Breast Implant Replacement

There are two main pathways to a consultation with a Specialist Plastic Surgeon. Your GP or another health practitioner can make a referral to Dr Avery. Alternatively, it is possible to refer yourself for a consultation. This decision may be made after talking with family or friends or following your own research into plastic surgery and Dr Avery.

The purpose of your initial consultation with Dr Avery is to discuss both your concerns and your goals. It is an opportunity to openly communicate what you want to change, alleviate, improve, restore, enhance, or remove. We will discuss any concerns you may have about your potential surgery and its outcome. We will also collect information that is specific and tailored to you, to add to the knowledge you acquired through your research outside of the consultation process.

When you arrive at Avery, you will check in with our front-desk team and complete a medical history form, if not already completed. We encourage you to bring a supportive family member or friend who can remain with you throughout the consultation if you like, and be a sounding board during your decision-making process following the consultation.

The consultation with Dr Avery will include an examination of the area of your body that you are concerned with and considering changing. Our aim will be to determine if plastic surgery can achieve what you hope it will, and if so, what specific plastic surgery procedures will address your concerns and meet your expectations in a realistic way.

Plastic surgery procedures generally impact both physical appearance and your psychological response to the new changes in your body. Besides all the advantages of having plastic surgery, it is important to be fully aware of any potential limitations of the operation and how they apply to your unique situation. This includes possible complications and what can be done if these occur.

We will discuss what the surgery involves, how it relates to you specifically given your uniqueness and current state of health, what the possible risks of the surgery are, and then decide if having the surgery is a safe and appropriate choice for you as an individual.

After your consultation, our support team will be there to talk through any further questions you have, including the cost of the surgery.

At Avery, our goal is to ensure you are equipped with the knowledge needed for you to feel empowered throughout the decision-making process, surgery and post-surgery.

Breast implant replacement or breast implant revision surgery has some similarities to the original breast augmentation surgery. In most cases, an incision will be made in the same place as the existing scar, unless additional incisions are required due to other surgical procedures also performed, such as a breast lift (also known as a mastopexy).

The operation involves accessing the pocket into which the implant is placed, using either a pre-existing scar or via a new incision generally in the inframammary crease.

Inframammary Incision

The most common incision placement is within the inframammary fold, which is the horizontal crease where the breast meets the body (breast fold). This incision offers direct access to the submuscular, subpectoral or sub-glandular planes; allowing the surgeon to accurately create the desired pocket boundaries without the need to dissect an access tract between the entry site and the actual pocket.

All implant sizes can be placed through this incision and there may be a lower risk of breastfeeding difficulties and changes in nipple sensation compared to some incisions that go through the breast tissue. A drawback of the inframammary incision is that the resulting scar may not be as hidden as other incisions.

Regardless of the incision used, the patient’s breasts may appear higher placed than planned with the skin appearing tight, immediately after surgery. This tends to settle down over the first six weeks after the operation as a more natural shape emerges.

The nature of the scars will depend on the technique that has been used and the patient’s genetics. Scars tend to be quite red in the first six weeks, changing to purple over the following three months and then fading to white. Abnormal scarring is uncommon in breast augmentation surgery.

A breast revision surgery generally takes between 1-3 hours, with another 2 hours for recovery before the patient can go home. Some patients choose to stay in hospital overnight.

As with all surgical procedures, breast implant replacement surgery does have risks, despite the highest standards of practice. It is not usual for any surgeon to outline every possible side effect or rare complication of a surgical procedure. However, it is important that you have enough information about the most common risks to fully weigh up the benefits, risks, and limitations of surgery.

The following possible complications are listed to inform and not to alarm you. There may be other complications that are not listed. Smoking, obesity, and other significant medical problems will cause greater risk of complications.

Some general risks and possible complications of surgery include, but are not limited to the following:

• Heavy bleeding from an operated site. This may require a blood transfusion.
• Infection that may require treatment with antibiotics or further surgery in some cases.
• Allergic reaction to sutures, dressings or antiseptic solutions.
• The formation of a large blood clot (haematoma) beneath an incision site may require further surgery.
• Complications such as heart attack, pulmonary embolism or stroke may be caused by a blood clot, which can be life threatening.
• Pain, bruising and swelling around the operated site(s).
• Slow healing, often related to smoking or diabetes.
• Short-term nausea following general anaesthesia and other risks related to anaesthesia.
• Tissue cannot heal without scarring and that how one scars is dependent on individual genetic characteristics. Dr Avery will do his best to minimise scarring but cannot control its ultimate appearance.
• Smoking or using nicotine products during the 3–4-week pre-operative and post-operative periods is prohibited as these could dramatically increase the chances of complications.
• All medications I am currently taking, including prescriptions, over the counter remedies, herbal therapies and supplements, aspirin, and any other recreational drug or alcohol use can affect the safety of my surgery.
• There can be no guarantees about the results of any surgery.

Some specific risks for breast implant replacement surgery include, but are not limited to the following:

• Hematoma (bleeding / blood accumulation) which may require surgery
• Possible impact on ability to breastfeed
• Infection
• Loss of nipple sensation
• Scarring which may influence future surgery if required
• Impact on my physical appearance, such as distortion, wrinkling, significant loss of volume; the extent and impact of this may be variable and unpredictable.
• Need for more surgery for surgical corrections (revision surgery – short or long term)
• Further recovery time if further surgery is required
• Pain and discomfort
• Failure to improve all symptoms thought to be related to breast implants
• DVT (deep vein thrombosis) – clot in legs or PE (pulmonary embolus) – clot in lungs
• Allergic reactions to tape, suture material, topical preparations, medications
• Implant rupture and inability to remove 100% of the residual silicone from the breast or lymph nodes
• It may not be possible to remove all of capsule (scar tissue layer)
• It may not be possible to remove implant and capsule as one (en-bloc removal)
• Dissatisfaction or disappointment with result

The Australasian Society of Aesthetic Plastic Surgeons (ASAPS)has further information about breast implant replacement surgery including the possible risks for this surgery.

An overnight stay in hospital may be required post-surgery to aid with your recovery. Depending on the complexity of the surgery and any additional procedures, up to 2-4 weeks off work may also be recommended.

There will be some bruising and swelling, which generally subsides about 2 weeks after the operation. You will be required to wear a compression garment or bandages for approximately 6 weeks to provide support and reduce post-operative pain or swelling.

A customised pain relief program will be created for you and issued before you leave the hospital. If circumstances change at any stage during the recovery period, then the pain medication can be adjusted accordingly.

The financial aspects of your surgery are as important as the medical elements when planning for surgery. At Avery, the surgeries we offer fall into three different financial categories: Self-funded – aesthetic surgery; self-funded – plastic and reconstructive surgery; and health insured – plastic and reconstructive surgery.

To make sense of these three financial categories, we have created a detailed price guide to help you understand what may or may not be covered by your health insurer/Medicare and your out of pocket expenses.

To download this guide, please click here.

For more information or to book a consultation, please contact our team on 02 4002 4150.

Breast implant replacement surgery is also referred to as breast implant revision surgery, and it involves the removal and/or replacement of breast implants for a variety of possible reasons. Replacement of breast implants is accomplished by removing an old implant and inserting a new breast implant either behind the breast tissue or under the chest muscle in order to enlarge its size. Breast implants do not have an indefinite life span, regardless of type, and may eventually require replacement surgery.

Breast implants are not guaranteed to last a lifetime. Future surgery is often required to replace one or both implants. As with all surgical procedures, revisional surgery may also be necessary to correct any problems that may also develop. Breast implants can be replaced after migration or rupture, or because they have gone hard (capsular contracture). Surgery may be required if there is a problem with the implant or if there has been a change in the relationship between the breast and the implant that has a negative impact on the breast appearance or the individual is experiencing pain. Some people also choose to have their breasts. For further risks associated with breast implant replacement surgery, please visit the risks section on this service page.

Replacement of breast implants is accomplished by removing an old implant and inserting a new breast implant either behind the breast tissue or under the chest muscle in order to enlarge its size. Breast implants do not have an indefinite life span, regardless of type, and may eventually require replacement surgery. Your surgery will be performed at an accredited hospital, under a general anaesthetic.

When a breast implant is placed inside the body, the body forms a layer of scar tissue around the implant, this layer is known as the implant capsule. How thick an implant capsule develops varies between people and varies over time. It can also be influenced by the properties of the implant and where the implant is placed (under or over the pectorals muscle in the chest). With time the capsule may cause symptoms such as pain or a change in appearance in the breast. These changes can occur with or without a problem with the implant itself such as an implant rupture. A capsulectomy refers to the surgical removal of this scar tissue layer. This can be performed during implant replacement or during implant removal. When the entire capsule is removed this is referred to as a total or complete capsulectomy. When it is removed all in one piece with the breast implant included, this is known as en bloc removal and is generally the goal when removing implants in women with symptoms suggestive of breast implant illness. At times, it may not be possible to remove the entire capsule due to factors such as its thickness or its attachment to other important structures. For further risks associated with breast augmentation, please visit the risks section on our service page.

Typically, if your surgery is considered cosmetic in nature and does not have a related item number, private health insurance does not cover this surgery. If the surgery is being considered to address significant developmental differences, changes from previous trauma, or to relieve nasal obstruction, then a Medicare item number may apply to the surgery and there may be some cover of this procedure through private health insurance.

Sun exposure can adversely impact early wound healing and have an adverse effect on the pigmentation and long-term quality of you scar(s). All scars should be protected from sun until they are mature, which may not be until one-year post-surgery. A spray tan is okay after a few weeks (once the wound is healed).

Pain following surgery will vary depending on the extent of surgery. Pain immediately after surgery may be reduced by the use of local anaesthetic at the surgical site given during the surgery. The pain will also be managed with tablets or injections as required. Physical measures such as the dressings and supportive garments as well as limited movement and possibly ice packs will all help minimise any pain. Pain is usually well tolerated within a few days after surgery with all these measures. If your pain is increasing following surgery this is usually a sign that you may need a review to ensure your recovery is proceeding as expected.

Dressings and supportive garments will offer support to the wounds and the areas of your body that are still recovering. You will be also be advised to restrict excessive movement of the surgical area in the first two weeks after surgery. A good general rule throughout your recovery is if an increase in movement or activity does not increase any discomfort or swelling, then it is probably safe and this gradual progression back to ‘normal’ will be encouraged.