Introduction Implant removal* If you are planning to enhance the appearance of your breasts through the help of plastic surgery, you will want some of the answers to some questions about the risks of breast enhancement surgery. One of these questions is the one related to the life span of the breast implants. Will you need to replace them after a certain period of time? The mammary implants don’t come with an expiration date set on the packaging, but they are usually replaced after fifteen to twenty years. Of course, there will be cases when earlier complications occur, and it will be necessary to remove the implants and replace them with new ones. In most cases, breast implants can last up to twenty years without having any issues, even more, if the patient looks after them properly. The new statistics show that fewer than 20 percent of the women who undergo breast augmentation procedure with breast implants were required to remove or replace the mammary implants within ten years after the surgery. This is accurate for the women who went through surgery for aesthetic reasons. For those who required the surgery for mammary reconstruction, the percentage rises to 50. The Revision of Mammary Implants Mammary implant revision may be necessary for any or all of the following: – The improvement of the symptoms from potential complications of breast augmentation surgery such as the capsular contracture, the malposition of the implant, the leakage or rupture of the implant. – The improvement of the aspect of the breasts if the initial implants presented any wrinkling and rippling, as in the case of malpositioning. There are cases when patients prefer to temporarily or completely remove breast implants. Others may choose to change them during another intervention. When considering the capsular contracture, the implant is under the pressure of the fiber tissue that is formed around the implant. Initially, the patient will be confronted with a certain level of discomfort and after this, some pain might occur at the breast level. The implant is being deformed from the inside, and the breasts may get an unnatural aspect that needs to be corrected through another surgical intervention. Implants that show the obvious signs of the capsular contracture or rippling can be replaced with different implants of the same or different dimensions or different textures. They may even be placed in different pockets if the plastic surgeon sees this as appropriate to that specific case. This may include implants that can be felt and even seen under the skin, as well as the implants that have migrated from their initial position. What Happens After The Implant Removal For the capsular contracture cases, the capsule that surrounds the breast implant will be partially or completely removed and careful hemostasis will be performed. After these steps, the breast implants will be changed with different ones and inserted into the same pockets or different pockets. For example, if the initial implant was placed under the mammary gland, now the plastic surgeon might decide to position it under the pectoral muscle. It is essential to know that the complete removal of the breast implants can have the same traumatizing effects as a mastectomy. This is why most plastic surgeons recommend the replacement of the implants and not their elimination. But again, it is only a question of the reasons behind the need to remove the implant that will be taken into consideration before making the final decision. After the breast implant has been removed, the breast’s skin that has been stretched by the implant will become sagging, and a mastopexy may be necessary, even if this means that more scars will be formed. The complications that can occur after the removal or the replacement of the breast implants are bleeding, infection, lack of sensation at the level of the nipple and areola, the mammary gland atrophy, and the deformation of the thorax determined by the pressure exercised by the implants. Keloid scars tend to occur more frequently in certain areas such as the anterior thorax, back, shoulders, etc. and people with darker complexion are more predisposed to develop keloid scars. These types of scars may be difficult to treat because they have a tendency to be recurrent. Recommendations to Minimize the Possibility of Breast Implants Revision Surgery First and foremost, it is crucial for all patients to become informed about breast augmentation surgery, even before making that appointment for the initial consultation with the plastic surgeon. After this, it can be as simple as following up with care and attention all the pre and post-operative recommendations. Having realistic expectations for the breast augmentation surgery will help you achieve a more satisfactory result, and diminish the risk of a breast implant revision surgery. The removal of the implants is also recommended for patients who are not happy with the result of the breast augmentation procedure, as well as in cases of potential complications after the initial surgery. Conclusion When due to certain causes, a patient that went through the breast augmentation procedure with mammary implants wants to have the implants removed, the procedure required is exactly the opposite of the enhancement surgery. Through the initial incisions, the implants will be removed, the interior capsule will be sutured, and mastopexy techniques will be used if needed. Wearing the compression girdle will also be necessary after this intervention. Your doctor will decide on an appropriate length of time. Removal of sagging skin after the implant removal is not a must. In some cases, when the sagging is mild, the plastic surgeon will decide to allow the skin to retract on its own, without performing the breast-lifting procedure.