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Breast Revision and Implants: Should They be Replaced or Permanently Removed?
It would wonderful if implants used in cosmetic and reconstructive breast surgery were of the perfect “one and done” variety: put in one or a pair and they will remain there unchanged and last a lifetime.
And, this should be true whether they are (it is) for a breast augmentation, as part of a mastopexy or in breast reconstruction.
Unfortunately, this is presently not the reality for several reasons. Factors leading to implant exchange (immediate replacement of implants) or permanent removal can be of either an elective nature or due to necessity.
Let’s look at some of these reasons for these types of breast revision.
Breast Implant Removal (Explantation)
When women undergo breast revision, there is no requirement stating they must replace the implants. They can either replace the implants or remove them depending on their aesthetic desires.
When women undergo breast revision, there is no requirement stating they must replace the implants. Women can either replace the implants or remove them depending on their aesthetic desires.
Why Women Choose Permanent Removal of Their Implants
Even though most women are very happy with their implants initially (for cosmetic reasons in particular), life and lifestyle changes can alter those feelings. Pregnancies and weight fluctuations may change the way that the implants look or feel on the chest or even the need for them at a certain point in life. Some women may just decide that, in some ways, the implants no longer have a positive impact on their active lifestyles.
Their Implants Were Not What They Thought
It is no longer the 80’s or 90’s and large or really large breasts are no longer the “in” thing. So, some may decide to adjust to the times, either by downsizing their implants or just having them removed. Of course, now that these women are a few decades older, this may not be a difficult decision especially if their implants are either ruptured or well past their prime.
Substantial Weight Gain
Perhaps when they had their breast augmentation, they weighed 110, 120, or 130 pounds. Now, many years later, they may be 160, 180, or even 200 andpounds or more. With this weight gain, their breasts have also grown substantially and become very large, maybe even causing discomfort or inconvenience. Their once crucial breast implants are now, at best, redundant and unnecessary. Treatment of such large breasts may consist of implant removal along with a breast reduction.
Complications and untoward sequelae can be associated with breast implants. For example, although they are generally very durable, implants are not permanent devices. Given a long enough time—whether 5, 10, or 40 years or more—they will ultimately wear down and need to be replaced or removed. At that point, some women may decide just to have them removed permanently. Others who experience capsular contracture, where the breast feels very firm or hard, may reach the same decision.
When it comes that time to decide whether to have one’s implants exchanged or permanently removed, financial considerations may lead to the decision of just having them taken out.
Their Implants Were Not What They Thought They Would Be
Though very rare, some women may just reach the conclusion that having breast implants is not what they thought it would be or they just don’t like them for whatever reasons. So, out they come.
Also very rare, some women want their implants removed for real or perceived medical problems or potential medical issues.
Breast Revision with Implant Exchange
Why Women Choose Implant Replacement?
Aesthetically Pleasing Breasts
Most women choose to replace worn down or ruptured breast implants because they have been very happy with the pleasing aesthetic results that they have created. Many can’t imagine going through the rest of their lives without them. Replacing them will allow women to retain their body contour as well as keep their wardrobes.
Size—Bigger or Smaller
At some point in time, there are women who decide that they want a change in their breast size—either bigger or smaller than what they have presently. Breast revision surgery will allow them to obtain that new look with larger or smaller implants.
Need for a Breast Lift
Breast sagging—whether the result of substantial weight fluctuations, pregnancy, or aging—can create a less than desirable look and a loss of confidence or feeling of attractiveness. Women who then decide to proceed with a breast lift and who already have breast implants in place may decide to switch out their old implants, whether they will be an updated version of a similar size or either larger or smaller.
Improve on Their Results
Some women have results that either were not initially exactly to their liking or had deterioration of the results over time. An implant exchange will provide the opportunity to address the present issues and obtain the desired look.
Customization of Results With Greater Implant Choices
With time there has been the introduction of a far greater range implant profiles (width to height ratios) and level of cohesiveness that has allowed for greater customization of results. This allows for far more options with regard to size and one’s body configuration—such as wide versus narrow. It also can provide for more superior results in individuals with very thin skin. Therefore, this is even more motivation for some women to undergo breast revision.
Switching from Saline to Silicone Implants
Silicone implants are far superior to their saline counterparts in many ways. At some point in time, whether due to implant deflation, weight loss or a desire for an improved or rejuvenated look, women will switch out their saline implants for silicone ones. This can also include a size and profile change.
Switching from Textured Surfaced Implants to Smooth Surfaced Implants
With information recently coming out regarding the very rare occurrence of a type of lymphoma, known as BIA-ALCL, in some women who have had textured surfaced implants, whether saline or silicone, concern has been raised. Though the FDA is not recommending women who have these implants to have them removed or replaced with smooth surface ones, some women are contemplating it. As of yet, this reason for an exchange is more theoretical than real.
To Replace or Remove—A Personal Decision
The above outlines some of the major pros and cons of implant exchange versus permanent removal. Ultimately, the decision of which choice to make is a personal one often based on a variety of factors.
And for those women who later on realize that whatever decision they made was not the right one, there is good news: selecting one of the above choices doesn’t mean that it necessarily has to be an irreversible decision.
Luckily, though, women rarely change their minds.
(And guys are so sensitive, ALWAYS wanting to share their feelings with their significant others.)
For more information about breast revision, breast augmentation, or breast lift surgery, contact Dr. Turkeltaub at the Arizona Center for Breast Surgery by calling (480) 451-3000 or by filling out our online contact form.