Stephen McCulley, Reconstructive and Aesthetic Surgeon. MBChb, FCS(SA)Plast, FRCS(plast)

There are a number of effective techniques to treat implant problems

Breast Implant Problems And Their Correction
Patients who have breast implants may experience a variety of problems. These can relate to the implant itself (including hardening or capsule formation, rupture, excessive wrinkling, incorrect size) or to a change in the skin overlying the implant (skin or nipple droop, poor quality scars). Sometimes it can be a combination of problems and it is important to have an experienced surgeon like Stephen McCulley to carry out this challenging procedure.

Hardening Of Breast Implants (Capsule Formation)
This occurs when the body forms a layer of scar around the implant that continues to increase. Although not in itself dangerous, it will progress over a period of time. Around 10% of patients form capsules over a 10 year period, and a small number develop them much sooner. Certain types of implant, including saline and polyurethane may have a slightly lower risk of hardening.

Options for treatment include removing the implant and scar tissue and replacing it with a new implant. When feasible it might also be better to change the position of the implant i.e. from under the breast to under the muscle. If a new implant is fitted it will usually need to be slightly larger in size. It is important to note that after removing the implant the patient will be left with a larger scar.

Another option is to remove the implant and then reshape the remaining breast using a breast lift (mastopexy). This is an excellent form of treatment if the patient has enough breast tissue to make a reasonable breast shape. If the skin is very lax with hardening then a combination of a new implant and a breast lift can be considered.

Implant Rupture
This understandably causes a lot of concern to patients and is a problem that was highlighted during the PIP reports in 2011/2012. Although Stephen McCulley has never used PIP implants in his practice, it is important to note that even the best quality implants have a small risk of rupture over time. Whilst it can be very alarming, it is not always an emergency and could be done over a time frame that suits the patient.

Implant – Intracapsular Rupture
There is over 40 years of evidence that shows silicone implants in particular are very safe. When this type of implant ruptures the silicone can sit within the scar capsule (known as an Intracapsular rupture) without leaking into the breast. In this case there will be little sign of rupture and is less likely to cause problems in the short term.

Implant – Extracapsular Rupture
In more serious cases the rupture can leak into the breast and spread (an Extracapsular rupture). When the latter occurs the implant should always be removed as it can become problematic with the formation of silicone lumps (silicone granuloma), silicone deposits in the lymph glands and potential deformities of the breast and infections.

Loose Skin, Droop Or Poor Quality Scars
Depending upon the scenario the breast can be lifted and the scars re-done. Stephen McCulley can also look to replace the implants at the same time, but this will depend on their age.

Rippling
This is when the natural folds or buckles of the implant can be seen or felt through the skin. It is more common in patients with thin breast skin or for those that have had implants under the breast and not the muscle.

There are various treatment options including:
Replacing the implant with a firmer implant
Transferring the existing implant under the muscle (in which the muscle would need to be lifted and re-attached to the breast)
Fat injection techniques which could make the skin thicker
Using ADM (a special type of material) that is placed on the implant in the affected area that will ‘shield’ the rippling

Costs
Removal of implants £2,600
Exchange of implants / capsule removal £5,825 – £5,975 including removal of the implants and capsule
Breast lift/Mastopexy £6,250

Frequently Asked Questions

If you'd like to see more then please view our frequently asked questions on Cosmetic Breast Surgery!

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