Breast augmentation (mammary augmentation) with implants is still one of the most frequently performed aesthetic surgeries. A planned implant change every 10 to 15 years, as was recommended in the past, is no longer necessary. However, follow-up operations, e.g. due to capsular fibrosis, may be necessary in the course of time. Since an implant is a foreign body, the body naturally envelops the implant with a fine connective tissue capsule. In certain cases, this capsule may thicken after several years, resulting in what is known as capsular fibrosis. Symptoms such as pain, hardening and distortion of the breast shape can occur, so that in these cases the capsule should be removed (capsulectomy) and the implants changed. If the breast has taken on a sagging shape due to changes in the body and the breast caused by age, weight fluctuations, or after pregnancy or breastfeeding, among other things, a lift should also be performed in combination with implant replacement. If the patient wishes to forego the reinsertion of an implant, a breast lift with or without volume replacement with autologous fat may be indicated in order to regain an aesthetic breast shape after implant removal.
The consultation
As a plastic surgeon, Dr. Lüdi specializes in breast surgery and will be happy to advise you personally on a woman-to-woman basis at her clinic in Basel.
Before an implant change or implant removal, there are usually two detailed consultations with Dr. Lüdi. It is very important to us that you are well informed about the procedure, that all open questions are answered and that your wishes are taken into account. In certain cases, further clarification, e.g. by means of ultrasound or MRI, may be necessary prior to surgery. Dr. Lüdi will discuss with you the surgical technique, the exact incision and placement of the implant, possible risks and complications as well as the aftercare.
The implant selection
In the context of an implant change, we usually recommend choosing a minimally larger implant due to the pre-stretching of the breast tissue mantle as well as the removed capsular tissue. We use only the most modern, highest quality implants from renowned companies.
On the day of surgery
On the day of the operation, Dr. Lüdi prepares a photo documentation before the operation and makes the markings on the breast. You will then be prepared for the upcoming operation and accompanied to the operating room.
The operation
Implant replacement can be performed under general anesthesia as an outpatient day surgery at our clinic in Basel or as an inpatient procedure at one of our affiliated hospitals. If possible, the existing scars are used for access. Depending on the case, an incision extension or additional incision may be necessary for a breast lift. This will be discussed with you before the operation. The implant and, depending on the indication, the entire capsule or only parts of it are removed. Subsequently, a new implant is inserted or, if necessary, the implant volume is replaced by the patient's own fat. In the case of an additional autologous fat transfer, fat is taken by liposuction from another part of the body, such as the abdomen, flanks or thighs, prepared and then inserted into the breast via small incisions using a cannula.
Immediately after surgery
After the operation, you can recover from the procedure in our beautiful patient rooms with a view of the Rhine and will be looked after by our team. After another visit by Dr. Lüdi, you can be picked up by an accompanying person and return home the same day. If the procedure is performed as an inpatient, it will be performed in a hospital and usually involves 1 to 2 overnight stays.
The aftercare
- The first follow-up visit by Dr. Lüdi takes place the very next day.
- For 6 weeks, you should wear a well-fitting sports bra during the day and at night.
- We recommend a rest period of 6 weeks to support an optimal healing process. This means that you should refrain from sports, carrying and lifting loads and sleeping in the prone position during this time. Sports such as climbing, diving, golf, tennis and PowerPlate should even be avoided for the first 3 months after surgery to support optimal healing of the implant. You should also not wear a push-up bra until 3 months after surgery.
- Pain intensity after surgery is generally moderate and well controlled with common analgesics.
- Scar care can be started from 3 weeks postoperatively.
Risks and complications
In principle, every operation involves certain risks, but in general an implant change is a low-risk procedure and complications are very rare. The risks and complications for an implant change are the same as for the initial operation. In addition to the general surgical risks (e.g. bruising, wound healing problems, post-operative bleeding, infection, scar problems), there is some risk of capsular fibrosis with breast implants. Treatment of this is only necessary if complaints are present.
During the consultation, Dr. Lüdi will discuss the possible risks and complications with you in detail and will be happy to answer any questions you may have.
Costs
The costs for implant replacement or removal depend on your wishes, the type and extent of the operation and the materials required. During a consultation, Dr. Lüdi will put together a treatment tailored to you personally and provide you with an individual cost estimate.
As a rule, health insurance companies cover part of the costs of the operation (implant removal and capsulectomy) if there is a medical indication (capsular fibrosis, implant rupture). However, the aesthetic part of the operation, including the costs of the new implants, tightening or autologous fat transfer, must always be borne by the patient herself.
Frequently asked questions
Simona Lüdi, MD, will be happy to welcome you for a personal consultation at our clinic in Basel. We look forward to seeing you.