Breast implant revision abroad in Tunisia

Breast implants do not have a definite life in advance. The lifetime of a breast implant filled with silicone gel depends on the possible occurrence of complications: failure, prosthetic malposition, shell, imperfection of the result. Therefore, a breast implant replacement or breast implant revision  is not systematically every ten years, they can be kept much longer, and sometimes shorter.

What is the lifetime of breast implants?

Breast implants are not lifetime defined in advance: According to official recommendations of the AFSSAPS (French Agency for Safety of Health Products), the lifetime of a breast implant filled gel silicone depends on the possible occurrence of complications. Therefore, a breast implant should not be changed systematically every ten years; it can be kept much longer, and sometimes shorter.

Why replace breast implants?

Patients require breast implants’ replacement for many reasons:

  • In case of rupture of the breast prosthesis
  • In case of prosthetic malposition: misplaced prosthesis
  • In case of formation of a shell
  • If the result of imperfection.

What is breast implants rupture?

A breast implant is broken when there is a leak of its contents through a breach of its envelope.

How suspect breast implant rupture?

The rupture of breast prosthesis can cause a local inflammatory reaction: increase or change in breast volume, pain, and hardening of the breast...

The rupture of a breast implant may, by cons, be completely asymptomatic (without evidence).

Therefore, the patients carrying breast implants have to systematic control mammograms or MRI for breach of suspicion.

What are the risks in case of rupture of silicone breast implants?

  • A mild local reaction inflammatory type.
  • The silicone gel is not toxic to the body.

When to change breast implants in case of failure?

The change in breast implants is not an emergency but must be programmed quickly from the time the diagnosis of rupture is asked to avoid permanent deformation of the breast.

Types of breast implants

Breast implants are composed of an envelope and a filling material.

  • The envelope is always made of a silicone elastomer.
  • Breast implants differ in content: silicone gel pre-filled implants or saline implants.

The vast majority of breast implants are now placed pre-filled with silicone gel. These implants, used for over 40 years, have proven:

  • Safety
  • Excellent adaptation to this type of surgery
  • Consistency very close to a normal breast

Dr. Chiraz Bouzguenda uses pre-filled breast implants highly cohesive new generation silicone gel textured shell avoiding kinking, and meet the CE standards:

  • Sebbin Breast implants
  • Cereplas Breast Prostheses implants

There are different forms of breast implants: round or anatomical implants and different profiles: low, moderate or high profile.

This wide variety of shapes, combined with a wide choice of volumes, can adapt the choice; almost "tailor" breast implants.

Before breast implant revision

  • A preoperative blood test is required
  • A preoperative mammography is routine for women over age 35 or with risk factors for breast cancer.
  • Medical guidelines to follow, by Dr Chiraz Bouzguenda, your female plastic surgeon Tunisia, are:
    • Stop taking aspirin, anti-inflammatory drugs, or oral anticoagulants 15 days before surgery, to decrease the risk of bleeding.
    • stop oral contraceptives (pill) one month before surgery, to reduce the risk of thromboembolism.
    • Avoid pregnancy within a year after surgery to avoid damaging the aesthetic result.

Type of anesthesia and hospitalization

  • Type of anesthesia: This is a conventional general anesthesia.
  • Hospitalization: The intervention requires one night of postoperative hospitalization.

Breast implant revision procedure

Breast implants change is a surgical procedure different from the first, but often better tolerated than the first implementation.

When changing breast implants, the surgeon usually uses the same incision as the first intervention: periareolar or inframammary way. It may be subject to change in plan (from subglandular to submuscular).

Sometimes, breast implants' revision is combined to breast lift.

What are the usual postoperative?

  • Pain the first days, especially when breast implants are placed behind the muscle. Analgesic treatment will be prescribed.
  • Edema (swelling), bruising (bruises) and discomfort to the elevation of the first-time arm.
  • A bra without underwire must be worn day and night for six weeks.
  • Monitoring Breast mammography as part of breast cancer screening is entirely possible with breast implants. You just specify the radiologist. It is advisable to perform a baseline mammogram a few months after surgery.
  • The work stop time is from 8 to about 12 days.The resumption of sporting activities is authorized from the 2nd month.
  • The final result (volume and shape of the breasts) is observed after 3-6 months. The final scar appearance is judged after at least 12 months.

What are the risks of breast implants?

Complications of surgery breast implants are fortunately very rare.

General complications

  • The thromboembolic events (phlebitis, pulmonary embolism).
  • The hematoma: it is the bleeding of the operated area. It can impose a reoperation under general anesthesia.
  • The lymphatic effusion, may appear a few weeks after surgery, and may lead to repeated aspiration and / or reoperation for drainage.
  • Infection is exceptional but possible. It may indeed be necessary to remove an infected implant, and then wait several months after healing to replace another.
  • A pneumothorax pleural breach is rare but possible.
  • Transient changes in sensitivity: type numbness, insensitivity in the nipple area.
  • The healing disorders may occur: wide scars, hypertrophic or keloid. Each may require a proper treatment.
  • Paralysis of the upper limb by elongation of the brachial plexus is exceptional. Related to the position of the arm during the intervention, it resolves spontaneously in a variable period of several days to several months.
  • Epidermal cysts can be observed on the periareolar scar.
  • Imperfections of the result are possible: asymmetry, insufficient correction. However, patients must admit that the results of aesthetic breast augmentation can be assessed only subjectively. It is therefore important to understand that the result may not exactly match the desired result.

Complications specific to breast implants:

  • Per-prosthetic fibrous shell: major risk of this intervention, unpredictable, that may occur unilaterally or bilaterally, sometimes months or years after the introduction of the implant. This is a reaction of the body around the foreign body that constitutes the implant. When painful and / or unsightly, the shell can lead to reoperation under general anesthesia, which may lead to a maximum of the definitive removal of the implant.
  • Strain or deflation of the implant: when the cracked or broken prosthesis contains physiological saline, it will deflate faster or slower. When it contains silicone gel, it leaks around the implant or in the fibrous shell (intracapsular rupture) or beyond it.
  • Formation of folds or aspect of waves more often seen with saline-filled implants with those who are pre-populated with silicone gel, this phenomenon is more common when the patient is thin, and her natural breasts are small.
  • Stretch: it is possible that the stretch marks and / or small veins appear on the skin of an implanted breast, especially if the implant is relatively large.

In all, one should not overstate the risks, but just be aware that surgery, even seemingly simple, always has a small share of hazards.

The procedure at the glance
  • Procedure : remove old implants and replace them with new ones, usually through the same incision as the first breast augmentation.
  • Anaesthesia : General
  • Operating time : 1 hour
  • Duration of hospital stay : two nights
  • Duration of the overall stay: 6 days
  • Convalescence : 7 to 10 days

Breast implant revision overseas abroad

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