There are several reasons a doctor may need to remove breast implants by surgery. Certain women choose to have their implants removed or exchanged because they want smaller or larger implants. Another reason some women remove their breast implants is because of discomfort from tightening of the capsule around the implant.
Removal
Implant removal typically involves making a small incision at the site of the prior scar. The doctor simply removes the implant. In certain patients who have had implants for many years, the breasts appear deflated after the removal of implants. A breast lift may improve the shape of the breasts.
Replacing
When replacing implants, the doctor makes a small incision over the prior scar and the surgeon replaces the old implants with new ones. During this surgery, the doctor releases the capsule formed around the old implants. The doctor then enlarges the pocket for new implants. If the capsule has tightened and changed the breast shape, the doctor removes the capsule before placing new breast implants. Saline and silicone implants are available. Numerous research studies boast the safety of silicone implants.
Smooth Breast Implants
A typical breast has a smooth silicone shell containing silicone gel or saline inside. However there are also silicone or saline implants that have texture. The shell of these implants has a fine sandpaper texture. These textured breast implants have a lower incidence of capsular contracture. Capsular contracture is the most common complication of breast augmentation surgery. Some surgeons choose textured breast implants when implants go over the pectoralis muscle. One of the drawbacks of textured breast implants is the higher risk for developing ridges on the breast implant. Another potential problem with textured implants is that they inherently develop tissue growth within the sandpaper like shell. The breast implants subsequently do not move within their pocket. Normally if a patient lies down the breasts move to each side. A textured implant does not move to the side as lay down and therefore lacks the natural flow of a normal breast. Smooth shelled breast implants are always moving within their loose pocket and as a result do move to the side as a person lies down. Most surgeons choose a smooth shelled breast implant if implant are going under the pectoralis muscle. When under the muscle, textured breast implants do not exhibit much reduction in capsular contracture.
Round
or
Teardrop Breast Implants
Another variable to choose when having breast augmentation is the shape of the breast. The patience chooses between round breast implants and teardrop or "anatomical" implants. Anatomical breast implants are shape like a teardrop in order to give the breasts a natural flow and bounce. Anatomical implants allow the breast to have a gentle slope until it reaches it maximal projection or fullness towards the bottom of the breast. Anatomical or teardrop breast implants typically have a textured shell and they do not accidentally rotate after breast augmentation. Rotation of a teardrop breast implant may still occur after breast augmentation surgery, which leads to breast unevenness or asymmetry while distorting the shape of the breast.
Round breast implants appear perfectly circular when placed on a table. When held upright, however, they assume a teardrop shape as gravity pulls the majority of the gel filling downwards. Textured anatomical breast implants are fixed and no not change shape as the body changes position, so even if a patient lies flat, round implants move, but teardrop implants stay in the exact position.
Breast Profile
The last breast implant variable to consider before undergoing breast augmentation is the projection of the implant. The larger the implants the larger the diameter of the breast; sometimes the size of the implant exceeds the diameter of the natural breast. Women with average chest diameters who desire small to moderate breast implants will typically receive a standard "moderate" profile implant. If the chest diameter is especially small or if a patient selects a breast implant diameter that is too large, the breast implants with either touch each other at the center of the chest (synmastia) or extend too far into the underarms, or both. In order to minimize the risk for synmastia or breast implants that extend too far into the underarms, surgeons choose implants with a narrower diameter containing the same volume of fill. For instance, a standard "moderate" profile 425cc breast implant volume has a diameter of 14.2 cm and a forward projection of 4.2 cm. A "moderate plus" 420cc breast implant has a narrower diameter of 12.9 cm and a projection of 4.8 cm. The narrowest 420cc implant is a "high profile" implant and has a diameter of 12.0 cm and a projection of 5.4 cm.
