Leaking saline implant replacement - Should scar tissue be removed before new implants are put in?

Question

I have saline implants, have a leak. Going to replace with silicone gummy bear implants. I am aBreast Cancer Survivor, This is my second saline leak with replacement in 17 years! Isnt the scar tissue supposed to be removed B4 new implants put in??? I also exercise, does that mean No Chest exercises? Will that cause another keak???

Emre Guvercin, MD, FEBOPRAS · Answer

No, the scar capsule does not automatically need to be removed before replacing a leaking saline implant. The capsule is the body’s normal response to an implant, and if it is thin, soft and healthy, it can often be preserved, avoiding unnecessary additional dissection. The FDA likewise notes that implant removal/revision may be performed with or without capsule removal depending on the clinical situation. If there is significant capsular contracture, calcification, abnormal tissue, infection, or another concerning finding, then partial or complete capsulectomy may be appropriate. Because you are a breast cancer survivor, I would also review your previous cancer treatment, reconstruction history and any radiation therapy before deciding on the pocket and implant strategy. Regarding exercise, normal chest training after complete surgical healing is not generally a reason for an implant to leak. Saline implants can eventually fail from shell or valve problems, aging, trauma, or other mechanical factors. You should be able to return to exercise progressively once your surgeon has cleared you after the replacement surgery.

Daniel Barrett, MD · Answer

Dear Gelbean,

it is hard to tell for sure without an examination. If you ave thick scar tissue, then it should be removed prior to placement of new implants. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Elisa Stein, MD · Answer

Gelbean,The scar tissue around an implant is called the capsule, and it does not automatically need to be removed when an implant is exchanged. If the capsule is soft, thin, and otherwise normal, it can often be safely left in place. If it is thickened, contracted, calcified, or abnormal, partial or complete removal may be appropriate.A second saline leak over 17 years does not necessarily mean exercise caused it. Normal chest exercises are not generally considered a cause of implant rupture, although you will need to avoid strenuous chest activity during your postoperative healing period.Because you are a breast cancer survivor, your reconstruction history and ongoing breast cancer surveillance should also be considered when planning your revision. Discuss your specific capsule and implant pocket with your plastic surgeon.Elisa Stein, MD

Manuel Diaz, MD · Answer

Hi. No, a special “detox” is not medically necessary before or after breast implant removal, and there is no good scientific evidence showing that detox programs remove toxins related to breast implants or improve surgical outcomes.
What is important is being in good health, having the appropriate preoperative evaluation, eating a balanced diet, avoiding smoking, and following your surgeon’s instructions. I would also tell your surgeon exactly what is included in the Pompa program before taking it, because some herbal supplements can increase bleeding or interact with anesthesia and may need to be discontinued before surgery.

Leaking saline implant replacement - Should scar tissue be removed before new implants are put in?

Answers (4)

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