Breast implant exchange or removal in Medellín

A breast implant exchange, also called implant replacement, takes out your implants and puts in new ones. Removal, also called an explant or explant surgery, takes them out without putting in new ones. In the US you'll often see them called breast implant revision and breast implant removal. According to the American Society of Plastic Surgeons (ASPS), an exchange lets you go up or down in size, change the shape or type of implant, and reposition it on the chest. In a removal, the ASPS explains, your surgeon can also take out any silicone that has leaked and the scar tissue that forms around the implant, called the capsule.

Breast implants aren't considered lifetime devices, the FDA explains, and at some point they may need to be replaced or removed. According to the ASPS, the reasons include:

• Wanting a different size, or switching from saline to silicone.
• Pain or hardening from capsular contracture.
• A rupture, a leak or an implant that has shifted out of place.
• Breasts that feel too heavy, discomfort, or not wanting implants anymore.

The ASPS adds that it's best if you're in good health, at a stable weight, don't smoke and have realistic expectations.

A capsule of scar tissue forms around the implant. The FDA describes two approaches to removal. One is to take out only the implant and leave the capsule in place, which requires less dissection and may carry a lower risk of complications such as bleeding. The other is to remove part or all of the capsule along with the implant, a surgery that can be more extensive and is sometimes called en bloc resection. According to the ASPS, the capsule is often soft and doesn't need to come out, but if it hardens and becomes painful, that's usually a reason to remove it. Your surgeon decides which approach is right for you after examining you.

If you have your implants removed without replacing them, the ASPS warns that your breasts may look flatter or saggier than before, with irregularities or dimpling. That's why another surgery is sometimes added:

• If your breasts sag or the skin is loose, we consider a breast lift, with new implants or using only your own tissue.
• If you're exchanging your implants and want smaller breasts, a breast reduction can be added in the same surgery.
• If you're getting new implants, our breast augmentation page explains the types available.

At your consultation, we'll tell you what makes sense for you.

Every surgery has risks, and this one does too. The ASPS lists, among others:

• Anesthesia risks, bleeding, hematoma, infection and fluid buildup.
• Deep vein thrombosis and heart or lung complications.
• Asymmetry, skin that loosens again, or a result that isn't what you expected.
• Changes in skin and nipple sensation, and persistent pain.
• Poor wound healing, skin loss, fat necrosis or needing another surgery.
• For an exchange, the ASPS also lists breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) or other very rare cancers in the capsule.

Before you decide, we walk you through each one and you sign an informed consent form.

You get your pre-op tests and, if needed, breast imaging such as a mammogram, ultrasound or MRI, according to the ASPS. You stop smoking and go over everything you take with your specialist: aspirin, anti-inflammatory medications and herbal supplements can increase bleeding. We'll tell you how to fast and what to bring. You need an adult to take you to and from surgery and stay with you for at least the first night. You go home in a post-surgical bra and sometimes with a drain, a thin tube that removes blood or fluid. You get clear instructions and follow-up visits until you're discharged.