Want to explant after 30 years and insert new implants in 1 surgery

I got a BA in 1986, silicone. I have been happy with them and have not had any problems. My implants are extremely natural looking with no constricture. However, recently I have had slight infrequent pain in my right breast. Due to this and the age of my implants, I would like to have an explant, capsule removal, and new larger implants. I am currently about 280 cc and would like to go up to 400 cc. Can this be done in one surgery or do I need to explant first and wait?

Doctor Answers 6

Implant removal and replacement

Generally speaking, the operation you are discussing should be doable in one stage providing there are no "surprises" in surgery. One important side note, however, is to be sure that when you do go forward that you fully address the breast pain (and your overall health) with an appropriate work up including a thorough physical examination, your regularly scheduled mammogram and possibly an ultrasound if indicated. And always, always make sure that any Plastic Surgeon you see is certified by the American Board of Plastic Surgery. No exceptions.


Fall River Plastic Surgeon
5.0 out of 5 stars 17 reviews

Want to explant after 30 years and insert new implants in 1 surgery

Thank you for the question. Definitive advice would require an in-person evaluation but (based on your description), it is usually possible to perform the operation you are considering in a single stage.  Sometimes, depending on the patient's specific situation (for example patient who requires a significant breast lift…), it is wise to stage the procedures. This does not sound like what you require.
Generally speaking, the best online advice I can give to ladies who are considering breast augmentation surgery ( regarding breast implant size/profile selection) is:
1. Concentrate on choosing your plastic surgeon carefully. Concentrate on appropriate training, certification, and the ability of the plastic surgeon to achieve the results you are looking for. Ask to see lots of examples of his/her work.
2. Have a full discussion and communication regarding your desired goals with your plastic surgeon. This communication will be critical in determining breast implant size/type/profile will most likely help achieve your goals. 
In my practice, the use of photographs of “goal” pictures (and breasts that are too big or too small) is very helpful. For example, I have found that the use of words such as “very natural” etc means different things to different people and therefore prove unhelpful.

Also, as you know, cup size varies depending on him who makes the bra; therefore, discussing desired cup size may also be inaccurate. Again, the use of computer imaging has been very helpful during the communication process, in our practice.
3. Once you feel you have communicated your goals clearly, allow your plastic surgeon to use his/her years of experience/judgment to choose the breast implant size/profile that will best meet your goals. Again, in my practice, this decision is usually made during surgery, after the use of temporary intraoperative sizers.
  I hope this, and the attached link demonstrating many examples of revisionary breast surgery cases, helps. Best wishes.

Explant/implant in 1 stage?

Congratulations on 30 years of trouble-free implants!  It is very reasonable to change them out at this point.  There is no reason why you would need multiple surgeries to accomplish this.  Your old implants can simply be removed and exchanged for larger ones.  Even if they are ruptured, if you do not have capsular contracture then a capsulectomy may not be necessary.
Contact a board certified Plastic Surgeon with significant experience in revisionary surgery for a consultation.

Want to explant after 30 years and insert new implants in 1 surgery

Most definitely you can have removal of your old implants and replacement with new implants in one session. If needed, a mastopexy (uplift) can be performed at the same time. Thank you for your question, and best of luck to you.

Implant exchange

In the majority of cases, yes an implant exchange and pocket revision can be performed at the same time. Best of luck.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Revision

You absolutely may have implants replaced at one setting. It is highly probable that the silicone has leaked by now. The capsule can be removed with calcification as necessary 

Stuart A. Linder, MD, FACS
Beverly Hills Plastic Surgeon
4.8 out of 5 stars 40 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.