Breast implant removal, also known as explantation, is a surgical procedure that some women may choose for various reasons. These can range from complications with the existing implants, changes in aesthetic preferences, or concerns about potential long – term health effects. While the procedure aims to address these issues, like any surgery, it comes with its own set of possible complications. Understanding these complications, including their symptoms, causes, and treatment options, is crucial for anyone considering breast implant removal.
Common Complications of Breast Implant Removal
Infection
Symptoms
Redness around the surgical site is often one of the first signs. The skin may look inflamed and have a reddish – pink hue that is more intense than normal post – surgical redness.
Swelling is another common symptom. The area around the breast where the implant was removed may become puffy and enlarged. This swelling can be accompanied by a feeling of tightness.
Pain is a key indicator. It can range from a dull ache to sharp, intense pain. The pain may be constant or worsen with movement.
Fever is a more serious sign of infection. A body temperature above 100.4°F (38°C) indicates that the body is likely fighting an infection.
Causes
Contamination during surgery is a major cause. If the surgical instruments are not properly sterilized, or if bacteria enter the surgical site from the air, the patient’s skin, or the surgical team, an infection can occur.
Poor post – operative care can also lead to infection. If the surgical site is not kept clean, or if the patient does not follow the doctor’s instructions regarding dressing changes and wound care, bacteria can thrive and cause an infection.
Treatment
Antibiotics are usually the first line of treatment. The type of antibiotic prescribed depends on the type of bacteria causing the infection. In some cases, a broad – spectrum antibiotic may be used initially until the specific bacteria are identified through a culture test.
In more severe cases, where the infection has spread or is not responding to antibiotics, the surgical site may need to be reopened to drain any abscesses (collections of pus). This helps to remove the source of the infection and allows the antibiotics to work more effectively.
Hematoma
Symptoms
Swelling that develops rapidly after the surgery is a common symptom of a hematoma. The swelling may be accompanied by a feeling of fullness or pressure in the breast.
Bruising can also be a sign. The skin may turn purple, blue, or black as blood pools under the skin.
Pain that is more intense than normal post – operative pain can be an indication of a hematoma. The pain may be throbbing in nature.
Causes
Bleeding during surgery is the main cause of a hematoma. If blood vessels are not properly sealed during the implant removal, blood can leak into the surrounding tissues. This can happen if the surgeon accidentally nicks a blood vessel during the dissection of the implant from the surrounding tissue.
High blood pressure can also contribute to the formation of a hematoma. Patients with uncontrolled high blood pressure are at a higher risk because the increased pressure in the blood vessels can cause bleeding at the surgical site.
Treatment
Small hematomas may resolve on their own over time. The body will gradually absorb the pooled blood. In such cases, the doctor may recommend rest and monitoring to ensure that the hematoma is shrinking.
Larger hematomas, however, may require intervention. The surgeon may need to drain the blood from the hematoma. This can be done through a small incision or by using a needle and syringe to aspirate the blood.
Seroma
Symptoms
Swelling is the most obvious symptom of a seroma. The breast may appear enlarged and feel firm to the touch.
There may be a sense of fluid – filled fullness. The area may feel squishy, similar to a water – filled balloon under the skin.
In some cases, there may be a mild discomfort or a dull ache, but this is not always present.
Causes
After the implant is removed, the body’s normal response is to form a small amount of fluid in the space left behind. However, if the body’s normal mechanisms for absorbing this fluid are disrupted, a seroma can form. This can happen if there is excessive tissue trauma during the surgery, which may interfere with the normal lymphatic drainage in the area.
In some cases, the use of certain medications or underlying health conditions that affect the body’s fluid balance can also contribute to the formation of a seroma.
Treatment
Minor seromas may be managed by applying pressure to the area. This can be done using a compression garment. The pressure helps to reduce the space for the fluid to accumulate and encourages the body to absorb the fluid.
For larger seromas, the doctor may need to drain the fluid. This is usually done by inserting a needle into the seroma and aspirating the fluid. In some cases, a small tube may be inserted to continuously drain the fluid for a few days.
Capsular Contracture (Recurrence)
Symptoms
The breast may feel hard. The texture of the breast tissue may change, becoming much firmer than normal.
There may be a change in the shape of the breast. It may appear distorted, and the nipple may be pulled in a different direction.
Pain can be associated with capsular contracture. The pain can range from a mild discomfort to a sharp, stabbing pain, especially when the breast is touched or moved.
Causes
If the original cause of the capsular contracture (when the implant was in place) was not fully addressed during the removal, it can recur. For example, if the scar tissue capsule around the implant was not completely removed, it can continue to contract.
Inflammation at the surgical site can also trigger the formation of new scar tissue, leading to capsular contracture. This can be due to an infection, hematoma, or seroma that was not properly treated.
Treatment
Mild cases of capsular contracture recurrence may be managed with massage therapy. Gentle massage can help to break up the scar tissue and improve the flexibility of the breast tissue.
In more severe cases, surgical intervention may be required. The surgeon may need to remove the remaining or newly formed scar tissue capsule to relieve the pressure on the breast and restore a more normal shape.
Nipple and Skin Changes
Symptoms
Nipple numbness or loss of sensation can occur. The patient may not be able to feel touch, temperature, or pressure on the nipple as they did before the surgery.
Skin changes can include changes in color, texture, or elasticity. The skin may become darker, rougher, or lose its normal stretchiness.
There may be a change in the position of the nipple. It may be higher, lower, or off – center compared to its original position.
Causes
Damage to the nerves during the implant removal can cause nipple numbness. The nerves that supply the nipple can be accidentally cut or stretched during the dissection of the implant and the surrounding tissue.
Changes in blood supply to the skin can lead to skin changes. If the blood vessels that supply the skin of the breast are damaged during the surgery, the skin may not receive enough oxygen and nutrients, resulting in changes in color, texture, and elasticity.
Manipulation of the breast tissue during implant removal can cause the nipple to change position. If the breast tissue is re – arranged or if there is a significant reduction in volume, the nipple may move.
Treatment
For nipple numbness, in some cases, the sensation may return over time as the nerves heal. However, if the damage is severe, there may be limited treatment options. Physical therapy or nerve – stimulating exercises may be recommended in some cases.
Skin changes may be managed with topical creams or treatments to improve skin texture and color. In more severe cases, additional surgical procedures may be considered to correct the skin’s appearance or position.
Less Common Complications of Breast Implant Removal
Allergic Reaction
Symptoms
Rash is a common symptom. It can appear as a red, itchy, and bumpy rash on the skin around the surgical site or even on other parts of the body.
Hives may develop. These are raised, itchy welts that can vary in size and shape.
Swelling can occur, not only around the breast but also in other areas such as the face, lips, or hands. In severe cases, it can cause difficulty breathing.
Causes
Allergic reactions can be caused by the materials used in the implant, such as silicone or the components of the implant’s shell. Some patients may also be allergic to the sutures used during the removal surgery or the medications used for anesthesia or post – operative pain management.
Treatment
Antihistamines are usually prescribed to relieve the symptoms of an allergic reaction. These medications can help reduce itching, swelling, and the appearance of the rash.
In severe cases, where there is difficulty breathing or other life – threatening symptoms, epinephrine may be administered. This is a powerful medication that can quickly reverse the symptoms of a severe allergic reaction.
Implant Rupture (During Removal)
Symptoms
If it’s a saline implant, a sudden deflation of the implant may be noticed during the removal process. For silicone implants, there may be a visible leakage of the silicone gel, which appears as a thick, sticky substance.
There may be an increase in the difficulty of the removal procedure as the ruptured implant may break into pieces or adhere to the surrounding tissue.
Causes
The implant may be damaged during the dissection process. If the surgeon uses too much force or if the implant has already weakened over time, it can rupture during removal.
In some cases, the implant may have been in a weakened state due to previous complications such as capsular contracture or previous minor ruptures that were not detected.
Treatment
If the implant is a saline implant, the remaining saline solution is usually drained, and the implant shell is removed.
For a ruptured silicone implant, the surgeon will try to remove as much of the silicone gel as possible. This may require careful dissection of the surrounding tissue to ensure that all the silicone fragments are retrieved. In some cases, additional imaging tests may be done after the surgery to confirm that all the silicone has been removed.
Prevention of Breast Implant Removal Complications
Pre – operative Precautions
Medical History and Screening
A thorough review of the patient’s medical history is essential. This includes information about any previous surgeries, allergies, chronic diseases, and medications. For example, if a patient has a history of allergic reactions, the surgeon can be more cautious about the materials used during the surgery.
Screening tests such as blood tests, imaging (like mammograms or ultrasounds), and physical examinations should be done to assess the overall health of the patient and the condition of the breast and implant.
Choosing the Right Surgeon
Selecting a board – certified plastic surgeon with extensive experience in breast implant removal is crucial. An experienced surgeon is more likely to anticipate potential complications and take appropriate preventive measures during the surgery. They will also have the skills to handle any unexpected situations that may arise.
Intra – operative Precautions
Surgical Technique
The surgeon should use precise and gentle surgical techniques. This includes careful dissection of the implant from the surrounding tissue to avoid damaging blood vessels, nerves, and the implant itself. Using the right surgical instruments and taking the time to perform the procedure correctly can reduce the risk of complications.
Maintaining a sterile surgical field is of utmost importance. This involves proper sterilization of all instruments, wearing sterile gowns and gloves, and using antiseptic solutions to clean the surgical site.
Implant Handling
When removing the implant, the surgeon should handle it with care to prevent rupture. This may involve using special techniques to gently free the implant from the surrounding scar tissue without applying excessive force.
Post – operative Precautions
Wound Care
The patient should follow the doctor’s instructions regarding wound care. This includes keeping the surgical site clean and dry, changing dressings as directed, and avoiding any activities that may cause the wound to get contaminated.
Activity Restrictions
Patients should restrict their physical activities in the post – operative period. This helps to prevent bleeding, hematoma formation, and other complications. For example, heavy lifting, strenuous exercise, and any activity that puts stress on the chest should be avoided for a certain period as advised by the doctor.
Conclusion
Breast implant removal is a surgical procedure that, while it can address various concerns, has its own set of potential complications. By being aware of these complications, their symptoms, causes, and treatment options, patients can make more informed decisions. Additionally, taking preventive measures before, during, and after the surgery can significantly reduce the risk of complications. If you are considering breast implant removal, it is important to have a detailed discussion with your plastic surgeon about all aspects of the procedure, including the potential for complications, so that you can be well – prepared for the surgery and its aftermath.
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