Breast Implant Deflation
From 1992-2006, silicone implants were banned in for use in cosmetic breast surgery. During that time, literally millions of breast implants were placed in women with very good results. However, as time elapses, many of these saline implants will either leak or get hard (fancy medical term is “capsule” formation). This is not a reflection of poor technique by the surgeon, but rather the natural history of breast implants. Those implants that were placed above the muscle, in a sub glandular position, are more likely to have these complications, than those placed below the muscle. However, all implants will eventually, given enough time, will either get hard or deflate.
What to do about this problem when it occurs?
First of all, there is no need to panic. A deflated saline implant is not dangerous – it just looks odd – to have one full breast and one deflated implant. A hard breast capsule, has usually come on gradually over months or years. A deflated implant is usually replaced with either a saline or a silicone breast implant. IF the capsule has thickened, I usually remove some or all of the capsule. Also if the implant was placed subglandularly, I usually will convert it to a submuscular position. If there has been a loss of breast tissue over time, I will usually recommend a silicone implant. There are a variety of silicone implants that vary in firmness and profile, which I can discuss at the time of the consult. It is very helpful, if you can bring along, either the operative note, or at least a knowledge of the size of your original breast implant in cc.
If the problem is significant hardness (grade 3 or 4 capsule formation), I will remove most or all of the capsule and then will usually recommend a silicone implant – sometimes a textured implant and sometimes one of the newer shaped, textured implants which have recently been approved. Sometimes, I will need to adjust the size of the breast pocket, if it has stretched or if a new implant size is selected which differed from the original breast implant.
I often like to use the Keller funnel (I have obtained their certification to use them) which allows for a smaller incision.
I usually do not place a drain.
Post Operative Expectations
If the original implant was placed in the submuscular location, frequently this second operation is much less uncomfortable since the muscle has already been stretched to accommodate the new implant. the surgical time will vary depending on how easy it is to remove the capsule. Mosts patients should be able to return to work in 5-7 days. When you can return to exercising can vary from 1-4 weeks and will be discussed with you after your surgery.
Disclaimer: Results may vary for different individuals.