Thinking About Your Old Implants
A large demographic of plastic surgery patients is emerging in relation to the presence of longstanding breast implants. Their specific needs are addressed in this section. Women who have had implants for twenty-plus years have changed mentally, physically, and, often, financially. The motivations of a young woman wishing to start her adult life with no reservations may have encouraged her to have breast implants, and lo, these many years later, pain and deformity and a hope for anonymity may have overtaken the initial enjoyment of the event. Often these patients are motivated for a change, but do not know where to turn. The entry point to a solution begins in the primary care setting. Most primary care physicians and healthcare providers such as family practitioners, OB-GYN’s, and dermatologists have followed these patients for a long time and recognize that a problem exists. The patient lives with the problem but has not yet considered crossing the threshold of the plastic surgeon's office to discuss implant removal or explantation. This is one of my favorite groups of patients. When they realize the possibilities, they are as gratified with their ultimate surgical solution as they were when they had the augmentation surgery first done.
The average American gains ten pounds per decade, and many of these patients, who originally came to the plastic surgeon for augmentation, can now contemplate a reduction with their explantation. The solutions involve reverse engineering the current body build and paying attention to patient expectation. For those who simply want the implants removed, an explantation is done. If necessary, a minor breast lift will add a minimum of operating time but secure a better esthetic result.
For those patients who still want the fullness of the implants but do not like their appearance and firmness, explantation can involve reimplantation of new implants, usually with lift and site change to above or beneath the pectoralis muscle. An implant placed today has greatly improved characteristics when compared to an implant placed twenty-plus years ago. The stability and longevity of today's implants are remarkably good.
By this time, many of these patients are familiar with capsules, or the body's reaction to the implants. The breasts may be quite firm or even rocky, as the very old capsules can be comprised of significant calcifications, often seen obstructing certain mammographic views and causing embarrassment and discomfort.
These gratifying procedures can be done in an ambulatory setting under general anesthesia, with a quick recovery, and, depending upon anesthesia guidelines, almost all subjects can safely undergo this restorative surgery. Even in its most elaborate form, such a procedure would run below eight to ten thousand dollars, complete.
Accomplishing Your Goals
We often have goals and aspirations that we would love to achieve, only to find they are thwarted by existing practical and, in this case, physical conditions. A happy middle ground can be achieved only through an open and honest consultation with your doctor.
Implant removal or replacement will leave scars. Talk with your doctor about scaring, their position and length, how long to heal and how much scaring will remain visible after you have fully healed. Ask about any possible complications of surgery.
After that, it is your responsibility to religiously follow postoperative instructions and suggestions. The role you play on this side of the procedure is as important as the role of your doctor on the other side. Only when you and your doctor have properly played your role can the best result possible be achieved.
In order for us best achieve the best results, you may want to consider the following:
• Be sure to prepare any questions you have about your implant surgery;
• If you have concern or doubts about your outcome, be sure to bring these up to your doctor;
• Bring in a list of medications, vitamins or any herbal supplements you take;
• Tell your doctor about any past or present medical conditions or surgeries;
• Ask your doctor about what you can do to minimize your discomfort after surgery and maximize your recovery.
Old Implants Examples