Explant Surgery

Explant Surgery

According to the American Society of Plastic Surgeons, there were 307,190 breast augmentations procedures in the USA in 2011, as well as 22,271 breast implant removals. Please keep in mind these figures are for the USA only.

Women who have explanted have reported the following

  • Most explant recipients say they are “back to normal” within 4 weeks of their surgery
  • Most women say their new breast size was better than expected
  • Some say a larger size would have been better but are still happy with their results
  • Not many would have preferred a smaller size after removing their breast implants
  • Some women are not happy with their scars, which are usually in the crease under the breast
  • Nearly all women report that their ‘real’ breasts softness was wonderful
  • Majority say their results met with their expectations

 

What happens during the explant/breast implant removal procedure?

Anesthesia

The patient will be given either a general or twilight sedation (local anesthesia) depending on the complexity of the surgery. Under twilight anesthesia the patient is semi awake and only the surgical area is numbed. However, in most cases the procedure is done under general anesthesia.

The procedure is most often conducted in an outpatient setting and takes an average of two hours, sometimes longer if a Mastopexy/Breast Lift is required. Some surgeries require an overnight stay or longer if infection or reconstructive surgery is involved.

The incision

The explant surgeon and patient should discuss incision options. The explant surgeon will explain which are most suitable for the patient and her desired outcome. Most times the explant surgeon will perform your explant via the original incisions.

After the aesthetic is administered, your surgeon will place a small incision along the scar created during the original Breast Augmentation procedure. The implant will then be removed, (deflated first if made of saline).

At this time (a new Breast Implant will be inserted if you are re-implanting) if not your Surgeon may or may not perform a Capsulectomy and or a Mastopexy/Breast Lift.

The following incision options are possible:

  • Inframmammary incision – in the crease under the breast.
  • Periareolar incision – around the nipple

The choice of which incision to use depends on several factors, including the size of the breast implants that are to be removed, the patient’s anatomy, the type of implant, and surgeon-patient preference.

The incisions are closed

The surgeon closes the incisions with layered sutures (stitches) in the breast tissue, and with skin adhesives, sutures and surgical tape to close the skin and keep it closed. You will be wrapped in compression bandages or have a tight surgical bra to wear for a time determined by your explant surgeon. Each one has different views on compression.

Initially, there will be evident incision lines. These will fade with time.

View the results

Explant surgery results are visibly evident straight away, due to loss of fullness. BUT the final results will take weeks if not months to be fully evident. There will be some swelling caused by the surgery, which will resolve within a couple of weeks. As the swelling dies down and the incision lines fade, you will have a better idea of whether the procedure met your expectations.

 

Capsulectomies are very useful in removing thickened, hard scar tissue that forms what is referred to as a capsule around a prosthetic device such as a breast implant. The capsule is made of three components, fibroblast, collagen and blood vessels. The reason of the capsular contracture and the increased capsular scar tissue is not specifically known. However, it may be associated with the possibility of a micro infection of staph, epidermis staph aureus or some other type of bacterium.

There’s normal lining called the capsule that develops after augmentation, and if this capsule stays enlarged there’s never a problem and the implant freely flows throughout the implant pocket. However, sometimes the capsule itself can shrink wrap and that shrink wrapping cause the implant to feel firmer or look higher or have an abnormal shape. “Capsular Contracture” A capsulectomy therefore is just the actual incision and removal of that scar tissue. In any case, whenever a capsulectomy is performed, the word “ectomy” means to remove the scar tissue.

 

Mastopexy (breast lift surgery) may also be conducted in order to help alleviate any changes in appearance caused by removing the breast implant.

There are three types of breast droopiness, also known as breast ptosis. Breast lift surgery is effective in treating mild, moderate, and severe instances of ptosis:

  • Mild: nipple is level with the crease
  • Moderate: nipple is below the crease
  • Severe: nipple is at the lowest point on breast and points downwar

Most patients can return to non-strenuous work after 10 days. Strenuous work or exercise should not be resumed until at least 3 to 4 weeks have passed, and sexual activity should be avoided for a minimum of 1 to 2 weeks. After that, you should continue to be extremely gentle with your breasts for at least the next several weeks. As with all surgery, it is important to understand that these guidelines can vary widely based on the patient’s personal health, the techniques used, and other variable factors surrounding the surgery. Any severe pain should be reported to

 

image  http://www.kornstein.com/breast-lifts/

Ptosis of the breast refers to drooping or sagging of the female breast. The cause of ptosis was unknown until recently. Many women mistakenly believed that the breast itself offered insufficient support and that wearing a bra can prevent sagging. Many also believed that nursing increased sagging. Research has shown that ptosis is a natural consequence of aging, though the rate at which a woman develops ptosis depends on many factors.

Breast ptosis is influenced by heredity which determines skin elasticity, breast size, and the balance of adipose and glandular tissue. Over a woman’s life, the primary influencing factors on sagging are cigarettesmoking, a woman’s body mass index (BMI), her number of pregnancies, her breast size before pregnancy. Ptosis can also be increased by weight gain because increased breast size contributes to ptosis.

Plastic surgeons categorize the severity of ptosis by evaluating the position of the nipple relative to the infra-mammary fold. In popular culture, this normal process is referred to as “sagging” or “drooping”, while plastic surgeons refer to it medically as ptosis.