Reasons To Undergo a Breast Implant Exchange
Breast Implant Size Problems
Some patients are unhappy with the size, shape, firmness of the breast implant post-operatively. This might be the case due to an initial miscommunication, change of body shape and weight over time, pregnancy, or just a change of preference. What was attractive to the patient way back then, may not be appealing now. A breast implant exchange can be either performed to use larger implants or to down-size. The later often makes an additional breast lift necessary due to the excess skin when a smaller implant is used. Patients who feel their breasts became too large overtime due to hormonal changes and weight gain may also opt to have their implants removed altogether.Exchanging the breast implant to a larger size often involves an adjustment of the implant pocket to the medial, lateral and inferior side. During the breast implant exchange, the previous pocket will be altered, and a so-called capsulotomy or capsulorraphy will be performed creating a better fitting pocket for your implant. When Dr Knoll sees a patient in her Frankfurt office for a breast implant exchange you can be sure she will be listening to your concerns and wishes. During your consultation she will explain all the your options available with their associated Pros and Cons, and risks of the procedure.
Misplaced Breast Implants
Some patients seeking breast implant exchange are looking for the correction of too high located breast implants on the chest wall. Reasons for this can be the initial surgery, muscle pull (pectoralis muscle) after the surgery displacing the implant, or capsular contracture. If capsular contracture is not the cause for high riding breast implants the corrective procedure is less invasive by adjusting the breast implant pocket and releasing muscle fibers. Depending on size, shape and age of the breast implant a new implant is advisable. Rarely the previous placed breast implant can be used.Alternatively, breast implants can be located too low as well. The so-called “bottoming out” can occur with time. The weight of the implant has either stretched out the breast tissue surrounding the implant; or the natural inframammary fold, which is a very powerful natural support structure of your body, was released during your breast augmentation due to implant size choice. Elevating the pocket during a breast implant exchange is more difficult to treat. This involves work on the capsule and sometimes a dermal allograft or xenograft will be necessary to reconstruct the support of the lower pole of the breast implant pocket to withstand gravity.
Capsular Contracture
A breast implant exchange becomes more complex when capsular contracture is present. A thin collagen layer is formed by the body around the implant, the so-called “capsule”, which is a normal reaction of the body to a foreign body. Capsular fibrosis and capsular contracture is a condition in which the scar lining/tissue that surrounds the breast implant, starts to thicken, harden and/or tighten. Although the etiology is not fully understood, research over the past decades have shown that certain triggers are involved, like biofilm (caused by bacteria) and hematoma. There are different degrees of capsular contracture (Baker classification 1-4). One being the mildest form, and 4 presenting with a severe deformity, hardening and pain. The degree of capsular contracture and the presence of biofilm can make a breast implant exchange more or less complex. This may require a change of pocket location (for example from above to below the pectoralis muscle), removal of the capsule, or in very rare cases a staged procedure.During your consultation Dr Knoll will explain to you in more detail how existing contracture will affect your breast implant exchange and will provide you with up to date research and clinical knowledge. Dr Knoll has performed scientific research related to the influence of silicone on capsular fibrosis which has been presented at several international and national meetings.
Breast Implant Rupture
Despite a lifelong guarantee given by some breast implant manufactures, a breast implant may eventually wear out and break making in a breast implant exchange necessary. Whereas a normal saline implant failure is easier noted by slow or very sudden loss of volume, silicone implant failure is less obvious. Ruptures in silicone implant patients, are generally noticed by a patient, who notice “something different” in shape or contour of the breast. In order to diagnosis this, it is generally ordered for an outside test, such as mammogram, CT scan, or sonogram to be preformed to check on the implant shell (the outside cover of a breast implant). Leakage is generally noticed the same as a rupture. In both situations a breast implant exchange is recommended in a timely manner, and you should be assessed by a board certified plastic surgeon to discuss your options. If you suspect that one of your breast implants is ruptured contact our Frankfurt office to set up your consultation. Dr Bianca Knoll and her staff will have your best interest at heart, and will do everything they can do to make your surgery go well, and your recovery proceed smoothly, safely and with the least amount of discomfort possible.
What To Expect Undergoing an Implant Exchange
A breast implant exchange is described by our patients as being much less painful than their initial breast augmentation. A breast implant exchange procedure is not described as very painful. Most patients describe a burning or pulling sensation, stating this recovery was easier than a primary (first) breast augmentation. The recovery time is for most patients shorter than after the initial placement of an implant. A breast implant exchange is performed under general anesthesia and may take anywhere from 1-4 hours depending on what is involved. During your procedure bacterial swabs, tissue and fluid specimens might be taken, to be send for lab analysis. In most of Dr Knoll’s breast implant exchange procedures no drains are required. The breast implant exchange can be either performed safely in an ambulatory setting. Depending on your general health, and your personal comfort, an overnight stay in the hospital might be preferred.After your surgery you may have some swelling and bruising, which will gradually subside within the following weeks. During that time Dr Knoll and her team will see you regularly in her Frankfurt office to accompany you during the wound healing process. Although most patients do not describe their post-operative course as very painful, you will be somewhat limited in your physical activities during your immediate post-operative period to ensure adequate wound healing. The success of a breast implant exchange procedure is clearly dependent on the meticulous planning, a patient’s realistic expectations and compliance, aesthetic sense of your surgeon, and skilled surgical performance of your surgery.
Dr Knoll and her team will be happy to provide you with further information about your implant exchange procedure and answer your questions during your consultation in our office.
Breast Implant Exchange Consultation
In preparation for your consultation, it is helpful to define your expectations and wishes pre-operatively for Dr. Knoll to recommend and preform the right surgical procedure for you. Dr Knoll will explain to you very realistic expectations, obtainable results, potential risks and benefits associated with a breast implant exchange procedure. During your consultation Dr Knoll will go over your options together with you, and will choose the best option from a medical and surgical standpoint together with you. If you have any information pertaining to previous breast procedures, implant identification (card/pass), or a previous operative report, please bring them with you. Any information provided by you will be very helpful and is appreciated. Dr. Knoll and her team will be happy to provide you with further information about your options to have a breast implant exchange procedure during your consultation in our Frankfurt office.
