Breast Implant Checks

Our team of plastic surgeons offer breast implant checks to assess your implants and provide advice for management of your existing breast implants.

Breast Implant Checks

We offer breast implant checks for patients that have had breast implants with our plastic surgeons. The implant check may involve the following: clinical examination; ultrasound scan; MRI scan; blood tests; and, formulation of a bespoke implant exchange plan if necessary. This service is available to our existing patients and patients that have had their procedures elsewhere.

Breast implants are a long term commitment and will require ongoing maintenance. It is important to have regular breast implant checks to assess your implants. We recommend having checks performed every 3-5 years. Breast implants will always require replacement at some point. You should have an implant health check even if you are happy with the results and are not experiencing any problems. A breast implant health check is an assessment of the implants rather than investigating any specific breast lumps. If you have a breast lump, we recommend seeing your GP for referral to a breast clinic appointment.

What happens during a breast implant check?

During you implant health check up you will be seen by our plastic surgeon who will undertake some or all of the following:

Implant History - Please try to bring with you information about your existing implants or the implant card you were given after your procedure.
Clinical Examination - Breast measurements, aesthetic assessment, problem identification
Referral for Investigations - Ultrasound, MRI or Blood Tests
Bespoke Implant Plan - Proposed plan for your implants such as time scales for repeat investigations or surgical correction of any issues.

What are the potential long term problems with breast implants?

There are numerous potential things and issues that can happen following breast augmentation. Many of these can be considered as part of the normal implant ageing process such as ptosis or drooping of the breasts due to the weight of implants; rippling due to thinning of skin or weight changes; or, separation of the implants due to continual muscle contraction and use. There are some common and also rare more serious potential complications following breast implant surgery.

Changes following pregnancy, breast feeding and weight loss or gain

Capsular Contracture

Capsular contracture is the thickening of the capsule around a breast implant which can occur in up to 10% of patients with breast implants. This can happen at any time after having implants but more common later in the implant lifetime. This can start as some dull aching or pains with no visible changes to the breasts. As the capsule thickens there may be hardening or firmness of the breasts. If the capsule calcifies it can feel very hard like a rock. With progressive capsular contracture, there can be changes to shape of the breast and it can look more solid, sit higher, narrower or distorted. If you have a capsular contracture, this can be improved by removing the old implant and capsule then replacing the implant. There may be a higher risk of recurrence of the capsule in patients with existing capsular contracture. There are measures we take to try and reduce the risk such as: antibiotics; antibiotic solution for the implant; using nipple shields; using a funnel for implant placement; changing surgical gloves and antiseptic washout of the pocket. Despite all these measures and more, capsular contracture may still occur and there may be some genetic predisposition to this.

Rippling

This can be common and normal particularly in slimmer patients. When you have an implant this will result in thinning of the skin as it stretches. When the tissues are thin, you may see the rippling. Most implants are not fully filled and so will always have some folds. The rippling are the folds in the implants. Sometimes you may also feel the edge of the implants at the sides or bottom of the breasts where the tissues are thinner.

Implant Displacement

Bottoming Out

Waterfall Deformity

Rupture

Implants can rupture although the newer generation implants are rigorously tested. The older generation implant ruptures may have presented with change in shape of the breasts. The newer implants have a more cohesive gel and so will often retain their shape making it difficult to detect a rupture. Sometimes, one can only detect a rupture with a scan. Most ruptures are contained within the capsule and called intracapsular. Occasionally, silicone can spread to the lymph glands and this is called an extracapsular rupture.

Breast Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL)

This is a very rare type of cancer that may be related to breast implants. The quoted incidence reported varies from 1 in 20000 to 1 in 80000 depending on the type of implants used. Smooth implants have a lower rate of BIA-ALCL. This is compared to about a 1 in 8 lifetime risk of women developing general breast cancer with or without implants. There were reports of higher rates with macro textured implants such as Allergan textured implants which have subsequently been withdrawn from the market. There is currently no specific recommendation that these brands should be changed or removed. The average time from implant insertion to symptoms is about 8 years. Patients may present with visible, painless swelling or seroma over a few weeks. They may also develop lumps within the capsule. If you have developed one sided swelling over a year following your surgery, this should be investigated urgently.

Squamous Cell Carcinoma (SCC)

Breast Implant Illness

This term is used to describe a range symptoms that are experienced by patients after having breast implants. The systemic symptoms are non-specific and include: discomfort; fatigue; joint ache; hair loss; memory loss; and many other symptoms. The term Breast Implant Illness (BII) is not currently recognised as a specific medical diagnosis and there is no specific diagnostic test. The current studies have not shown a direct scientific link between breast implants and these symptoms. There have been numerous studies looking at implants and autoimmune conditions previously that have been inconclusive. The current studies show varying degrees of improvement in symptoms following implant removal but still a significant proportion may have ongoing symptoms. The latest guidance from BAAPS has stated there is no additional benefit or relief in symptoms using complete en bloc capsulectomy versus other techniques. En bloc procedures can potentially cause higher rates of complications. The diagnosis of BII is one of exclusion and so all other possible causes of these symptoms should be explored before considering implant removal.