Thinking of changing your breast implants?

What you need to know if you are considering an implant exchange... 

Despite the fact that modern silicon and saline breast implants are durable, anyone with breast implants is aware that they are not for life; at some point they need to be changed or removed. There is no hard and fast rule as to when this is, some women can safely keep their implants for longer than the recommended time frame. 

As with any part of the body, the breast tissue and skin undergo natural ageing and so eventually implant replacement will become necessary, though this differs from person to person. 

Some women unfortunately experience complications with implants or the surrounding tissue resulting in pain or discomfort. Generally, however women opt for a breast implant exchange procedure in order to alter their appearance. 

There are vital factors to consider when changing breast implants such as size, shape, positioning, and type of implant. 

An implant exchange should be meticulously planned as these factors must all be precisely thought out in order to achieve the optimal outcome. Due to changes within the soft tissue of the breast some cases will require (or be recommended) a breast uplift in addition to the implant exchange procedure to achieve the best results. 

The following are the most common reasons to change implants and how to know when it is time to get checked by your doctor. 

Common signs to indicate you need a breast implant exchange:

PAIN / DISCOMFORT 

You have been experiencing pain or discomfort due to your implants - if the implants themselves are causing this pain or discomfort then you must request a breast implant revision. There are a number of causes for implants to become uncomfortable such as: 

• Capsular Contracture - There are varying levels of severity of this - the formation of scar tissue surrounding the implant is normal for the healing process yet when this ‘capsule’ becomes hard and contracts around the implant this can lead to aesthetic and physical problems (pain in extreme cases). 

• Lymph node damage - Some patients with breast implants have been found to have enlarged lymph nodes, or lymphadenopathy, often occurring in the armpit area.

• Seroma - The symptoms of seroma include swelling and possibly leakage of fluid at the site of the wound/scar. Occasionally accompanied by redness and mild pain, and can appear as a lump or cyst.

• Badly placed implants - the positioning of the implants could be interfering with the body’s natural situation, for example, if the implant was not placed correctly the muscle could be sitting differently causing you to feel uncomfortable. 

• Rupture - if you have silicon implants there is a possibility they can rupture or leak if the integrity of the implant is disturbed.

Pain is not a normal occurrence with breast augmentation, so you should seek your surgeon’s advice if you are experiencing any (once you have fully recovered from surgery). Daily life with breast implants should be just as it was before, you shouldn’t feel any discomfort at all. 

RUPTURE

While this is not life-threatening, a ruptured implant should be treated as urgent, seeking medical attention immediately is strongly advised in order to prevent any infection or internal scar tissue. 

How can an implant rupture? Generally the materials which implants are currently made form are extremely durable however if extreme pressure was placed on the area there is a possibility of a rupture. A car accident for example. Another cause can be that the shell of the implant may have weakened over time. 

Ruptured Saline Implants

If your implant is a saline version the affected area would be visibly noticeable straight away as the implant would naturally deflate once ruptured. This is nothing to worry about internally as the fluid within the implant is absorbed naturally by the body and does not cause further complications. Aesthetically though the breast will appear deflated. 

Ruptured Silicon Implants

These are not easy to detect and so need to be diagnosed via ultrasound or MRI. If a silicon implant ruptures the gel leaks out slowly meaning that the difference would not be visible immediately if at all. 

BOTTOMING OUT

If your implant shifts and sits lower than it should, below the breast crease, this is known as bottoming out and is obvious to look at. It can appear almost as a double breast as the implant slips below the nipple area sometimes causing the nipple to rise a little and the outline of the implant becomes visible. This is more common with larger breasts due to the weight of the implants but skin laxity with age can also cause this to occur. The tissue within the breast area is unable or no longer able to support the implant and causes it to ‘bottom out’. 

ROAMING IMPLANT

The breast implant should always be in the correct place once it has settled in its position, if your implant is rotating or moving dramatically then this is cause for concern and medial attention. Implants can shift for the following reasons:

• Lateral displacement- if the area within the breast, or the implant pocket, is too large then the implant has the space to move too far away from the centre line of the chest.
• Symmastia -when the implants move too close together - this can occur (very rare) if too much tissue is removed from around the breastbone area as this can cause detached muscles between the breasts.
• Rotational displacement - rotation can also be caused if the implant pocket is too large. This can be difficult to notice with round implants but the teardrop shape will appear unnatural should it change position.

IMPLANT SHAPE CHANGE

If the shape of your implants has changed significantly this could be due to any of the causes above. Generally this won’t occur to both implants at the same time so it can be detected easily. Again, this is not a huge medical risk but may cause serious dissatisfaction and emotional stress. 

CAPSULAR CONTRACTURE

When the body treats the implant as a foreign object and creates excess scar tissue in order to isolate it, this can cause capsular contracture. An overproduction of hardened tissue which is graded at four different levels of severity - 

1. No interference with the implant or the augmentation results, no symptoms.
2. Minor cosmetic symptoms - can feel firmer to touch but aesthetically fine. 

         3-4. Hard misshapen breasts which are not aesthetically pleasing and can even become painful. 

Grade three and four are often treated with a change of implant. 

NOT HAPPY!

If you are simply not satisfied with your current augmentation, this may prompt you to seek a breast implant exchange. Whether you prefer to go larger or smaller it is advised to allow the body to heal properly (if your initial surgery was recent) before you proceed with another surgery. Speak to your surgeon and they will advise you how to best move forward. To find the correct surgical strategy for your implant exchange contact Dr. Kaye or Dr. Frank at Ocean Clinic for a consultation. 

For more information on breast implant positioning read our recent blog on where implants can be placed and why, or take a look at our Instagram post on Implant Pockets.