Recovery and Pain to Expect During Breast Implant Replacement?

Thank you for your question. Discomfort is normal and it will depend largely on what is needed for your procedure and where the silicone rupture is contained to.  The procedure could be a simple hour procedure if the silicone is limited to the capsule, versus many hours if it has infiltrated your breast tissue or beyond.There are many things that can make your post-operative pain tolerable:1) Injectable numbing done at the time of surgery (some can last for several days)2) Muscle relaxants so your muscle is not as tense3) Narcotics to help address pain. Usually more effective if you stay ahead of it4) Non-narcotic medications (e.g. anti-inflammatories such as Advil)You often find that discomfort does correlate with size of the implant and the degree of stretching of the soft tissue of the breast.I would also revisit with your plastic surgeon if you are experiencing discomfort despite their post-operative measures.

Yes, if you have ruptured silicone implants, the standard of care is to remove them and the surrounding capsule. Most will elect to have new implants placed.Silicone nodules in the breast should be removed as best as possible and biopsied if needed to confirm the lump to be silicone and not cancer. If silicone has spread in large amounts into the breast, chest muscles, arm pit, lymph nodes, or other sites, the patient and surgeon must decide on how “aggressive” the operation should be as there will likely be greater deformity and potential complications. The risks of trying to remove all silicon are generally worse than the benefit; so some silicone will remain. If silicone is in your lymph nodes then follow up with a general surgeon may be required. If the implants are ruptured or more than 10 years old, consideration should be given to replacement. New implants are made from a highly cohesive gel. These “gummy bear” implants have less problems and retain their shape even when the outer shell breaks. The procedure is an outpatient operation performed under oral sedation, IV sedation, or general anesthesia depending upon the length and complexity of surgery Patients will feel sore and tired during the first 48 to 72 hours following surgery. During these first few days, the patient should engage in light activities, refraining from lifting or raising the arms above the head. Swelling and bruising will subside during the first week after surgery and will be controlled by pain medication. The initial surgical tapes will be removed a few weeks after surgery during a post-operative visit. Patients typically may return to a work a few days after surgery,only a light workload during the first two weeks, 6-8 weeks  for more physical jobs.  Your plastic surgeon will guide you. Most of my patients tell me it is less painful thought a more involved surgery than their original breast augmentation.

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!