Having a breast augmentation with silicone implants is a long-term commitment. There is a potential for capsular contracture, implant rupture and change in shape of the breast over time with ageing, all of which would require further surgery in the future.
At your consultation, Miss Tadiparthi will spend time to go through what implant surgery you have had previously and understand your concerns regarding your breast size or shape. She will then perform a full assessment and go through the surgical options that would give you the best possible outcome. It is important that you have details from your previous surgery if available at the consultation as it can provide crucial information on the size and type of implants used, whether they were inserted above or under the muscle and also the technique used for any breast uplift surgery. Having the consultation letters and operation notes from your previous procedures ensures that you will get a better outcome from your redo surgery as it allows more planning e.g. ordering the correct implants, positioning of the implants in the breast pocket and surgical markings for redo uplift surgery.
In women that have breast implants inserted, the breasts can change over time. The body forms a shell or lining around the implant which is called a ‘capsule’. All breast implants regardless of the brand, shape or size develop a capsule around them. However, in some patients, the capsule becomes hard and thick from scar tissue, and this is called ‘capsular contracture’. Capsular contracture can cause visible distortion of the breast shape or size leading to asymmetry and discomfort of the breast which requires further surgery.
The exact cause of capsular contracture is unknown. Factors such as, infection or collection of blood around the implant, smoking, pregnancy and have been suggested by research. Smooth breast implants have been associated with a higher rate of capsular contracture compared to textured implants. Miss Tadiparthi therefore uses Mentor textured implants which are known for their high quality and safety, and low rates of long-term capsular contracture and rupture.
Ruptured Breast Implants
Breast implants can rupture over time as the silicone shell degenerates. It may be obvious from the look and feel of the breast that the implant has ruptured. The breast may feel different in its consistency or the breast may appear smaller in shape or become swollen and painful. Some women may notice small lumps in their armpits called ‘silicone granulomas’, which is the body’s reaction to the rupture silicone gel. These granulomas only need to be removed with surgery if painful or causing problems.
In some women, it may not be possible to determine whether an implant is intact and so an ultrasound or MRI may be needed to confirm whether the implant is ruptured.
There is no fixed time period as to how long breast implants can remain in the body. Therefore, implants do not need to be removed or exchanged unless the implants have ruptured or surgery is being performed for capsular contracture or to alter the size or shape of the breast.
Breast Implant Removal and Implant Redo Surgery
Over time, the shape of the breasts following augmentation or mastopexy (breast uplift) can change and further surgery may be required. If you have had a breast augmentation or breast uplift with another surgeon and are unhappy with the result, surgery to revise the size and shape of the breast, or position of the nipple area may be possible. Miss Tadiparthi will go through your concerns regarding your breasts, perform a thorough examination and use the information from your previous procedure if available, and discuss the surgical options that would give the best result.
Other Breast Changes after Augmentation
There may be differences between your breasts following breast implants e.g. shape, position of implants. Surgery may be possible to improve the appearance of your breasts.
Following augmentation, the implants can remain high on the chest (especially if the implants have been positioned under the muscle in the original procedure), while the breast descends with ageing and gravity. In such cases, the implants are repositioned above the muscle if there is adequate breast tissue coverage and a breast uplift may be required.
If a large implant is used and the skin and tissues of the breast are not firm enough to support the implant. The lower part of the breast skin becomes stretched and the nipple appears relatively high in position. This can be referred to as ‘bottoming out’ and it may be seen after breast augmentation, breast uplift, or breast reduction surgery.
I no longer want to have breast implants. What can be done?
Some women may have had breast augmentation at a younger age and no longer wish to have breast implants. It such cases, the implants can be removed along with most of the capsule around the implant. If required, a breast uplift procedure (mastopexy) can be performed to bring together the remaining breast tissue, reshape it and create a smaller, more uplifted breast.