Breast Implant Problems & 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)

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.

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.

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

Silicone Syndrome

This is a generalised term covering a wide range of potential issues related to the presence of silicone in the body, potentially made worse by rupture and movement of silicone implants. Most of this remains unproven with mixed
scientific reports. Many reports show no excess incidence of issues in breast augmentation patients. These reported symptoms include a wide range from fatigue, pain, hair loss, lethargy. The other area reported is an increase in
autoimmune diseases such as Sjogrens syndrome and Rheumatoid arthritis. It is important patients are aware of the existence of these reports in choosing to have silicone implants

BIA-ALCL and BIA-SCC: (Breast Implant Associated – Anaplastic Large Cell
Lymphoma and Sqaumous Cell Carcinoma).

These are very rare, usually localised cancers associated with breast implants (and other types implants in the body). The ALCL is a lymphoma type cancer (blood cells) and SCC associated with textured implants. They usually present with swelling of the breast (most common) or a lump and occurs in approximately 1 in 2,000 to 1 in 100,000 cases depending upon implant type and varying reports. Some reports state the incidence as higher. It is only seen in textured implants and higher in Biocell type texturing as found in Allergan implants. There is no advice to remove these implants if no problems. More details are available at breastcancer.org or an information sheet in resources on this site.

Costs

Removal of implants £4,150 or with capsulectomy £5,850
Exchange of implants / capsule removal from £8,250
Removal of the implants, capsule and breast lift/mastopexy from £9,850

Prices as of August 2023. There can be some variation of costs with complexity of problem and
hospital used. A full quotation will be provided after consultation.

Lower fees are available if surgery performed by a recommended associate of Stephen
McCulley. Please ask the team.