two sizes, while for others only the option from 36A to 36B is possible. Therefore, the patient herself will not be able to decide exactly how much implants are needed, so it is best to completely rely on your plastic surgeon and try to heed his advice and recommendations.
If breast implants were placed 10-15 years ago, do they need to be replaced?
— Everything is very individual. It cannot be said that implants from one manufacturer last a lifetime and not from another. Doctors cannot predict how the implant will behave years from now. I repeat: the interaction with the implant is influenced by many factors - immune status, hormonal levels, age, and health status change.
I want to encourage our future, current and former patients not to be subject to the hysteria about implants and their removal. When there is a rupture, capsular contracture, or suspicion of some infectious or oncological diseases, then, of course, you need to check both your health and the implants. But this does not mean that you need to run and delete everything at once! After all, this is followed by the next stage - what will happen to the breast next?
Breast prosthesis manufacturing companies
When choosing implants, you need to take into account the reliability and reputation of the manufacturer. Below is a rating of the most popular and good manufacturers of the new generation.
- America offers an extensive catalog of implants from Mentor. Mentor breast implants have an anatomical and round shape with a textured surface. The filler is a highly cohesive gel. Mentor dentures are the most durable and resilient.
Among other advantages of Mentor prostheses, the following can be noted: the elasticity of the structure allows you to make small cuts on the skin, the shell consists of three layers, which provides increased strength, tearing is not possible, and a long service life.
The Mentor company produces anatomical implants with saline filler, which allows you to adjust the shape during and after surgery. For those who are interested in how much Mentor implants cost, we can say that the average price is about 50 thousand rubles.
- France is famous for prosthetics from the Arion company. Anatomical and round endoprostheses intended for breast augmentation with silicone are filled with gel or hydrogel. The shelf life of implants is very long, and damage to the shell is minimal.
- Germany offers varieties of prostheses from Polytech. Gel-filled implants do not deform. The surface is textured or smooth.
- Implants from Motiva ergonomix are often chosen, which have an anatomical shape with a textured surface. The shell consists of two layers, which provides high resistance to tearing. Motif implants have gel as a filler.
Numerous studies and the experience of women themselves indicate that Motiva ergonomix implants are safe, last for many years, and perfectly correct and enlarge the breasts. Implants from this company cost approximately 200 thousand rubles. They do not need to be replaced even after ten years. “I got implants many years ago. There is no discomfort. The breasts are firm and natural and have not changed shape.”
- The English company Nagor offers a wide variety of shapes and sizes of breast prostheses. All of them have a long service life, are not damaged, and are safe. They mainly have a textured surface and a gel filler.
- The leading position is occupied by the company producing breast implants – Allergan. You can choose prostheses that take into account all the structural features of a woman’s body. The shell consists of several layers, the filler is biogel. “I’ve been wearing Allergan implants for nine years now. The breasts are still beautiful, attractively shaped and pleasant to the touch.”
Implants from these manufacturers will remain popular in 2018. The shape of the made breast becomes lush and voluminous. In most cases, it remains soft and natural to the touch.
What is EN-BLOC operation? Is the implant always removed along with the capsule?
— Implants are always removed as one block along with the capsule. That is, the implant and the entire complex of tissues that give rise to the pathological process - contracture or rupture of the implant. Then, outside the body, visual (the capsule is cut, the integrity of the implant and its contents are checked) and histological examination. This technique for removing a pathological block, called EN-BLOC or capsuloectomy , has been used for a very long time. This method is nothing new for medical professionals. Now “enblock” is just a beautiful term that has appeared in everyday life. We at the LIPEX clinic have been performing such operations for a long time.
Is it possible to remove old implants and immediately install new, more modern ones?
- Yes, sure. If there is no pathological process and there are no contraindications, then you can immediately undergo breast enlargement surgery and improve shape using other implants - more modern ones, with a higher degree of guarantee. At the same time, you can tighten or reduce the amount of tissue. That is, after removal of the pathological process, the patient has access to all types of surgical interventions on the mammary gland.
There are, but extremely rare, situations when this is impossible. Most often this is due to infection or when there is a risk of the cancer spreading. Then the treatment stage is carried out first, and only then everything else.
Reconstructive plastic surgery
The Altai Territory has a very high incidence of breast cancer. And women most often come to the surgeon without breasts, after a mastectomy.
According to statistics, about 30% of women with breast cancer have their breasts completely removed. 70% of patients manage to save it: they have the tumor removed at the same time and the mammary gland is reconstructed.
Often women turn to an oncologist already with the third or fourth stages of cancer, so there is nothing left but to completely remove the breast. Preservation of at least part of the mammary gland is possible only in the first or second stages of cancer.
In total, about 3% of the total number of operations are reconstructive plastic surgery (personal statistics of Olga Mishutkina).
How quickly does a woman’s body recover after implant removal?
—Usually the operation is performed under general combined anesthesia. Removing or replacing breast implants is a simpler operation than breast augmentation, since the “bed” for the implants is already formed. The operation lasts 1-2 hours. Everything is removed, as I already said, in one block, so the healing process goes quite quickly. It is necessary to wear corrective compression garments, come for dressings and check-ups with your doctor. In the first days after the operation, you should not travel by plane - this should be considered by those who plan to arrive for the operation from other countries.
Patients spend 1-3 days in the hospital, depending on their condition. All the nuances - additional manipulations, what incisions and shape of the breast will be, possible risks and recommendations are discussed during a personal consultation in the doctor’s office.
In the early postoperative period, you should not play sports. If the implant is installed a second time, the rehabilitation period will differ. If under the muscle, then the restrictions for playing sports will be longer, if under the fascia of the pectoralis major muscle, then the rehabilitation period will be shorter. You can completely forget about breast surgery, if there was a primary installation of implants under the muscle, you can do it in three months, with a secondary one – up to six months: it all depends on the condition of the muscles and on the manipulations that are performed.
Rehabilitation period
It takes at least a month. During the first four weeks, the patient must wear compression garments prescribed by the doctor. You cannot refuse such a bra: it supports the breasts in an anatomically correct position, prevents the displacement of prostheses and accelerates regeneration processes. After a month, you can replace it with a regular thick sports top. Models with hard underwires and a push-up effect will need to be abandoned until the scars heal completely. Specialists at the Bust Clinic breast surgery center will give all the necessary recommendations for the rehabilitation period. Patients at the clinic are given a special reminder: following these instructions can speed up the regeneration process and reduce the risk of side effects.
I don’t want to remove implants: how often should I check my health?
— The presence of implants, if there are no pathological processes or health complaints, is not a reason for additional checks. Just like other women, owners of breast implants should visit a gynecologist at least once a year, undergo the suggested checks and screenings, and have an annual breast ultrasonography. The doctor may prescribe additional tests - mammography, computed tomography, biopsy, checking tumor markers. All women should monitor their health, regardless of whether mammoplasty was performed or not.
