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Do Textured Breast Implants Cause Tissue Loss During Removal?

I currently have the Inamed 410 form stable implants - 280 grams. I am having them replaced in March 2009 with 200cc Mentor Round Moderate Profile Silicones. The 410s are textured and I've heard that when these implants are removed, the breast tissue that they had adhered to can be removed with the implant as well. Is this true?

I didn't have much tissue to start with and would hate to lose any that I did have. Also, the fact that my first BA was in early December of 2008 (only three months before my re-do) mean that perhaps the implant hasn't completely adhered? Thanks in advance. Your repsonses have been very comforting.

Asked 36 months ago by sandyt123 in Toronto, Ontario
Sort 29 expert answers by:
+2

There should not be tissue loss

I do a lot of revision work in Orange County of breast implants, and I am on the study for the 410 implants for reconstruction and for revision surgery. There should not be any loss of tissue because of the implants being textured generally. I would not personally do your surgery until the inflamation had gone down from the original surgery. I would wait at least 6 months in the best of cases, and probably a year for the best results. The reason for this is that there is still... more
Dan Mills, MD
Orange County Plastic Surgeon
+2

No tissue is lost during textured implant removal

The textured surface of this implant is readily separated from the capsule that has formed around it and you will not lose any tissue. Make sure the shape change is what you are truly looking for!
Michael S. Beckenstein, MD
Birmingham Plastic Surgeon
+2

You need to have an open dialogue with your plastic surgeon discussing your issues and concerns

To accurately answer your question, a detailed physical examination needs to be performed. In general, textured implants do promote a thicker scar capsule surrounding the implant. Assuming that you do not have a problem with hardening of the breasts due to ‘scar capsular contraction’, your plastic surgeon should be able to preserve the vast majority of your tissue surrounding each mammary implant. Your concerns are very valid. I would encourage you to continue to have an open... more
Stephen A. Goldstein, MD
Denver Plastic Surgeon
+2

Textured breast implants do cause a thicker capsule around breast implants

Sandy, Be sure and discuss these concerns with your doctor. It is true that textured breast implants do cause a thicker capsule around the breast implant, which can be very adherent. If the doctor feels he/she has to remove the entire capsule before inserting your new implants, then there is some risk that some of the breast tissue around the implant could be removed as well. However, I have removed textured implants and replaced them with both silicone gel breast implants and with saline... more
Brooke R. Seckel, MD
Boston Plastic Surgeon
+1

Tissue loss with implant removal

The volume change in your implants after explantation depends on what other tissue, if any, is removed with your implants. Textured implants become adherent to the tissues inside, but are easily separated from this tissue during surgery. The scar (capsule) around your implant may or may not be removed with your implants. Scott Newman, MD fACS
Scott E. Newman, MD
New York Plastic Surgeon
+1

Breast Tissue is Not Removed with Implant Removal!

Implant removal does not mean breat tissue removal.  Even when capsulectomy is performed to remove scar tissue around the implant, care is taken so that no breast tissue is removed.
Marisa Lawrence, MD
Atlanta Plastic Surgeon
+1

Removal of breast implants does not mean removal of breast tissue

Rest easy--implants, even textured ones, can be removed without removing breast tissue.  I'm curious about your decision to switch from the Allergan Style 410 to the Mentor round gels--what had led you to this surgery?
Carmen Kavali, MD
Atlanta Plastic Surgeon
+1

Removal of breast implants and capsulectomy

Breast implant exchange is different than a capsulectomy, in which the capsule is removed.  In most cases, a meticulously performed capsulectomy will not result in significant volume change in the breast tissue itself. 
Raffy Karamanoukian, MD
Los Angeles Plastic Surgeon
+1

Removal of textured implants

The removal of textured implants should not leave any deformity. Removing a textured implant is no different than any other implant. I have seen post operative seromas on two occasions, but they resolved quickly.
Gary H. Manchester, MD
San Diego Plastic Surgeon
+1

Implant removal

No, the capsule does not necessarily need to be removed with breast implant replacement. If the capsule is thick and problematic then removal may be recommended. But removal of all capsules can cause too much breast volume loss in an already small breasted patient. The textured implants are easily separated from the implant and the capsule can be left in place if it is not thick or problematic.
James Apesos, MD
Dayton Plastic Surgeon
+1

Breast size is the same

Unless a capsulectomy is performed, the breast tissue is not removed and minimally affected during an implant exchange, regardless of the type of implant - textured or smooth. Capsulectomy may reduce breast volume. You must also consider that different implants have diufferent shapes, in spite of similar volumes, this may make them appear of a different size.
Robert M. Freund, MD
New York Plastic Surgeon
+1

Removal of implants does not require removal of any breast tissue.

Removal of old implants (silicone or saline) is easy and does not require the removal of any breast tissue.  Sometimes the capsule that formed around the implant will be removed, but this is not breast tissue and did not exist until the implant was placed.
Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
+1

Textured breast implants and removal

When you remove textured implants this will not cause tissue loss. Although the implants encourage a small amount of tissue in growth into the shell, this is not a significant amount of tissue and the implant can be easily separated from the surrounding breast tissue and capsule.  
B. Pat Pazmino, MD
Miami Plastic Surgeon
+1

Tissue is not normally removed when exchanging implants

If the surgeon is simply removing the implants and replacing them with round implants, you should not lose any tissue.  The surgeon will separate the  implant from the capsule fairly easily, leaving the capsule behind.  Now, if the capsule has to be removed eithe partially or completely, you might lose some tissue.  The surgeon will try to remove just the capsule itself however sometimes it is difficult to do this and some breast tissue is removed also.  If you... more
Tracy Pfeifer, MD
Manhattan Plastic Surgeon
+1

Reaction to implant removal

It is probably more likely that because you have silicone gel implants there will be more scarring/tissue reaction that needs removal. The textured implant part is probably not a large factor. Best Regards.
John P. Di Saia, MD
Orange Plastic Surgeon
+1

Cohesive gel implants

The textured implants whether they are cohesive gel or other forms of silicone can be removed fairly easily in most cases without any further loss of tissue. 
Steven Wallach, MD
Manhattan Plastic Surgeon
+1

No tissue loss will occur

Even if your tissues have fully adhered to the implant, it is a simple matter for the surgeon to sweep the junction between you and the implant with their finger and take the implant out. It sounds like velcro but no tissue is removed. Please also know that you will see a drastic size and profile change going from your current to your planned implants.
Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
+1

Texture implant will not cause tissue loss

Please discuss your concerns with your plastic surgeon. Make sure that you are changing implants for the right reason. Changing the implant will not add tissue to your breast. Texure implants adher to the tissue but that makes removing the implant harder but you should not loose tissue. The othere option is fat grafting. If you have thin skin and small amount of breast tissue, this will add volume.
Kamran Khoobehi, MD
New Orleans Plastic Surgeon
+1

Generally, you should not have tissue loss.

Given that your initial surgery was just a few months ago and you are replacing with a smaller implant, there should not be any loss of tissue. If you have had significant scar tissue develop, the pocket may have to be modified, but you should discuss these concerns with your surgeon since he is very familiar with your particular situation and your exam. My best to you and to your quick recovery. Dr. Parva
Behzad Parva, MD
Washington DC Plastic Surgeon
+1

Removal of textured implants will not cause tissue loss

To sandyt123, Hi! You don't say why you are having the implants replaced, but you are probably doing the right thing. I have seen a lot of problems with shaped textured implants and I don't use them. My other suggestion is to use moderate PLUS profile round implants. The "moderate profile" implants are really partially underfilled low profile implants, and they can cause rippling even though they are silicone implants.
George J. Beraka, MD
Manhattan Plastic Surgeon
+1

Breast Implants and Volume Loss on replacement

Thanks for the question. Changing implants in itself will not cause tissue loss. If you have a thick capsule and it needs to be removed then there can be some tissue loss as part of removing the capsule. In addition, the thickness of the overlying tissue may stretch out some and appear thinner - this doesn't mean that there is tissue loss, but the distribution post-breast augmentation can be very different. Be sure to discuss the shape of the implant as well as your expectations. Also make... more
Steven H. Williams, MD
San Francisco Plastic Surgeon
+1

Texture will not cause a loss of breast tissue

The texture on the 410 implant will grab somewhat to keep the implant from rotating in the breast pocket. I have changed several of these and the capsule will separate easily from the implant without loss of breast tissue. Your surgeon may need to open the capsule when the new implant is positioned, we call this capsulotomy, however it is unlikely that the capsule need be removed. I hope this relieves your worry. Best of luck.
Peter E. Johnson, MD
Des Plaines Plastic Surgeon
+1

You may be talking about the capsule

Sandy, You will not lose any significant amount of breast tissue with removal of the textured implants. The scar tissue capsule that forms around ALL implants does sometimes adhere to the textured surface of the implant and small pieces of it may be extracted with the implant upon removal. However, this tissue is of no volume significance to the breast. Good luck!
Kenneth R. Francis, MD
Manhattan Plastic Surgeon
+1

No need to lose tissue

The textured implants can usually be easily peeled from the adherent capsule. Even if the capsule is removed, it is quite thin and amounts to very little volume overall.
Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon
+1

No

The textured surface of contemporary implants will sometimes become adherent to the internal capsule but this can easily be separated with digital pressure. The only implant which does result in tissue loss is the polyurethane coated implant. They were banned in the USA over 12 years ago and probably most if not all have been removed. The surounding tissues actually grew into the polyurethane and made removal quite difficult.
Donald Kress, MD
Frederick Plastic Surgeon
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