Why do breast implants need to be replaced?

Implant exchanges are performed for a variety of reasons. Sometimes, there is a clear problem with the implant, for example, a rupture or a capsular contracture. In some cases, a ‘silent’ implant rupture may have been detected on screening that has led to an implant exchange. There may be more global changes in the breast aesthetic, for example, breast slippage over the implant (‘waterfall’ deformity), implant visibility/rippling or a desire to change implant size that influences the decision to exchange. Sometimes, women choose to exchange their implants because their current set of implants have been in place for a long time, even though, they have not caused them any problems. 

When should I exchange breast implants?

It depends what the reason is for wanting your implant exchanged. If there is an implant rupture then it is better to get the implant exchanged sooner rather than later. Where the problem is related to capsular contracture or to improve the overall aesthetic of the breast you can afford to take time to understand your surgical options so you can choose the procedure that best suits your needs. 

How long does a breast implant exchange take?

Breast implant exchanges can be considered as simple or complex. A simple exchange usually involves removing the old implants and placing new implants in the same pocket. This takes up to 1 hr under a general anaesthetic. Complex exchanges may involve management of the implant capsule (such as capsulectomy), changing the plane of the implant (from above to below the muscle or vice versa), dealing with a ruptured implant or performing a breast uplift at the same time as an exchange (augmentation-mastopexy). These types of exchanges can take up to 2-3 hours under a general anaesthetic depending on what is being done. 

Can you replace breast implants with smaller ones?

Yes, implant sizes can be changed at the time of exchange to accommodate either smaller, or bigger, implants. Changing the size of your implants significantly may incur additional procedures. For example, if you downsize your implant significantly you will probably require a breast uplift (augmentation mastopexy) in order to restore your breast shape with a smaller sized implant.

Can I change my implant size before surgery?

You will have plenty of time to decide on the right size of implants for you. In my practice, we meet twice before deciding to proceed to surgery and I will have a pre-operative appointment with you a few weeks before surgery, also. By this time, you and I will usually have come to a mutual understanding about your size aspirations after surgery and I will measure you up for your implants at this appointment. These are then ordered to be available on the day of surgery and I always order a range of implants to allow for contingency during surgery. If you decide to change the size of your implants significantly after this appointment new implants will need to be ordered and this may delay your surgery.