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Making a Change — Implant Revision and Replacement

breast reductionWhile patients going into breast augmentation surgery expect the procedure’s results to be long lasting, that isn’t always the case. Dr. Malamet performs breast augmentation revision and breast implant replacement procedures for a variety of reasons for his patients and for patients from other surgeons.

Capsular contracture
Sometimes people forget that implants are foreign bodies, and when a foreign body is placed within the human body there is a reaction. This reaction is called the “capsule” and it is made up of calcified cells and scar tissue. Sometimes the capsule becomes very thick and causes the implant to shift or the breast to feel very firm, or there may be pain from the constricting scar tissue. This is called capsular contracture, and more severe cases often demand revision surgery. If the capsule is very calcified, Dr. Malamet will remove it along with the implant. If it isn’t, he usually will leave it in place. If there is a rupture of a silicone implant, the capsule may contain silicone shell fragments, silicone gel, and inflammatory cells that all need to be removed prior to placing new implants.

Changing the implant size
Sometimes a patient will come to our offices expressing dissatisfaction with the size of her implants. When this happens, Dr. Malamet first suggests she wait one full year before opting to make a change. This allows for any swelling to fully subside and for the implants to settle. At that point, if the patient still wants to change her implant size, Dr. Malamet will enter through the original incision. If a larger implant is desired, he will increase the size of the pocket, the space in the breast to hold the implant. If the patient seeks smaller implants, he will reduce the size of the pocket with sutures to fit the smaller implants. In cases of reduction, a breast lift may be done in conjunction with the implant revision to remove any sagging tissue and possibly relocate the nipples.

Implant position
Sometimes a less experienced surgeon will place the implant pockets either too far away or too close together and the patient is not happy with the placement. In these cases, Dr. Malamet will use scar tissue from the capsule and will reconstruct new pockets for the implants in better positions.

Implant rippling
Although this doesn’t usually happen with silicone implants, occasionally, particularly with saline implants placed atop the chest muscle, the implants show rippling and the edges may even be able to be felt. In these instances, Dr. Malamet enters through the original incision and replaces the implants with better muscle coverage. This may involve switching implant types and/or placing them in new breast pockets. In more extreme cases, he may opt to place the implant behind the pectoral muscle, rather than atop it.

Implant removal
When a patient decides she no longer wants to have her implants, they are removed through the same incisions. Dr. Malamet will also remove the capsule if it is calcified and thick. Usually a breast lift will be recommended along with the removal surgery to rectify sagging and to remove excess skin.

While complications and problems can occur, the above circumstances are further reason to do your research before choosing your plastic surgeon. Some of these problems can be avoided through experience and knowledge. That’s why you should trust these types of surgeries to a doctor with extensive experience and training, a doctor like Dr. Malamet.

Do you have questions about your augmentation, even if it was done by another doctor? Call Dr. Malamet at 818-380-3130 and set up a consultation.