Implant Removal

Where symptoms dictate,  Rozina recommends a radiological investigation of implant integrity (mammogram or MRI) to detect any ruptures or leaks since this will affect surgical planning and the requirement for additional care.

The procedure is usually performed as a day case surgical procedure requiring a general anaesthetic

The old scar is cut out so you are left with a single fresh new scar.

The implant is removed intact with any adherent capsule.

Once the implant is removed the pocket is irrigated and inspected before closure of the wound, simple dressings and discharge home with a  compression garment

More often than not the capsule is only a very thin soft layer adherent to the breast tissue and it is not possible to remove it without sacrificing significant and unnecessary breast tissue. In such  cases a capsulotomy is performed – radial and circumferential incisions are made through the full thickness of the capsule to disrupt its integrity. The bleeding and subsequent inflammation will assist the pocket to close.

Whether a capsule should be removed is dictated by its grade (1-4) as defined by how it feels and looks. A thicker, calcified capsule requires removal for pain relief and to allow the pocket to close. The thickened capsule is excised. Usually this is a subtotal or partial capsulectomy (capsule removal) since the whole capsule cannot always be reached. This procedure is equivalent in operating time and in pain and recovery time as the initial breast implant placement.

A long-standing calcified capsule may be removed in toto with the damaged implant

Controversy arises with requests to remove ALL of the capsule with often more harm than good being done. If the capsule is thin and supple, not easily discernible or able to be accessed without lengthening the scar and/or removing some breast tissue then there is little benefit in such a radical approach. Capsule  also covers the chest wall  and injury to muscle, rib and lung is rare but possible.

The matter of capsule management will be discussed and agreed prior to the surgery

Ideally not.

Large implants may have squeezed and squashed your natural breast tissue (atrophy) so that when the implants are removed, your breasts look older and emptier than you remember. Also your breasts would have continued to age over the intervening years.

Much sagginess will be mitigated by your natural skin elasticity depending on your skin quality, age and menopausal status.

If required, there are ways to correct empty sagging breasts. Breast uplift and  fat transfer, may both become more desirable or suitable as you get older.

No, , a new implant may be placed in a new pocket under the muscle (if it was originally over the muscle) or vice versa.  A different shape, texture, size or weight of volume may be selected.