Breast Implant Replacement: 7 Questions Answered

As mentioned in our previous article; 2016 breast surgery trends, we have seen a significant increase in demand for breast implant replacement surgery. If you have previously had a breast augmentation and are considering replacing your breast implants, then read on to find 7 of the most popular questions answered, by our breast surgery experts.

Aurora Clinics; picture showing breast implants1: Do I have to have my implants exchanged with the same plastic surgeon that I had my original breast augmentation with?

Normally we advise that if there is an issue with your current breast implants then you should return to the surgeon who initially carried out your breast surgery as they know your case history, circumstances and the materials used.

However, this is not essential.

If you do choose to have your breast re-augmentation with a different surgeon it is important that, where possible, you get the following information from your previous surgeon regarding your initial procedure:

  • Make of implant
  • Size of implant
  • Shape of implant – anatomical or round
  • Plane of implant – in front or behind the muscle
  • Any other relevant details about the first operation itself

With this information, your surgeon will be able to formulate an appropriate treatment plan for your replacement breast surgery to give you the best possible result, as Mr Richards explains further in this video:

2: Do I need two separate surgeries? One to remove my current implants and another to put the new ones in?

Generally we would remove and replace your implants in one single surgery but there are some occasions when you may consider two separate surgeries.

If you have a condition around the implant such as an infection your surgeon may recommend that your implants are removed for a minimum period of 3 months to allow your body to fully clear the infection. The reason for this is the body finds it very difficult to clear infections around artificial materials such as breast implants. Once the infection has settled you will then be able to have the second stage where the implants are replaced.

Some patients also feel they would like to have a holiday from breast implants to see how they feel with a smaller bust. This allows the breast tissue to contract naturally so you can see how you would look with slightly smaller implants to help you make a decision on the best size for you.

Generally it is best to speak to you surgeon to be as well informed as possible as to the options available to you.

Aurora Clinics: Photo of Breast Reduction Surgery3. Does the new implant go in the same place as the old one? 

Your current implants will be placed either in front or behind of the muscle. If you have no significant problems with your current implant it is likely your surgeon will maintain the existing pocket to achieve the shortest recovery period.

If however you have an issue with your current implants your surgeon may well discuss changing the pocket. For instance if you have a capsule and you can feel the edges of your implant and its currently placed in front of the muscle your surgeon may discuss moving the implant to behind the muscle to give a smoother outline to your bust. This is achieved by extra coverage of your muscle around the implant so it does not show through the skin to the same extent.

In some cases your surgeon may discuss moving your implant from behind to in front of the muscle. This typically occurs if your muscle is holding the implant in a high and unnatural position so placing the implants in front of the the muscle gives a more natural appearance to the bust.

4. How much bigger or smaller can I go? How do you determine the best size for me?

One of the main reasons women decide to change their implants is because they are unhappy with the size of their bust and they either want to go bigger or smaller.

When you had your original surgery, the chances are you had a consultation and a sizing appointment to determine the best size for you. It is more difficult to work out the best size when you already have implants in place. Generally the surgeon will take measurements of your breast base and shape and will be able to design an implant that suits you. It’s also helpful for your surgeon to have the details of your original implants, as discussed earlier.

In some cases the size of your original implant is not readily available and in this case the surgeon will have a range of implants available in theatre to enable them to choose the optimum size to fill your soft tissue envelope after removing the old implants. A vast majority of old implants have their size stamped on their shell which helps the surgeon make the best decision of which would best suit you.

We also use temporary sizers during the operation which pump saline into the breast to see which size would best suit your frame. In this video, you can see Mr Adrian Richards using this temporary sizer on a previous patient at 1:22 minutes:

Essentially, the amount you can increase or decrease the size of your implant depends on your tissue and chest size. In some people who have very tight tissue and a small chest it is not advisable to increase the size of the implant too much as it will distort the natural tissue and be too wide for the patients chest.

It is also possible to go for smaller implants during your replacement surgery. You can go as small as you like up to the point that you can go back to your natural breast tissue and completely remove your implants. Going smaller or having an explant can sometimes mean you will need a mastopexy, also known as a breast uplift. This is because the tissue around the implant will have been stretched to accommodate the larger implant which will result in excess skin. The downside of having an uplift is that it will result in more scarring (which is discussed below).

5. Is the recovery period for replacement surgery the same as when I had my original breast augmentation?

The good news is that often the recovery period is much quicker with less pain, discomfort and downtime when you have an implant exchange compared to your original breast augmentation. This is because the pocket in which the implant sits and the tissue stretching has already occurred during the initial surgery.

The exception to this comes when the pocket in which the implant sits is changed so for instance if your implant is moved from in front to behind the muscle. In this case, the recovery period will be similar to that of a breast augmentation with the implants placed behind the muscle.

6. How will the scarring differ from my original breast augmentation scars?

Generally, the scarring following further breast enlargement procedures is very similar to your first breast augmentation. If your current breast implants were inserted through your inframammary fold (the area where your breast and chest meet) then this scar can simply be removed and your implants replaced. Your new scar will therefore be in the same place as when you had your original surgery. The only difference may be that the scar is slightly shorter as scars tend to be approximately 4-5 cm now rather than the traditional 6cm.

However, there are 2 reasons why your scars may differ:

  1. If you are replacing your implants with a smaller implant you may need an uplift procedure at the same time. An uplift is most commonly performed with a lollipop scar, as pictured below.
  2. If your original implants were inserted through your areola then your surgeon may choose to insert the new implants through the inframammary fold. This means you will still have your original scar around the areola along with the new scar in your breast fold.

It is always worth discussing with your surgeon the nature of how your scars are likely to look following your second breast augmentation.

7. Can I keep my breast implants once they have been removed?

Not any more. In the past, surgeons were allowed to give patients their breast implants following surgery. However, with recent regulation, medical devices such as implants need to be disposed of in an effective and hygienic manner with no risk of contamination.

After your implants are removed we inspect them carefully to see if there is any damage and then take photographs for our records.  As they are medical devices and are potentially contaminated they are then disposed of with the other medical waste from your operation.

If your implants are damaged upon removal, then they will be sent back to the implant manufacturer.

For more information on what is involved in a breast implant replacement procedure, watch the following short clip:

We always encourage people to do as much research as they can when considering cosmetic surgery, so for more information on breast implant removal and replacement surgery: