Breast Implants Replaced While Awake and Without the Use of EPI? (photo)

I had breast augmentation done 10 yrs ago. Ten days post-op I hemorrhaged and therefore I developed capillary contraction. I have since had two more children and breastfed them. My left implant that is rock hard has now shifted and is at least a cup size bigger than my right one. I have a history of SVT for the last 7 years. I am extremely sensative to epi, I would love to have my implants replaced. I am very self conscience of them, however I fear being put to sleep. What are my options?

Doctor Answers 5

Mini Ultimate Breast Lift with Implant Removal

Your implants are 10 years old and during that time weight gain adds breast volume.  From your photographs, your breasts appear to be quite large and are very low.  You would probably benefit from implant removal and mastopexy more than placement of another implant.  This can all be done through a circumareola incision without the vertical scar or lollipop or boat anchor.  This procedure does not require Epinephrine.  You should consider a new alternative called The Mini Ultimate Breast Lift with removal of implants.

Best Wishes,

Gary Horndeski, M.D.

Texas Plastic Surgeon
4.6 out of 5 stars 223 reviews

Implants should not be replaced under local anesthesia

You have a complex breast history. I am corry to hear about the SVT. I would not operate on you under local anesthesia. See a board certified plastic surgeon. Without epinephine, the risk of bleeding is markedly increased. If you cannot undergo a reagent, consideration should be given to just removing the implants.

Robert L. Kraft, MD, FACS
New York Plastic Surgeon
5.0 out of 5 stars 40 reviews

Breast implant replacement while awake

Certainly it is possible to have implants replaced while under a local anesthesia in the simplest of situations, however yours is complicated by a history of bleeding and capsular contracture. General anesthesia might give your surgeon the ability to do what is best without limitation.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 42 reviews

Implants Can Be Replaced Without Epinephrine & General Anesthesia

It is certainly possible to have your implants replaced without using either epi or general anesthesia.  It could be done under local anesthesia with IV sedation.  It appears that a lift may be appropriate as well, but this too could done with this anesthesia.

John Whitt, MD (retired)
Louisville Plastic Surgeon
5.0 out of 5 stars 2 reviews

Surgical treatment of capsular contracture

Thank you for your inquiry.  You have a little bit of a difficult set of problems.  Of course, I am going to recommend that you meet/consult with a board certified plastic surgeon in order to come up with the most appropriate plan for you.  The photograph helps.  Personally, I would never embark on revision such as this under local anesthesia.  You probably need a complete capsulectomy and may need a lift.  I cannot tell how much of your breast is implant and how much is your own natural tissue from the photo.  You might consider smaller implants.  You might need a reduction.  These surgeries may need to be staged.  At the same time, you do not necessarily need epinephrine involved.  I would recommend you meet with your cardiologist and find out if they have any reason why you cannot undergo general anesthesia.  Of course, you could just not do any surgery, but that probably is unacceptable to you, which I would understand.  Best of luck to you.

James E. Chappell, MD
Annapolis Plastic Surgeon
5.0 out of 5 stars 18 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.