This procedure is intended for patients who have already undergone breast augmentation with a prosthesis.

Reasons for changing breast prosthesis can be :

  • The lifespan of “old model” liquid silicone gel prosthesis is 8 to 10 years.

Newer, more cohesive silicone-gel implants have a longer lifespan. In the event of clinical complaint or rupture, as evidenced by radiological assessment, the prosthesis should be replaced systematically.

  • The patient’s desire to increase the volume of her breasts or to rectify an unsatisfactory result obtained during breast augmentation.
  • The appearance of breast ptosis following the fitting of large-volume prosthesis or natural sagging of the breasts as a result of aging. Any ptosis will be corrected (ptosis cure) during the same operation, usually by changing the prosthesis to a more suitable volume.
  • Formation of a troublesome fibrous shell (capsular shrinkage) surrounding the breast prosthesis.
  • Complication following insertion of breast augmentation prosthesis (rupture due to wear of the prosthesis wall or following trauma, gel breakage, deflation of a prosthesis “concerns physiological saline prosthesis”).
  • Prosthesis displacement with breast deformation

Appearance of a localized inflammatory reaction in the breast, change in breast texture, appearance of one or more inflammatory nodules (siliconomas).

As with the first breast augmentation procedure (see “Breast augmentation” section), after careful questioning and a thorough clinical examination, the patient will be asked to undergo biological and radiological tests.

  • The surgeon will determine the volume and type of prosthesis to be fitted, in consultation with the patient’s wishes, the shape of the new prosthesis to be fitted “anatomical or round”, the prosthesis fitting plan “whether or not to keep the same plan as the first operation” and any associated procedures to achieve results “cure of ptosis, treatment of the shell…”.
  • When prosthesis rupture is suspected clinically and on mammography or breast ultrasound, a request for a breast MRI will remove any doubt.

THE OPERATION AND ITS AFTERMATH:

  • After consultation with the anaesthetist and visualization of the check-ups.
  • Procedure: The operation lasts 1 hour for breast prosthesis replacement alone, and 2 hours for combined procedures.
  • The approach will take the old scars from the breast augmentation operation. (no new scars).
  • The procedure is the same as for breast augmentation by prosthesis.
  • In some cases, the surgeon may have to place external drainage in the breasts, which will be removed before leaving the clinic.
  • the shaping bandage is replaced by a breast implant support bra, which must be worn for at least 4 weeks. Painkillers are also prescribed before leaving the clinic to soothe post-operative pain.
  • A 7-day leave from work is recommended. Carrying heavy objects, sports activities, sun exposure and smoking are strongly discouraged for the 1st month following surgery.

Complications

There are few complications associated with breast prosthesis replacement. They are rare, but should be noted

  • bleeding, in the form of a hematoma, sometimes requiring repeat surgery.
  • infection, which may require removal of the prosthesis (breast augmentation will then be performed after 6 months).
  • in the event of associated mastopexy (breast lift), there is an additional risk of delayed healing and reduced sensitivity of the areola.
  • a lower risk of recurrence of periprosthetic shells
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