Common Reasons to Exchange Implants

  • Leaking or ruptured silicone or saline implants
  • New product options with less leak-prone implants
  • Desire for a different size, which may be due to weight changes or different needs
  • Scar tissue
  • Problems with the original surgery
  • Better shape with a new implant
  • Change implant position
  • Switch from saline to silicone (or vice verca)
  • Asymmetry

Changes in Breast Implant Position

Sometimes, implants are placed too widely across the woman’s chest. This can cause the breasts to point outward, drop out of place, or slide into a position that is not natural.

In this case, the position of the implants addressed by modifying the pocket in the breast tissue where the implants rest on the chest wall.

Changes in Breast Implant Size

How breast implant size is changed depends on the type of implant. Silicone gel implants must be completely removed surgically and changed to a new implant. Saline implants are easier, as the amount of sterile solution may be changed through a small incision. If the patient wants larger saline implants but the size of the saline shell is too small to accommodate more solution, a new implant must be placed.

Change in Breast Implant Type

Sometimes patients decide to change from a saline to silicone implant, or vice versa. This may be done for many reasons. Some patients decide to switch to saline implants due to visible rippling on the sides of the breast from existing saline implants, for example.

Fixing Capsular Contracture

Capsular contracture is a complication of breast implant surgery that causes hard scar tissue to form around the implant. This scar tissue squeezes the implant and may make the breast feel firm or hard.

It can also affect the shape, position and appearance of the implants. Patients who have severe capsular contracture must have the scar tissue removed with a capsulectomy. In less severe cases, the scar tissue can be surgically released with an incision to free the implants to their normal position for a more natural appearance and feeling.

Changes in Breast Implant Placement

Breast implants may be placed above or below the pectoral muscle. Dr. Shapiro typically prefers placing implants below the muscle, as this produces a more natural feeling and appearance by giving the implant the additional “padding” of more tissue to hide the implant shape. It also reduces the risk of complications like capsular contracture.

Dr. Shapiro can move the implant position from above the muscle to below the muscle or vice versa.

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Allergan Breast Implant Recall

Allergan, the makers of BIOCELL breast implants, issued a recall in July 2019 for their line of macro-textured implants and tissue expanders. A recall was voluntarily issued as a cautionary measure due to a higher risk of developing BIA-ALCL (breast implant-associated anaplastic large cell lymphoma). The following styles of textured implants and tissue expanders were recalled:

  • Natrelle saline-filled breast implants
  • Natrelle silicone-filled breast implants
  • Natrelle Inspira silicone-filled breast implants
  • Natrelle 410 Highly Cohesive Anatomically Shaped silicone-filled breast implants
  • Natrelle 133 Plus tissue expander
  • Natrelle 133 tissue expander with suture tabs

What is BIA-ALCL?

BIA-ALCL is a rare non-Hodgkin’s type of lymphoma that grows slowly, making it easy to catch and treat. Since 1996, there have been only 288 registered cases of BIA-ALCL in the United States. Symptoms of BIA-ALCL include a lump or bump in the breast or armpit, painful swelling, fluid retention, a red rash across the breasts, or hardening of the tissues around the breast implant.

What are macro-textured implants?

Macro-textured implants are silicone or saline textured implants with a rougher or bumpier surface than regular textured implants, developed to adhere more thoroughly to the surrounding tissue, reducing the chance of implant movement or rotation. Textured implants are not commonly used in the US, making up only 10% of implants. Macro-textured implants, such as those recalled, are used in only 5% of breast augmentations.

Will I need to have my Allergan implants removed or replaced?

If you currently have the recalled implants but do not have any symptoms of BIA-ALCL, it is not advised that you remove them unless they are older (8 to 10 years). However, you are urged to consult with your doctor to determine if breast implant exchange, implant removal, or a breast lift is the right option for you.

Dr. Shapiro has over 28 years of experience in helping patients in Scottsdale and the Paradise Valley achieve greater confidence with breast augmentation, breast lift, breast reduction, and breast implant revision procedures. If you are concerned about your current implants or are interested to learn more about which implants may be right for you, please reach out to schedule a consultation.

Implant Exchange Recovery

Healing after this procedure is generally easier than the first procedure with very minimal downtime. Most patients experience only minor swelling and bruising that dissipates on its own within one to two weeks. Because the space already exists for the breast implants, muscles do not need to be cut or stretched, except when the implant position is changed from above to below the muscle. In this case, the recovery period may be longer than the first procedure.

This procedure may be straightforward or complex, depending on the reasons for the surgery. Sometimes exchanging the implants is a complex procedure, such as when there is extensive scar tissue or several problems from the first procedure. The more work that is performed, the longer the recovery.

Are You a Candidate?

Women in good physical health who want to correct problems from a previous augmentation surgery or change the appearance of their breast implants may be a good candidate for this surgery.

There are a few cases in which implant exchange is not possible. This includes if there is reduced blood flow or a current infection.

Meet Dr. Daniel Shapiro

A world-class plastic surgeon in a league of his own.

Dr. Shapiro is an award-winning, board-certified plastic surgeon with nearly three decades of experience in his field. With impressive technical skill and a talent for creating natural-looking results, his practice has become a leading destination for discerning patients throughout the country.

Known for his compassion and honesty, Dr. Shapiro strives to educate his patients so that they are empowered about their care. He carefully explains the procedures, expected results, and techniques in a way that anyone can understand. Additionally, he personally guides his clients every step of the way – from the initial consultation to their post-operative care – to ensure an enjoyable experience and the best possible results.

Practice Policy Update Regarding COVID-19 View Update Virtual Consultation

Practice Policy Update Regarding COVID-19

Dear Patients,

It is with great pleasure that I announce the reopening of my practice for both surgical and non-surgical services on May 1, 2020. As per the governor Ducey's executive order on April 22, 2020, elective surgery has been allowed to proceed, with appropriate precautions taken by health care professionals to ensure continued vigilance against the spread of Covid-19.

Our office staff and the staff of Paradise Valley Cosmetic Surgery Center and Surgical Recovery Center have proactively taken necessary precautions to meet strict criterion for health providers according to the state of Arizona. These include necessary patient screening for Covid-19, strict protocols for cleaning offices and treatment rooms, adequate PPE, and continued social distancing. As before, waiting areas will have minimal capacity, and friends and family members should not accompany one into offices or treatment areas.

With great anticipation we welcome you back to the practice, and wish you all continued health and safety.

Sincerely, Daniel Shapiro MD, FACS

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