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Removal of breast implants, intact or ruptured, may have positive implications if patients are symptomatic. A constellation of symptoms associated with breast implant illness, and autoimmune disease are considered when treating patients who have breast implants and are concerned about foreign body reaction. In our office, we begin this journey with a consideration of symptoms and exclusion of obvious autoimmune problems. In many of our patients, en bloc removal of breast implants with capsulectomy is important and beneficial. Further clinical evidence about breast implant illness is evolving and will continue to guide treatment. I would suggest removal if there is a possibility of foreign body reaction.Best, Dr. KaramanoukianRealself100 Surgeon
Yes, this is 50% of my breast practice at this time. many women need several steps to get the best resultsCAPSULECTOMY/CAPSULOTOMYOne ofthe most common problems with #cosmeticsurgery is #breast #capsularcontractureor the development of thickening, and contracture of the capsule that existsaround the breast implants. Severe capsule contracture probably occurs in lessthan 15% of augmentation patients. Every woman has a breast capsule aroundtheir #implant and this is a normal phenomenon. The capsule itself could be asthin as Saran Wrap but may also become calcified and thickened. As it thickensand shrinks, the patient may develop a feeling a firmness of the breasts and inits worst situation, the breast may become painful and abnormal in appearance,achieving a very round, hard, and uneven appearance. There may be distortionand possible breakage and leakage of an older implant, but may also include anewer implant. Nicotine users, such as smokers, have up to a 30x increased riskof capsular contracture.#Salineimplantsmay deflate spontaneously. When the patient has significant symptoms, completeor partial leakage of their saline implant, or concerns regarding siliconeleakage, it is recommended that the implant is removed and exchanged.Frequently, this is performed on both sides depending upon the age of theimplant. #Capsulotomy or opening of the capsule may be required or frequently #capsulectomy,which is removal of the scarred capsule, is recommended to ensure adequatepocket dimensions.Newimplants may then be placed in the same existing position or may undergo achange of placement frequently from submammary to subpectoral position and, onoccasion, the other way around.NEOPECTORALPOCKETThisis sometimes used as a technique to provide a stronger more secure placement.In this case, the implant is removed and the capsule is dissected from themuscle, creating a new or “neo” pocket for the implant.EXPLANTATIONOF IMPLANTSExplantationis the term that has been given to describe the removal of the breast implant.Whatdoes explantation involve? Two choices exist for explantation:1.Implant removal while leaving the capsule. This is a simple procedure andrequires localanesthesia, IV sedation, or (uncommonly) general anesthesia. It is relativelyinexpensive. Microscopic amounts of gel may remain in the capsule.2.Capsulectomy: This will enable the surgeon to remove as much silicone asreasonable without creating significant deformity. This operation may require alarger incision. The surgery and recovery time will be longer. Generalanesthesia is usually necessary and subsequently all of the costs associatedwith this operation will be higher.
You are wise in that you are considering the safety of combining the contemplated procedures. Generally speaking, most patients do well with all of the procedures you are thinking about. However, based on intraoperative findings, on occasion it is better to delay the breast lift for a another day. As you know, the main concern here is the amount of dissection and the resulting compromise of blood flow ( necessary for tissue survival and healing). Therefore, sometimes these decisions are best made intraoperatively based on clinical assessment of the blood flow present after each step of the procedure performed. I hope this helps.
When these were still around and in place for short periods of time, they were quite difficult to removed because of the thickened capsule that formed. But for many patients, after 10 years there would be no remaining polyurethane foam (the coating) and removal can be just as with other implants. If the gel has leaked, the capsule may also be thick If either of these are true, it may be safer to limit the procedure to implant removal and capsulectomy, and to regroup in six months regarding the lift. This should be a contingency plan even if the plan is to do all at once. Best wishes.
Removing the implants is fine and doing the lift maybe OK too. If you do not have a lot of tissue to mold it can be difficult and therefore delaying the lift may be beneficial in that case.