Breast implant replacement
- Surgery time: 45–120 minutes
- General and local anesthesia
- Major outpatient surgery
- No drains, dressings, or bandages
- Recovery room stay: 1–2 hours
- Recovery: 2–3 days
- Exercise from 3–4 weeks
- Preoperative assessment
- Surgery
- Recovery room
- Postoperative follow-ups
- Post-surgical band kit and support garments
- 24-hour emergency phone number.
What does implant replacement involve?
Breast implant replacement is a surgical procedure in which the previous breast implants are removed; a capsulotomy is performed, or in cases of periprosthetic capsular contracture, complete removal (capsulectomy) is required. A new prosthesis is then placed, suited to the new circumstances.
Normally, the same scar is used for the replacement, but in some cases an incision in the inframammary fold may be preferred.
Sometimes a change in implant plane is needed. That is, if the prostheses were previously placed in the subcutaneous plane (above the muscle), they can be positioned under the muscle, providing more coverage for the implant. We can also thicken or improve the tissue surrounding the prosthesis by performing a fat transfer beforehand during the same surgical session.
In addition, if the breasts are sagging, a mastopexy (breast lift) can be performed at the same time as the implant replacement.
Breast implant replacement can be a relatively straightforward procedure if it is done preventively, or if the periprosthetic capsule is in perfect condition.
Who is it for?
It is indicated for women who have capsular contracture issues, implant rupture, or as a preventive measure when the implants have been in place long enough to justify a replacement.
The reasons for replacement vary: personal and psychological reasons, or problems related to capsular contracture.
The alternative would be a fat transfer performed at the same time as the implants are removed. If the areola–nipple complex is positioned lower, a fat transfer can be combined with an augmentation mastopexy (lifting and increasing breast size).
Planning
During the first consultation, the size and shape of the breasts, the firmness of the skin, and your overall health status will be assessed. The different surgical techniques will be explained to you, and we will discuss the size and shape your breasts will have, as well as the options or combination of procedures that will be best for you.
Surgery
It is performed under general anesthesia at the Hospital Mediterráneo as an outpatient procedure, meaning you do not need hospital admission. The average stay in the recovery room is 2 hours.
Using a small 5 cm incision, the implant replacement is carried out.
We do not use drains, except for a few limited and well-justified exceptions. In the scar area, a 3M Micropore paper tape dressing is applied, and it is left in place for three weeks until the stitches are removed.
What is the postoperative period like?
You will not need dressings, as the incision is protected with tape until the stitches are removed. After the implant replacement surgery, it is normal to feel somewhat tired for a few days, but you will be able to live almost normally once you leave the recovery room, thanks to the local anesthesia we use during the procedure. It is very important to perform the movements that begin in the recovery room; this will help us avoid shoulder, back, and neck muscle contracture, which are responsible for postoperative pain. (video) Most discomfort can be well controlled with the prescribed medication, although the breasts may be sore for a couple of weeks.
What risks and complications are there?
Breast implant replacement surgery is a safe technique, provided it is performed by a qualified plastic surgeon. The risks are the same as when you first had implants placed. We remind you of them here:
- Capsular contracture: occurs when the internal scar (capsule) that forms around the implant tightens excessively, squeezing the implant and making the breast feel firmer. 1–4% for textured cohesive prostheses placed under the muscle. It can be treated in different ways, and in some cases it requires removing the capsule (total capsulectomy) and replacing the prosthesis. We reduce the risk by avoiding the peri-areolar approach and drains.
- Bleeding/hematoma: uncommon and highly related to excessive strain. Only in specific cases does it require a new procedure to remove accumulated blood (less than 0.5%).
- Infection: very rare thanks to the surgical technique; a film that protects the nipple; antibiotics (pre-, intra-, and postoperative); and above all, avoiding the peri-areolar approach and the use of drains. (less than 0.1%).
- Sensation changes: some women notice the nipples are more or less sensitive, or even without sensitivity. These changes are usually temporary (less than 12 months), although in a small number of cases they may be permanent. They are directly proportional to the width of the prosthesis used.
- Implant capsule rupture: uncommon with today’s cohesive prostheses. If rupture occurs, the prostheses must be replaced.
Frequently asked questions
Does implant replacement hurt?
It hurts less than the first time you had the implants placed. The immediate postoperative period (first 12 hours) is not painful, thanks to local anesthesia with adrenaline. When you get home, you will start the medication and the exercises to avoid muscle contracture, which is what causes postoperative pain.
When can I return to my everyday life?
After the implants are removed, you can return to work in a few days, depending on the activity you do. It is important not to do any strenuous activity during the first two weeks.
When will I be able to resume my sports activities?
You can start running again at around 3 or 4 weeks. Start gradually and at a moderate level, then progress.
Is Clínica de San Pío a good place to have a mastopexy in Almería?
Only a reference surgery center with extensive experience in this field—such as Clínica de San Pío—can ensure the safety and quality required to carry out this procedure in Almería.
In Spain, you can check the training of the plastic surgeon you consulted through the College of Physicians in your province and by visiting the website of the Spanish Society of Plastic, Aesthetic and Reconstructive Surgery (SECPRE).