Recovery and Pain to Expect During Breast Implant Replacement?

My Breast implants were done in the early 80's. I just found out that they are both ruptured. I am very concerned about the removal of the silicone which has leaked.

However, I would also like to know if I can have them replaced, and is this going to be a very painful procedure? How long will I expect my breast implant recovery and pain to last? I have a very physical job.

Doctor Answers (12)

Breast implant exchange

+2

Generally, breast implant removal, even if ruptured, can be done with tolerable discomfort. The real discomfort comes if you need to convert from above the muscle to below. Even that discomfort however is only about the same as a first time under the muscle patient. I generally use drains in cases like yours and these can be in for about a week depending on the volume of drainage.


Seattle Plastic Surgeon
5.0 out of 5 stars 51 reviews

Recovery after Breast Implant Replacement

+2

Recovery after Breast Implant replacement will vary significantly, depending on where the initial implant is (over or under the muscle) and the amount of spread of the silicone into the surrounding tissues. If the implant is under the muscle, the recovery will be longer, especially with a physical job. If over the muscle, recovery should only be a few days. The biggest question is how you discovered the ruptured implants. If this was by pure chance (a routine mammogram or study not related to symptoms), there may be no reason to replace them. As long as the silicone is fully within a scar capsule, it is generally quite safe. I have followed many such people for years with no problem. If, however, symptoms led to the discovery, and there is diffuse silicone within the tissues, more cutting of the tissues is required, and thus, there is more post operative discomfort and longer recovery.

Robert T. Buchanan, MD
Highlands Plastic Surgeon
5.0 out of 5 stars 4 reviews

Breast Implant Rupture

+2

This is becoming a more prominent problem as a lot of the silicone implants placed earlier on are rupturing and patients are presenting for removal. Usually the scar tissue that surrounds the ruptured implant remains intact, at this can be removed all en bloc.

On occasion I have had rupture of the silicone implant outside the capsule or scar tissue which results in silicone infiltrating into the breast tissue. This may require more time and pain overall. Also it depends if the breast implants are in front or behind the muscle, that will also change the recovery.

But yes, new implants can be placed during the same time.

Good luck.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 46 reviews

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Implant rupture and replacement

+2

Your question about post-operative pain is difficult to answer because the amount of infiltration of the silicon into the surrounding muscle and/or breast tissue as well as the presence of granulomas needs to be considered. It may be a very quick and easy replacement with mild pain, or more significant if extensive removal of tissues is required. Did you have an MRI (with or without contrast)?

Theodore Katz, MD, FACS
Philadelphia Plastic Surgeon
5.0 out of 5 stars 7 reviews

Recovery after revision augmentation

+1
Dear Butterfly,
Thank you for your post.  In general, if the implants are not too wide and a capsulorraphy or suturing of the capsule on the side is not needed, then your recovery will be short.  In a revision where the implants are removed, or implant material in the case of a ruptured implant, the pockets are revised slightly in order to accommodate the new implant.  Since most of the pocket is already formed, the healing process is quit, and pain is low.
Best Wishes,
Pablo Prichard, MD

Pablo Prichard, MD
Phoenix Plastic Surgeon
5.0 out of 5 stars 28 reviews

BBA Recovery

+1

It really depends on a few factors. Adequate pain control is likely the most important. Individual pain tolerance differs greatly. I find that women who have had children generally have less post-op pain, as they have a much higher pain tolerance. From a surgical point of view, there are several things the surgeon/anaesthesiologist can do to decrease your post-op pain.

I generally perform breast blocks prior to making any incisions with a mix of short- and long-acting local anaesthetics. I have found this greatly reduces post-op pain. I also encourage patients to take the prescribed pain killers regularly every 4 hours especially for the first 24-48 hours. If you don't stay on top of the pain in the immediate post-operative period, it is extremely difficult to "catch-up". Most of my patients experience very little post-op pain after breast augmentation.

Of course, the type of augmentation you have will also determine your post-operative discomfort. Larger implants, and subpectoral implant placement will also increase post-op discomfort. This doesn't mean you shouldn't get large implants, or place them under the muscle - you simply need to know what to expect. Many women also experience difficulty with sleeping in the first few weeks after augmentation due to the weight of the implants on their chest. This is more significant in back-sleepers.

To answer your question about time off work, my experience has been that there is a huge range. I have patients that go back to work the next day (against my advice), and I have had patients take as much as 2 weeks off of work. It really depends on what you do for work, and how you feel. As for taking care of your kids, if your implant is placed under the muscle, it will be a few weeks before you feel comfortable enough to pick them up.

As for scars, I tell patients it will take a year to see the absolute final result. Practically, however, by 3-6 months the scar will be very close to the final result. I suggest 3M paper taping, and have a specific scar massage protocol I use to help speed scar resolution.

I hope this helps. Good luck!

Sincerely,

Asif Pirani, MD, FRCS(C)
Toronto Plastic Surgeon
5.0 out of 5 stars 28 reviews

Recovery expectation after Breast Implant Replacement

+1

Hi there-

The recovery experience you should expect will depend a great deal on the details of the operation you and your surgeon decide on after review of your current situation, your goals for appearance, and the alternatives available.

Generally speaking, if you had the existing implants removed and new ones placed into the existing pockets, the pain and disability should be significantly less than you experienced with the initial procedure for their placement.

Should you and your surgeon decide other maneuvers are necessary, such as a breast lift, conversion to another pocket location, or pocket reconstruction, you would need to expect a bit more recovery. With regard to the specific limitations and your ability to perform at your particular job, you would need to review these with your surgeon after making decisions regarding the procedure itself and your desired timing.

Having said all of that, I would certainly recommend that if you have older silicone implants and know they are ruptured that you have them removed as soon as possible to avoid silicone migration and other potential issues.

Good luck!

Armando Soto, MD, FACS
Orlando Plastic Surgeon
5.0 out of 5 stars 113 reviews

A complicated question

+1

Butterfly,

Your question may be more complicated than it sounds. Since the implants are both leaking you will likely require total capsulectomies (removal of the entire scar capsule and implant) on both breasts. This can be a technically demanding surgery, with extensive dissection and a rough recovery depending on how adherent the capsules are to the muscle, ribs and surrounding structures. A consult with your board certified plastic surgeon will give you a better idea of how much and how complicated your surgery will be. Good luck!

Kenneth R. Francis, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 32 reviews

Breast Implant Exchange

+1

In most cases, the breast implant exchange procedure is much less involved than your original surgery. If your implants were placed under the muscle, then you may have had some discomfort after your original surgery from the muscle stretching. Since the muscle is already stretched, then you will not have this same discomfort. However, if you have contracture or scar tissue that needs to be resected then your recovery may be more involved. Good luck with your surgery.

David Shafer, MD
New York Plastic Surgeon
5.0 out of 5 stars 57 reviews

Discomfort After Replacement of Ruptured Silicone Implants

+1

Implant exchange is usually not a very uncomfortable procedure, but he leaking gel may make the surgery more involved, and cause more discomfort. Some docs prefer to use drainage tubes as well, so ask about this possibility.

I agree with the other docs in that the implanty placement procedure is usually the most uncomfortable.

John LoMonaco, MD, FACS
Houston Plastic Surgeon
5.0 out of 5 stars 181 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.