Joshua Lampert, MD
May 2, 2023 – A recently published paper on Journal of Cosmetic Surgery Open Forum explains a new approach to breast implant surgery (removal of breast implants). The newspaper entitled “Safe breast shaping after implant removal and total intact capsulectomy using the breast implant lift and fixation technique” shows that this breast lift and implant technique can be safely performed simultaneously to allow for total intact capsectomy, preservation of breast tissue and nipple blood supply, and a more pleasing aesthetic result.
While the current scientific literature is replete with various approaches to breast implant placement and replacement, there is very little research or publication describing safe aesthetic approaches to breast implant surgery.
“I developed the technique of breast implant lift and fixation in order to treat the ever-increasing number of patients with implants that I have seen in my practice over the past 12 years,” says the study’s author. Joshua Lampert, MD, plastic and reconstructive surgeon. “I searched textbooks, journal articles, and scientific literature and could not find a suitable prior solution.”
In this approach, the technique allows the surgeon to safely remove the entire breast implant capsule with a total intact capsulectomy. This is also often referred to online as “en bloc”, where the breast implant is removed as well as the capsule of scar tissue that forms around the implant. This is ideal in many cases, and especially if a patient has had ruptured silicone implants and does not want silicone spilled into the breast cavity.
The main advantage of Dr. Lampert is that it allows safe removal of the breast implant and capsule and also maintains the maximum supply of breast tissue and blood to the nipple. This preserved breast tissue is then shaped into a better aesthetic breast mound by “soaking” the tissues and lifting the breast. Dr. Lambert believes his technique is a simple series of steps that any plastic surgeon can complete when trying to help treat patients with breast implant problems who are trying to “stop breast implants.”
About 20 percent of patients report some type of complication related to their breast implants which can include rippling and wrinkling, implant displacement, asymmetry, late hematomas, and neoplasm. However, beginning around 1997, a much larger public awareness debate about breast implant-related illness (BII) began. BII can include symptoms such as joint and muscle pain, chronic fatigue, concentration problems, rashes and skin problems, anxiety, and more. A recent survey found that 66.7 percent of breast implant patients report concerns about their implants, and 35 percent are strongly considering having the implants removed as a result. This led to a “mass exodus” of women choosing to “cut out” breast implants.
“When an implant is removed, the breast is often left with overly thin and stretched skin that can be difficult to manage. I found that the resulting excess skin left after implant surgery was similar to what I had seen in my previous experience with massive weight loss after bariatric surgery,” says Dr. of Medicine.
In addition, breast implant surgery can leave the breast with a deflated central cavity area, loss of taper shape, and undulation and inversion of the nipple as the areola collapses toward the chest wall.
In this study, 64 patients underwent the breast implant lift and fixation technique with bilateral breast implant removal and total capsectomy. The mean age of the patients was 42.95 years. Mean follow-up was 6.5 months. A limitation of the study is the lack of a formal patient satisfaction survey.
Overall, the results showed that this technique has low complication rates, preserves breast tissue and blood supply to the nipple, and should be considered for subsequent breast reconstruction in women who choose to have their implants removed.
Additional authors include Alexandra Townsend, BS; Sunny Shah, MD; Antoun Bouz, MD, and Natasha Nichols, APRN, FNP.
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