Old Implant Replacement

Revision Surgery for Old Silicone Gel Breast Implants

Approximately four million American women have undergone breast augmentation in the last 40 years. Many women were either discharged shortly after surgery, or have
lost contact with their primary surgeon. Other women with older generation breast implants (Evolution of Breast Implants)
were never informed that their breast implants would not last a lifetime, and may have lived for years with hard, aging devices.

Although the safety and efficacy of silicone gel implants has now been well established (Institute of Medicine Report:
Safety of Silicone Breast Implants and “In the News”, Safety of Silicone.) local breast complications can occur when older generation breast implants have been neglected,
especially beyond 10 years. These local complications can include capsular contracture (a hardening of the scar tissue around the breast implant), rupture of the gel implant,
either within this capsule or beyond into the local breast tissue, or the inability to obtain clear and accurate mammograms due to a thick calcified capsule, and the firmness
that this can produce.

Any surgical procedure should be considered carefully. Replacement of older generation silicone gel implants should only be performed when the long-term benefits
and risks associated with revision surgery have been fully discussed. Options should include complete removal without replacement, as well as replacement with newer
state–of-the-art devices.

Patients interested in replacement surgery should obtain their previous surgical records, if possible, including the size, style, and manufacturer of the implant.
Often, medical records older than 10 years are no longer available, but patients should make every effort to track down their own records prior to their consultation.
Any patient over 35 will require an up-to-date mammography. Other radiological studies may be indicated to determine if the implant has ruptured, and if the gel has
traveled beyond the capsule. An MRI is presently the best test to evaluate an aging breast implant, but newer ultrasound procedures are on the horizon.

The final surgical procedure will depend on the complexity of the problem. Multiple problems may require the use of various surgical techniques to restore a more
natural appearing breast. I spend a great deal of time with my revision patients, many of whom may never have had the opportunity to learn about the full range of
implant choices, as well as the long-term consequences of their decisions. The revision procedure may include replacement of the device or removal without replacement,
changing the location of the implant, (subglandular or partial submuscular) and addressing the stretched skin, if necessary. My goal is to restore a woman’s soft, natural
appearing breasts, as well as to give her stable, long-term results. In addition, the removal of aging silicone breast implants may help provide better future breast
imaging in screening for breast cancer.

Breast Revision Problem Implants Photo Gallery
Breast Revision Saline to Gel Photo Gallery
Breast Revision Old Silicone Gels Photo Gallery

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