Northern Virginia- Fairfax and Manassas
By: George Bitar M.D.
Board Certified Plastic Surgeon
Millions of women in the United States have breast implants, and an implant is a device that has given millions of patients’ great satisfaction and self-image enhancement. Breast implants, and the patient’s decision to have a breast augmentation, are not infallible, so it is not surprising to know that some patients are not happy with the implants for one reason or another and would like them removed or removed and replaced. The reasons vary from an implant rupture, to having a capsular contracture to “I just got tired of them”. The decision to remove a breast implant should be thoroughly discussed between the patient and the surgeon, just as seriously as discussing having a breast augmentation operation.
Usually, women who would like to have breast implants removed fall into one of the following categories:
1. Implant removal only.
2. Implant removal and replacement.
3. Implant removal with a breast lift.
4. Implant removal, replacement, with a breast lift
In this section, we will address implant removal and removal with replacement, since the other situations are addressed thoroughly elsewhere. It is important to state that we perform all the above procedures at the same time as the implant removal if those are the patient’s wishes.
An initial consultation is set-up where we will discuss the implant removal and all the above listed options to decide whether you are a good candidate for the surgery. If you elect to have your implants replaced we will have an additional discussion regarding selection of your new implants. Your medical history is reviewed and you will be asked to see your medical doctor for a physical check-up and a few labs to make sure you can undergo the surgery safely. You are given the opportunity to be seen by your own doctor to give the green light for surgery, as well as getting a mammogram. You are given the opportunity to talk to patients who have had the same surgery you are considering. We will see you shortly after the surgery (in a day or two usually). You are seen regularly after your surgery. You are always welcome to come back for follow-up, even years after your surgery, free of charge.
The patient is given anesthesia in the operating room. The incision is made under the breast or the nipple, and the old implant is removed. Since any implant will be encapsulated with scar tissue, some of it may need to be removed at the same time. Next, a drain to empty the fluid that builds up in the empty pocket, is placed, and the skin is closed. The breasts are wrapped to provide some pressure, so the pocket will close nicely. The drain is removed in the office the following week.
The Breast Implant Removal and Replacement Procedure
The patient is given anesthesia in the operating room. The incision is made under the breast or the nipple, and the old implant is removed. Since any implant will be encapsulated with scar tissue, some of it may need to be removed at the same time. If the capsule needs to be adjusted with sutures it is typically done at this stage. Temporary implant sizers are placed into the pocket and inflated. The patient is then sat up and checked for symmetry. Once the optimal result is achieved the sizers are removed and the new implants are placed into the pocket and rechecked. The incisions are then closed.
At the Bitar Cosmetic Surgery Institute, we take pride in making sure we provide for our patients the best surgical experience possible. This is a process that includes the pre-operative preparation, the actual surgery, and the after care.
General complications can occur with any surgery. Cosmetic surgery is usually a safe surgery performed on healthy patients and, as all surgeries go, is with low risk. What we do to even lower the risk of complications is to operate at a first class hospital, with board certified anesthesiologists and nurses. To avoid post-operative complications, we advocate early mobilization –patients seen in our office one or two days after surgery- and active participation in their own post-operative care. When we create a partnership, the results invariably improve.
Bleeding after breast implant removal is minimal. Sometimes, a small amount of bleeding can be observed, but if the bleeding in a breast after a breast implant removal becomes significant, then the patient needs to have the bleeding removed in the operating room in a usually straight-forward procedure. Before surgery, our patients are tested to make sure they don’t have any common bleeding disorders by their own physicians, and by lab tests. We use tumescent solution, similar to that used in liposuction, before starting the procedure to decrease the amount of bleeding.
The most important step in avoiding infections, in our opinion, is to perform the surgery at a first-rate surgical facility with board certified anesthesiologists and nurses . Patients are given the appropriate intravenous antibiotics coverage throughout the actual surgery and afterwards. During the surgery, the skin surface of the patient is cleaned properly. As a result of these extra precautions, our infection rate is minimal.
Loss of Nipple Sensation or nipple / Areolar skin
Similar to what has been said about ability to breastfeed, loss of nipple sensation is a potential complication. Temporary loss of sensation from a “stunned” nerve or a bruised nerve may occur in the time period after surgery, but sensation usually returns within a few weeks, if the patient had sensation in the first place.
Our office will provide you with a detailed post-operative instruction sheet that will be individualized to your needs. We usually see patients the day after surgery in one of our offices to make sure that everything is O.K., and that you are healing as planned. Multiple visits in the year after the procedure will ensure the best outcome possible.
For more information about this procedure contact us, call our office and speak to our friendly staff member at 703-206-0506.
Information on this web site is for information only. Do not use the information to diagnose or treat your plastic surgery or cosmetic surgery problems. Please contact your plastic surgeon with all questions and concerns.