Do I need to have two surgeries or it can be done at once: remove leaking implants, capsulectomy and put new implants?

I had my implants in 1993. After my mamogram /ultrasound I was referred to a hospital for a consultation. A surgeon told me that my implants (both) are leaking and I need to remove them and capsules as well. I will have drains for one week and I need time to heal. I asked if it possible to put new implants, she recommence do it after 3 month. I went for a second opinion to a plastic surgeon. He said, that he does not use drains and he can put implants right away. Any suggestions?

Doctor Answers 3

Implant exchange and capsule removal

Every surgeon is different and every surgery is different. I often will exchange the implants and remove the capsule and may or may not use a drain.

New York Plastic Surgeon
4.1 out of 5 stars 28 reviews

Do I need to have two surgeries or it can be done at once: revisionary breast surgery

Thank you for the question and picture. It is extremely common to receive different opinions from different plastic surgeons about the best way to treat a specific “problem”. Each plastic surgeon may have his/her opinion that is based on their specific/unique education, experience, and personal preferences. Their opinions may also be shaped by unfavorable results they have encountered in their practices.  

Although these different opinions can be confusing and a source of anxiety for patients, it is good for patients to understand the different options available. Ultimately, it will be up to each patient to do their due diligence and select their plastic surgeon carefully. Part of this selection process will involve the patients becoming comfortable with the plastic surgeon's experience level and abilities to achieve their goals as safely and complication free as possible. If I were you, I would ask to see as many examples as possible of similar patients who your plastic surgeons have helped with revisionary breast surgery.
 Although definitive advice would require in-person evaluation, there's nothing in your description that makes me concerned that a single stage approach would not be possible.  Sometimes, when breast implant removal, capsulectomy, mastopexy, and breast re augmentation surgery is planned, a two-stage procedure is safer. I can tell you, that in my practice, I do use drains when capsulectomy surgery is carried out.

 Again, select your plastic surgeon very carefully. Working together you will, the best plan to achieve an outcome that you will be pleased with.  You may find the attached link, dedicated to revisionary breast surgery concerns is helpful to you as you learn more. Best wishes

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,487 reviews

Replacing implants at the same surgery as old ones are removed

  • Removal of implants can take 2 minutes or 2 hours depending on whether they are saline filled versus the old liquid silicone implants that have leaked.  If two minutes then for sure they can usually be replaced at the same time so long as the pocket is tidy.  If there is silicone throughout I would usually recommend waiting.  There are other advantages to waiting including the pocket getting tighter and the breast contracting should you wish for a smaller implant or to use a tear drop shaped breast implant for your augmentation.  I usually tell patients I will try to put them in at the same time but my first goal is to provide good care and great results.  Placing an implant in an untidy pocket will potentially lead to significant capsular problems.
  • Dr Rodger Shortt is a plastic surgeon in Oakville.  He is the Director of the Cosmetic Surgery Training Program and an Assistant Clinical Professor at McMaster University.  He strives to provide the best possible plastic surgery results and excellent care to patients from GTA including Oakville, Toronto, Mississauga, Georgetown, Milton, Burlington and Hamilton.

Rodger Shortt, FRCSC
Toronto Plastic Surgeon
4.9 out of 5 stars 65 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.