Breast Implants : Revision Surgery

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Hi! I am Dr Michael Szalay and today I am going to talk about revision surgery after breast implants.

Sometimes it is necessary to perform revision surgery after breast implants. Helpful information about complications after breast implants has been gathered by Allergan and Mentor, the 2 largest breast implant manufacturers in the world. They have conducted  10 year studies on patients who have had breast implants. Here are the 4 most common reasons why revision surgery may be necessary:

1. Capsular hardening

This refers to hardening and contracture of the capsule around the breast implant. It can result in pain, abnormal shape and abnormal position of the implant. Capsular hardening rates have been listed by Allergan as 19% at 10 years for their standard smooth and textured implants.

The use of polyurethane implants dramatically reduces the capsular hardening rate to 1%.

2. Rupture

Rupture refers to a tear or hole in the outer shell of the breast implant. Various studies estimate the risk at about 1% per implant per year. So, because each patient has 2 implants, the risk after 10 years may be about 20%. There is no evidence that this rate is different for different types of implants.

3. Implant Malposition

This can refer to :

  • the implant moving out of place eg dropping too far (“bottoming out”)
  • the implant rotating if it is a teardrop shape  eg it might turn on its side and look abnormal
  • the implant flipping over on itself if it is round, which also looks abnormal

The Allergan study indicates an implant malposition rate of 7% for their standard smooth and textured implants.

In my experience, polyurethane implants have a much lower malposition rate of about 2%.

4. Breast Sagginess

This can occur for various reasons including ageing, breast feeding and weight fluctuation. It can also occur due to the weight of the implant stretching the breast tissue which occurs more commonly in the following patients:

1/ Those who have loose breasts to begin with.

2/ Those who fail to properly support their breasts after implants.

3/ Those who have large implants.

In my experience, breast stretching is less likely with polyurethane implants as they hold their position better than standard smooth or textured implants.

Conclusion

Whilst revision surgery may be necessary with any breast implant, the use of polyurethane coated implants significantly reduces  re-operation rates.

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