Dr. Polo, I have had breast implants for 10 years. I heard you should replace them after this long, but really I just want to remove them. What will my breasts look like if I do this?
Lately I see almost as many breast implant removal patients as I do breast augmentation. This is actually a trend seen across the country. Like the patient in the survey above, many of my implant patients do not experience implant-related complications. Instead, they have concerns about implant safety, usually based on something they heard from a friend or in the media. Often, these concerns are unwarranted or based on misinformation.
The practice of exchanging breast implants after only 10 years is outdated. This dates back to 1992, when the FDA placed a moratorium on sales of silicone breast implants in the US. Extensive clinical trials conducted during this period and beyond show implant rupture rates of less than 10% at 10 years. These and other data collected during clinical trials have led the FDA to conclude that silicone breast implants are reasonably safe devices. In 2006 their sales were approved again.
Current recommendations for implant follow-up are for patients to undergo ultrasound 6 years after placement and every 2-3 years thereafter. Implant exchange is only necessary when rupture/leakage is detected, as an optional procedure. Breast implants are no longer traded based on age alone.
However, many women develop a fear that, over time, their breast implants may contribute to health problems, particularly if they break. My responsibility as a plastic surgeon is to inform patients of their true risks and help them make informed decisions. For some patients, removal of their implants, without replacement, may be the best medical decision. Others may choose to have their implants removed just for peace of mind.
In cases where the patient’s own breast tissue has a volume of at least B cup and the quality of the skin and tissue is good, simply removing the implants can leave a satisfactory result. Otherwise, at the time of breast implant removal, some additional procedures may help maintain an aesthetically pleasing appearance.
Most of the time, when an implant of significant size has been present for many years, simple removal would result in the appearance of loosening. Performing a breast lift, or mastopexy, at the same time allows me to remove excess skin, lift the nipple position, and reshape the breast. This maintains a more vibrant appearance.
Another useful free procedure performed at the time of breast implant removal is autologous fat grafting. This procedure allows me to at least partially restore lost volume by removing viable fat from an area with liposuction and then transferring it to the breast. Typically, a maximum increase in cup size is possible with a single fat grafting procedure. Additional, staged fat grafting may be performed after several months to further restore lost volume.
Autologous fat grafting can be done either alone or in combination with a lift at the time of breast implant removal. If the combination of the two is associated with unacceptable risk, I find that the lifting process usually takes priority. Fat grafting can later be performed more safely and effectively as a staged procedure.
If you are considering having your breast implants removed after many years, consult a plastic surgeon, board-certified by The American Board of Plastic Surgeryto help you determine your best course of action.
Dr. Max Polo.
Dr. Polo is a graduate of University of Miami, Miller School of Medicine. He is a certified Plastic Surgeon and a partner in Miami Plastic Surgery. He has been in practice for over 20 years during which he has remained an active member of his medical staff Baptist Hospital and South Miami Hospital. Dr. Polo is dedicated to patient safety and Plastic Surgery education and has been recognized by his peers through election to leadership positions, including past president of the Miami Society of Plastic Surgeons and president-elect of the Florida Society of Plastic Surgeons . Dr. Polo is a specialist in Cosmetic Surgery of the face, neck, breast and body. His greatest expertise is in breast augmentation and moms. His practice also includes the full range of non-invasive treatments such as Botox, fillers, CoolSculpting, ultrasound, lasers and radio frequencies.
Favorite points of Dr. Polo on the island include Crandon Park Golf Course, the beach at Cape Florida Light and The Spa and Rum Bar at the Ritz Carlton.
You can email him questions at mpolo@miamiplasticsurgery.com.
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