Tara Casey spoke with
Sydney cosmetic plastic surgeon Dr Darryl Hodgkinson about replacing deflated
breast implants. |
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"Implants, like everything else, don’t
last forever and patients must realise that it is likely that
they will have to undergo another procedure after a number of years,”
explains Dr Darryl Hodgkinson, who prefers to use saline implants because
of the safety aspects.
Saline implants are filled with a sterile, intravenous fluid and are
supplied deflated (without fluid in them) so they can be inserted through
the smallest of incisions, which is a major benefit to most patients.
Capsular contracture is one of the possible complications of breast
implants. The body, recognising a foreign substance forms a scar around
it – a “capsule”. This capsule can contract and cause
distortion and an uncomfortable, sometimes painful hardening around
the implant. Saline implants have a remarkably low incidence of capsular
contracture – less than 2%.
While saline implants are round, when they are placed half behind and
half in front of the muscle, the muscle puts pressure on the top half
of the implant creating a natural tear-drop shape when the patient is
both laying horizontal or standing.
There is the possibility of the implant rupturing inside. If they do
deflate (which is in less than 1% of cases), the saline is merely absorbed
by the tissues and excreted through the urine.
“Patients will accept that a saline implant may break and leak
eventually,” says Dr Hodgkinson. “No-one panics if they
are aware of this. It’s imperative that we tell patients the truth
and do not gloss over the hard facts.”
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previous column)
A ruptured saline implant is immediately recognisable by the patient
as the breast will go flat. If this happens replacement surgery is recommended.
“It’s pretty simple replacement surgery. The company replaces
the saline implant so it’s about 10-15% of the original cost,”
says Dr Hodgkinson.
A new implant is inserted through the old incision site into the pocket
that is already in existence. This means there is minimal recovery time.
“We put in over 200 implants a year and only see one or two
leaked implants a year,” says Dr Hodgkinson. “Patients try
and recall something they did to break it but it’s often just
a slow progressive weakening of the shell.”
If the patient has an expectation that the implant may rupture and
is fully aware of the consequences when it happens, it does not need
to be a traumatic event. Leaking saline is not harmful to the body and
replacement surgery can be undertaken with minimal fuss.
Case Study
When Bettina called to see Dr Hodgkinson she was uneasy and looking
for help. Her saline breast implants from surgery performed many
years ago by another surgeon had ruptured and she required corrective
replacement surgery. "I wish that my surgeon had told me that
implants don't last a lifetime at the time I had my original surgery,"
said Bettina. "If he'd done that I would have been a lot more
prepared." After replacement surgery Bettina feels relieved and
has more realistic expectations about the outcome of her surgery. |
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