The Use of Form Stable Highly Cohesive Gel Implants in Breast Implant Revision Surgery
The most common breast implant revision surgeries in the United States are done to correct problems that were a result of improper implant selection or poor
surgical technique. Revision procedures may also be necessary to remove or replace aging, older generation gel and saline devices.
Local problems may include capsular contracture, stretch deformities, wrinkling, implant palpability, visibility, asymmetries, and even pain. Often, patients
have had problems with their breast implants for many years. Many women were either discharged by their plastic surgeon without any follow-up care, or are uncomfortable
with the idea of returning to their original plastic surgeon.
Preoperative patient education is extremely important.
- Patients undergoing a breast implant revision procedure need to understand and accept the risks associated with implant
revision surgery or opt for implant removal alone.
- Revision goals must be realistic: obtaining a soft, comfortable implant, improved breast screening for cancer, and long lasting results.
- Patient desires must be converted into realistic surgical choices. Some long-term problems may be uncorrectable.
Any surgical procedure should be considered carefully. Revision or removal of aging breast implants or revision surgery for local implant problems should only be
performed when the long-term benefits and risks associated with the revision procedure have been fully discussed.
Patients should attempt to obtain any information about their previous breast implant surgery. Important information can be gained from old operative reports,
and any information on the size, style, or manufacturer of their breast implants may be useful when selecting a replacement implant. Patients over 35 should also
have an up-to-date mammography. Additional radiological studies, such as a breast MRI, may be necessary to evaluate the integrity of older gel implants.
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.
The advantages of using a form stable cohesive gel implant may include:
- variable height, width and projection which will provide a wider range of options for the surgeon.
- decreased visibility and palpability of the implant especially in revision patients.
- that it is designed not to leak with extremely low rupture rates.
- very low capsular contracture rates.
The disadvantages of using a form stable cohesive gel implant may include:
- that it requires the surgeon to create a carefully developed and precise pocket for the new implant.
- the possibility that with any shaped implant there is the risk of rotation.
- enrollment in a long-term follow-up study ( this may also be considered an advantage).
- the cost- form stable gels may be a few hundred dollars more expensive than round gels.
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