What is breast implant removal and replacement surgery?
Implant removal and replacement surgery, also known as capsulectomy, refers to the removal of the scar tissue or capsule which typically forms around an implant.
It is a procedure which is undertaken when a breast implant is being replaced and is intended to alleviate discomfort while offering the potential of improving both the feel and appearance of the breasts.
The capsule (scar tissue) which forms around the implant is a completely normal reaction to the insertion of a foreign body (the implant) into the breast. There are cases in which the capsule thickens and contracts. This is known as capsular contracture and can make the breasts feel a lot harder. As well as being uncomfortable or painful for an individual, capsular contracture which gets progressively worse can distort the shape of the breasts. A capsulectomy can address issues with the look and feel of the breast, and serve to alleviate the pain.
The procedure can be done for the purpose of reversing a previous breast augmentation procedure.
Is implant removal and replacement surgery for me?
One of the primary reasons to undergo implant removal and replacement surgery is to address complications which have been experienced with breast implants.
These problems can include capsular contracture or infection, which lead a plastic surgeon to recommend the removal of the breast implant.
Implant rupture, deflation or folding are other causes of complications which can lead to the need for implant and removal surgery. The procedure can also be necessary when women experience necrosis or dead tissues developing around the implant, bleeding, or a build-up of calcium.
In some cases, the decision to opt for implant removal and replacement surgery can be a personal choice. Some women might feel that breast implants they received as part of a breast augmentation procedure have given their breasts the wrong size or shape, or the implants have moved into the wrong position due to factors such as pregnancy, weight gain, or weight loss.
How is Implant removal and replacement surgery performed?
Implant removal and replacement surgery is typically performed using the same incisions which were made during the breast augmentation procedure.
During surgery, the capsule which surrounds the implant is taken out, and a new implant is then inserted into this vacant area known as ‘the pocket’. In cases of capsular contracture, patients are typically recommended polyurethane implants as a replacement. That is because, compared to a standard silicone implant, polyurethane implants are accepted as having less risk of capsular contracture. Once the new implants have been inserted, the skin incision can be closed.
Usually implant removal and replacement surgery takes an hour and is performed under a general anaesthetic, which means that the patient is asleep during the procedure. Implant removal and replacement surgery usually requires a one night stay in hospital, although on some occasions the patient is permitted to go home on the same day.
Advice On Breast Implants
Since December 2018, many regulatory bodies around the World have issued statements regarding their own position and some have limited the distribution of other textured devices. The advice does vary from country to country because the research data available is limited and not conclusive. None have called for the precautionary removal or replacement of textured devices that are already inside patients’ breasts.
Breast implants however are not lifelong devices and in general will need removal or replacement at some point. In an effort to have more robust data about both conditions, the Breast and Cosmetic Implant register (BCIR) collects breast implant data for patients in England and Scotland. The MHRA continues to collect and analyse UK information through a reporting system. It also has links with up to date information from international public health organisations. The most recent advice from MHRA on BIA-ALCL was updated on the 4th April 2019.
View the MHRA statement on Allergan
Download the BAAPS statement on ALCL