Removing Old Breast Implants
The lifespan of an implant is uncertain, but we do know that the longer they are in, the more commonly complications are seen. On average 10% have ruptured by 10-years and you may not even know about it. That does not mean you should ignore them! If you have old implants I always suggest you see a specialist for review, consider MRI surveillance or even replacing your implants.
My Silicone Implants Have Gone Hard
This is usually a sign of capsular contraction. But it can also be a sign that something more significant is going on. On the one hand capsular contraction may occur due an underlying rupture but occasionally the implant can feel hard if fluid suddenly appears around the implant. This is called a seroma and could be a sign of breast implant lymphoma. Although uncommon, it is associated with textured implants occurring with a life time risk of around 1 in 1000 to 1 in 3000 women with the most textured variety of implants. So always see a knowledgeable specialist who is familiar with these problems and knows when and how to investigate for common and uncommon problems.
I Want To Remove My Implants With Capsulectomy and to have a Breast Uplift
This is a more common approach that I use for women that simply want the implants to be taken out and not replaced. Where there has been capsular contraction or concern about swelling (seroma), the capsule might need to be removed too. Some women want it to be removed for peace of mind even if it is normal. Surgeons who do this all the time will discuss the pros and cons and advise of the consequences, but in general it can be done. But in the absence of cancer it is not advisable to persist in trying to remove every last piece of it, if it looks normal to the surgeon and removing it could cause other damage to the rib or lung. An experienced surgeon knows what is appropriate.
Breast Uplift at The Time of Removal of Implants
With old implants there may be sag of the breast in addition to capsule thickening around the implant. The shape of the breast can collapse into a very poor appearance when the implants and capsule are removed. This occurs because the skin excess is no longer filled by anything and so just falls flat against the hollow of the chest wall where the implant was. The nipple often falls low on the breast or even several centimeters or more below the infra-mammary fold (the crease line under your breast). Therefore, a simultaneous procedure that I perform is to remove the implant and capsule and carry out a breast uplift. This reduces the skin excess but keep any remaining breast tissue. The nipple is elevated on a double pedicle into a better position. The ‘before’ image show two rounded breasts with big areolae which point downwards. The after images show the smaller breasts after implant removal with full en-bloc capsulectomy and mastopexy (breast uplift)