Most of the time, we incise through already existing inframammary (below breast) scars for an explanation; however, when a capsulectomy is performed, the incision is considerably long, leading to a visible permanent scar.
Breast lift after implant removal is useful only for a limited time. The rate at which the breast lift needs renewal depends on the size of the original implant and the patient’s breast structure. The extent of breast lift at the time of implant removal is limited by blood flow availability. Many times, the breast cannot be lifted to the maximum extent due to decreased blood flow caused by either current or past surgical incisions. It is recommended by many aesthetic surgeons not to renew the incision for at least one year. However, you can further discuss with your surgeon for any exceptions.
Tenderness at the implant site and change in breast shape is the most prevalent complaint reported by many patients. It happens due to capsular contracture caused by the rigidity and thickness of scar tissue around the implant.
By removing 600 CC implants after an explant surgery, it’s highly unlikely that the breasts will look natural. However, they can get a natural-looking appearance with some kind of revision surgery, for example, a breast lift surgery or replacing the previous implant with a smaller one.
There are several reasons to replace or remove a breast implant. Some of them include leakage of the implant (more common in saline implants), rupture of the implant (silent rupture is more common with silicone implants), capsular contracture, autoimmune trigger, wear and tear to the implant and other health or cosmetic concerns.
After you’ve had your breast implants removed, the breasts will initially look flattened. It can take two to three weeks for the breasts to get their volume back. If you’ve additionally had a breast lift after the breast explant surgery, your breasts will not have a deflated appearance.
A fat transfer from other parts of the body to the breast is done to maintain the breast’s fullness. At the time of consultation, your breast explant surgeon will examine your abdomen, back, flanks, thigh, hips, and buttocks to be certain that adequate fat tissue is available for grafting.
Textured breast implants are known to cause a rare form of T-cell lymphoma (cancer) known as breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). The decision to remove textured breast implants should be made under the light of most current information and recommendations by the FDA. If you have a previous history of textured implant, we advise you to visit your breast explant surgeon for consultation.
No known risk factors have been attributed to the development of BII, irrespective of the implant’s presence. Therefore, it is controversial to label any particular risk factor to BII.
Nonetheless, the patient should be counseled regarding the risk carried by breast implants such as BIA-ALCL. They should be educated regarding the fact that BIA-ALCL is not itself a carcinoma of the breast tissue. If diagnosed early with effective, prompt treatment, it is readily curable. Chemotherapy and Radiotherapy can be used for more advanced cases.
Multiple studies show variable results among patients, some of whom achieved permanent remission from autoimmune disease symptoms while the rest experienced temporary relief. There hasn’t been any published paper that precisely pinpoints which symptoms may or may not relief after the removal of the implant with or without capsulectomy.
It depends upon the actual state of the implant. For example, if the implants have been damaged, ruptured, or the breast is tender and encapsulated, they should be replaced immediately. In the rest of the scenarios, the patient can replace them as per their convenience.
The removal of the implant is only possible when the patient has a sufficient amount of breast tissue to maintain its fullness. The excessive skin can be tightened around it by a procedure known as breast lift, to further augment breast shape. However, it is challenging to remove the implant without replacing them until and unless the patient meets the abovementioned criteria.
BIA-ALCL is a rare form of immunity-related cancer, specifically affecting T-lymphocytes developing within or around the scar tissue capsule of breast implants. It is prevalent among patients who had breast augmentation with a textured implant. The most frequent symptoms experienced by the patients are persistent swelling and tenderness in the implant region. Theoretically, it takes 7-10 years from the initial date of implant for these symptoms to develop, but they can occur earlier. It is highly recommended to consult your physician if you experience any of these symptoms, as early diagnosis and prompt treatment can have a better overall prognosis.
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