Breast Implant Revision Surgery FAQs

Breast Implant Revision Surgery FAQs

How does Fiala Aesthetics fix implant hardness?

For women that wish to continue with implants, the key steps in fixing implant hardness are:

  • removing the scar tissue layer
  • doing something to reduce the risk of a recurrence of the problem.

Removing the scar tissue layer is known as “capsulectomy”.  Think of it like carefully peeling the orange peel off an orange. Your own normal breast tissue is left intact, and only the abnormal scar tissue, or “capsule”, is removed. Once the tight scar tissue is removed, the implant is no longer squeezed into a tight & unnatural shape, and the breast will feel soft again, and more comfortable for the patient. A drain is usually placed into the pocket when a capsulectomy has been performed. Most commonly, in this situation, we recommend that a new implant be used at the same time.  Scientific data shows that capsulectomy (scar removal) works better than surgical capsulotomy (dividing the scar tissue, without removal).

To reduce the risk of recurrent hardness, there are several options. If the old implant was “above the muscle”, it’s often wise to convert the implant to the sub-pectoral position. If the old implant was already “behind the muscle”, new advanced options like the use of Strattice may be considered.  Strattice is a dermal matrix, which has a capsule-preventing effect when placed inside the breast, covering the implant.

What if I just want to remove the implants?

Yes, that’s an option too. Implant removal without replacement can be done.  For women that have had several episodes of breast hardness, this may be the best choice to minimize the number of future surgeries.  If a capsulectomy is needed or is requested by the patient, we can perform that as well.

In many cases, a breast lift can be performed at the same time, if there is obvious tissue laxity (loose skin) or a droopy shape.  Alternatively, fat grafting to the breast can be done, to restore at least some of the volume of the breast. For those women who have a good breast shape and reasonable skin elasticity, sometimes simple implant removal without any mastopexy (breast lift) can also work well.

What if I have a ruptured silicone breast implant?

Dr. Fiala is very familiar with this problem.  The treatment is a surgical one – consisting of removing the old implant and free-floating silicone gel, and performing a capsulectomy to complete the “tidy up”.  At that point, a new implant – either silicone gel or saline – can be placed, if desired by the patient.

What is ALCL, and how can I tell if I have this?

ALCL is an uncommon, lymphoma-like reaction that can occur around an implant.  ALCL typically shows up as a significant fluid collection around a textured breast implant, about 8-10 years after surgery.  The breast looks swollen externally.  It can be easily ruled out by a breast ultrasound or MRI.  If there is a fluid collection, the fluid needs to be sampled, and sent to the lab for testing, as many fluid collections are benign, and are not ALCL.  The ALCL can typically be treated by implant removal with total capsulectomy.  If you develop a swollen breast after having a normal result for many years, particularly on one side, please alert your surgeon, so that proper investigations can be done.

Why should I choose Fiala Aesthetics for my breast implant revision?

With a busy breast-implant-related practice, Fiala Aesthetics has extensive experience in these breast implant revision surgeries and a high success rate in these challenging revisional procedures.


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