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QUESTIONS ASKED PRIOR TO EXPLANT SURGERY

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Posted on: January 27th, 2015 By: Stuart A. Linder, M.D., F.A.C.S.

Common Questions Asked Prior to Breast Implant Removal

 

The decision to remove breast implants can be a difficult one; however, once you understand and

establish realistic expectations, many women still have a few questions prior to having

explantation surgery. Below are a few typical questions that are often asked during consultations

in my Beverly Hills practice. Feel free to call our office at any time at 310-275-4513 with

questions related to breast augmentation, revision and explantation surgery.

The first question is:

1. Is breast explantation surgery covered by insurance? Different PPO policies have

different inclusions and exclusions. Some PPO policies will consider explantation of

implants, a functional surgery and yes, will cover the operation as a functional procedure.

Implants that are often removed for infections, seroma or associated with a malignancy or cancer to the breast may often be covered by

PPO insurance. Ruptured silicone implants are often covered by PPO insurance; however, they do often require evidence of the

rupture prior to the operation which can be obtained by MRI radiographic testing. Medically, saline implants can also be determined to

be ruptured in preoperative photographs of the patient with a ruptured saline implant may be useful as well. Capsular

contracture and removal of scar tissue associated with explantation can often be covered with PPO insurance and once again, inclusion

and exclusion must be determined by each specific policy.

2. Is general anesthesia required for breast explantation surgery? Absolutely. General anesthesia is always required in our

patients for explantation surgery. Board Certified Anesthesiologists always put our patients under general anesthesia either via laryngeal

mask airway or general endotracheal tube intubation if the patient has a history of reflux. This is especially important as to we do not

want the patient to have any remembrance or pain in this surgery. Removing scar tissue is often a component of explantation surgery,

requires that the patient does not move on the operating room table as the capsule does also affix to the intercostal rib space.

3. Where is the incision point for removal of the implant? The incision points often on revision and explantation can be made

along the inframammary fold. This is an excellent location for removal of implant, implant material and capsulectomy as well as

placement of the JP drain through that same incision and securing it with a 3-0 Prolene suture. Inframammary incisions are most often

used for complete explantation; however, a periareolar incision can also be performed if the patient desires it.

4. Will I need a lift after removal of the implant? Rather than do a concurrent full mastopexy or breast lift at the same time as the

explantation depends upon the amount of skin laxity the patient has. This can be determined by a Board Certified Plastic Surgeon

who has experience performing explantation with or without breast lifts. In some situations the size of the implant may have a

determination as to whether a lift is required. Patients who present in my office who have had surgery at a different place

with a different surgeon and are not able to identify the implant information prior to surgery with us, may make it difficult to determine

if they are on the borderline whether a breast lift is needed. At this stage, the patient may be asked to simply do the explantation

with drainage and present for a breast lift if necessary, as a second stage three to six months later.

5. How long is recovery after breast implants are removed? In general, six weeks is a good period of time to allow your breasts to

recovery as well as to allow some of the skin to contract and allow the fluid to be reduced through the JP drain. The drains were

removed after one week. Antibiotics are maintained for at least seven years until the JP drains are removed. The sutures are taken out

on Day 14 and patients are able to shower on day 7 after the drain tubes have been removed. It takes at least six to eight weeks for the

swelling as well as the fluid within the tissue to recover. In terms of tightening of the breast, it can take six to 12 months for the skin to

retract. You will be wearing a Dr. Linder Bra as tightly with as much compression as possible will certainly help in the tightening

aspects.