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Breast lift with implant exchange can be a tricky surgery. The surgery requires the removal of the implants, which should be changed if they are over ten years old, if they have become compromised, such as ruptured, or if there is a thickening of the capsule, which is termed capsular contracture. Another reason is to switch from saline to silicone implants.
This is because our breast skin and soft tissues become thinner as we age. This will make the firmer saline implants more visible and less natural. In addition to exchanging implants, patients also require a lift to counter the effects of gravity and lift the breast mounds to a higher, more aesthetically pleasing position.
This means repositioning the breast mound from your upper abdomen to your chest. A breast lift will also help position your nipple in the center of your chest and your newly created breast mound.
Why is Breast Lift with Implant Exchange Tricky?
The breast lift with implant exchange is tricky because it requires the undermining of the breast mound to remove the implant along with the capsule when it is thickened, which compromises blood flow to the nipple and areola. This compromise in blood flow is further compounded by the fact that back cuts must be made into the breast to raise the nipple to its new, desired position.
Traditional surgical maneuvers must be modified to avoid vascular compromise of the nipple and areola. The first modification involves altering the traditional inferior pedicle to a superior pedicle. The pedicle is the pathway to the nipple and areola that must be preserved to maintain blood flow.
The traditional pedicle allows for blood flow from the bottom up, but since the implant lies over the lower breast pole, this pedicle will get compressed and become non-functional. Instead, a superior pedicle provides blood flow to the nipple and areola that is out of the way from compression from the implant.
The final maneuver in a breast lift with implant exchange involves modifying the breast pocket. Often the implants get lateralized, falling off the chest into the armpit area. This occurs if you do not wear a comfortable bra at night.
When you sleep on your back, the implants naturally fall out laterally. Similarly, you will push your implants out laterally if you sleep on your tummy.
Lateralization will be accelerated as your breast mounds fall off your chest onto the upper abdomen, with no pectoralis attachments to keep the implants centralized. When performing a breast lift with implant exchange, it is critical to optimize the breast pocket.
This will be done by manipulating the capsule formed around the old implant. This capsule can be cut out strategically and also sewed tight with sutures, depending on the breast pocket alteration desired.
In summary, a breast lift with an implant or an exchange is a tricky surgery requiring an experienced breast surgeon.