Breast implant surgery is one of the most common procedures performed in plastic surgery. There are subsequently a growing number of women who have breast implants for cosmetic or reconstructive reasons (after breast cancer surgery). With this large number of breast implants, there are certain women who choose to have their implants removed or exchanged. This is commonly due to their preference for smaller or larger implants. Another reason is tightening of the capsule around the implant which can occur occasionally.

Implant removal typically involves making a small incision at the prior scar from the last implant insertion surgery. The implant it then simply removed. In certain patients who may have had their implants for many years, the resulting breasts appear "deflated" following the removal of their implants. A breast lift (mastopexy) may therefore be necessary to improve the shape of the breasts.

When replacing implants, a small incision is again made over the prior scar and the implants simply replaced with new ones. In such cases, the capsule which has formed by your body around the old implants needs to be released and enlarged to create a large pocket for the new implants. If this capsule has tightened leading to a change in breast shape, the capsule is typically removed prior to insertion on the new implants.

Options for replacement implants include saline or silicone. Numerous research studies have demonstrated the safety of silicone implants. But the ultimate decision as to the type of implant remains with you. The plastic surgeon will spend as much time as is necessary to inform you regarding your options such that you can make an informed decision.

You may choose to have your procedure performed under light general anesthesia, or regular general anesthesia. After you are comfortably relaxed or asleep, plastic surgeons inject your breasts with a long-acting local anesthetic which will keep you pain-free for hours after the surgery. A small incision is made typically at the prior scar on your breasts. The implant and the capsule are removed. If you have chosen to have a breast lift, one will be performed at this point.

A replacement implant of your type and size selection then inserted into the breast pocket. If your prior implant was over your chest muscle (pectoralis), plastic surgeons typically prefer to place the new implant under the muscle to improve the shape of your breasts while minimizing the chance for a future capsule problem. The wound is closed in multiple layers to assure the best scar and a compression bra is placed on you. The entire procedure typically takes about 2 hours. You are able to go home or to a care facility approximately one hour after the procedure.

You can enjoy regular food after your surgery, but start slow. You should be pain-free until the day after your surgery. If you experience some discomfort, prescription pain medication will be available to you. You should walk around the house with some assistance. Your plastic surgeon will see you in the office the day following your surgery. You are asked to take your prophylactic antibiotics and other medications as necessary.

We expect that you walk around the house every day, slowly increasing your level of activity daily. Avoid raising your shoulders above 90 degrees for 2 weeks, for instance to reach a plate high in the cupboard. Our staff will be in regular contact with you every day to assure that your recovery is a smooth and comfortable one. Your sutures will be removed in 5-7 days. You should begin massaging your implants one week after your surgery to maintain their softness. The swelling will decrease every week, such that by 6-8 weeks, about 80% of the swelling will have dissipated.

It will take 6 months for your breasts to mature from the surgery and for the final results to be evident. Following the second week after your surgery, you can take off your bra if you are going out in the evenings. You otherwise are strongly encouraged to wear a supportive bra as often as possible to counteract the strong forces of gravity pulling your breasts downward.