Definition & Overview
The removal of an intact mammary implant is a medical procedure used to remove a breast implant. A breast implant is a prosthetic gel or fluid-based material that is used to increase the size and fullness of breasts. They are used for two purposes: reconstructive and cosmetic.
There are two types of breast implants in use today. They are:
- Saline breast implants – These are made of a silicone elastomer shell and are filled with medical-grade saline.
- Silicone-gel implants – These are made entirely up of a silicone elastomer exterior and are filled with a transparent silicone material. Some of them have a fluorosilicone layer to add strength.
Who Should Undergo and Expected Results
The removal of an intact mammary implant is used for both cosmetic and medical purposes.
Cosmetically, the procedure is for patients who wish to replace their implants with one of a different type or size. It is also beneficial for people who have changed their minds about getting a breast enlargement. Removing the intact implant will restore their breast size back to normal.
Some, however, need to have them removed for medical purposes, such as if they experience some breast implant complications like:
- Capsular contracture
- Recurrent or severe infections that do not respond to antibiotic treatment
Capsular contracture cases are also graded prior to implant removal. Only Baker grade III and IV are considered for intact implant removal. The grading system is as follows:
- Grade I – The breast is still soft but some thickening can be felt.
- Grade II – The breast is a little firm but there are no visible changes in its appearance.
- Grade III – The breast is firm and a little distorted in shape.
- Grade IV – The breast is hard and is severely malpositioned or distorted. It may also cause the patient some pain and discomfort.
Furthermore, patients who experience the following symptoms should consider having their implants removed even when it is intact:
- Inability to reach out or reach overhead
- Difficulty to comb one’s hair
Other medical reasons for the removal of intact mammary implants include:
- Interference with breast cancer screening (such as a mammography)
- Breast cancer
Patients who undergo a mastectomy for the treatment of breast cancer sometimes have breast implants placed. However, the implants may need to be removed at a later time if breast cancer treatment so requires.
How is the Procedure Performed?
The removal of an intact mammary implant is performed under general anaesthesia as an outpatient procedure. For simple intact removals, the procedure can last for up to an hour. However, for complex implant removal and replacement, the procedure can last longer.
The procedure follows the steps below:
- The patient is placed under anaesthesia.
- The surgeon makes an incision, usually in areas that are hidden so that the scars will not be visible.
- Through the incision, the surgeon accesses the implant and removes it from the breast pocket.
- When the implants are removed, the surgeon closes up the incision with sutures.
After the removal of an intact mammary implant, patients may need to take at least a week off from work. They are also required to stay away from heavy exercise for at least three weeks. They are also given a special bra to wear during the initial recovery period. It is also necessary to take care of the incisions or surgical wounds until they heal.
Possible Risks and Complications
As a surgical procedure requiring anesthetics and an incision, the removal of an intact mammary implant can cause some complications, such as:
- Allergic reaction to anaesthesia
- Blood clot
- Post-surgical wound pain
Excessive bleeding and signs of a possible infection should be brought to the attention of a physician. The same is true for adverse reactions to the anaesthetics used during the procedure. Post-surgical pain, however, can be managed with pain medications.
Adhesions and scar tissue are not always a cause for concern. They can sometimes be broken up with regular breast massages. The scar tissue may soften, but the process may take several months. Patients may talk to their surgeon about this.
The appearance of the breasts after the removal of a breast implant depends on several factors, such as:
- The size of the implant
- How long it has been in place
The thickness of overlying breast tissue
“Breast repair/reconstruction not following mastectomy.” https://www.unitedhealthcareonline.com/ccmcontent/ProviderII/UHC/en-US/Assets/ProviderStaticFiles/ProviderStaticFilesPdf/Tools%20and%20Resources/Policies%20and%20Protocols/Medical%20Policies/Medical%20Policies/BreastRepair_NotFollowingMastectomy.pdf
Angell M. “Evaluating the health risks of breast implants: The interplay of medical science, the law, and public opinion.” N Engl J Med 1996; 334:1513-1518. http://www.nejm.org/doi/full/10.1056/NEJM199606063342306#t=article