Saline implants do not have a predetermined lifespan. According to official recommendations of the AFSSAPS (French Agency for Safety of Health Products), the life of a breast implant filled with silicone gel can vary depending on the possible occurrence of complications. As a result, the breast implant may not be changed every 10 years, it can last more than 10 years as it can last less.

The change of implants is usually done in the application of patients based on different reasons:

• In the case of rupture of the breast prosthesis.
• In the case of poorly posed prosthesis: prosthetic malposition .
• In the case of shell formation.
• In the case of imperfect results or insufficient volume.

The rupture of the breast prosthesis is characterized by leakage of its contents through a breach of its envelope.

• How suspect breast implant rupture?

  The rupture of the breast prosthesis can cause a local inflammatory reaction: increase or change in breast volume, pain, and hardening of the breast...

  

  However, breast implant rupture can be completely asymptomatic (without symptoms).

  Thus, patients who have breast prostheses have interest to perform control mammograms systematically even MRI if they suspect the occurrence of rupture.

• What are the risks in case of rupture of silicone breast implants gel ?
  • A mild local inflammation.
  • No risk from silicone gel (it is not toxic to the body)
• When changing breast implants in case of failure?
  Not constituting an emergency, the change of breast implants is programmed quickly from the time the break is confirmed. This will prevent breast to deform irreversibly.

Capsular contracture or peri-prosthetic shell is the term used to describe the scar tissue that can form around the breast implants causing hardening of the breast, asymmetry relative to the other breast, and discomfort with a tightening feeling of the capsule.

Capsular contracture is an unforeseeable complication but is also the most

Common complication after breast augmentation. Although currently, we do not know what causes capsular contracture, there are techniques that can reduce the risk of peri-prosthetic hulls.

• How to reduce the risk of capsular contracture?
  • Use of textured breast implants.
  • The retro-muscular position of the breast implant.
  • Massage the breasts after breast augmentation with implants.
  • The technique of implantation without contact. Only Dr. Bouzguenda that will handle breast implants to reduce the risk of contamination of the breast implant.
• How to diagnose capsular contracture?

  Capsular contracture is usually diagnosed on physical examination by a plastic surgeon. You may notice that the breast is not as flexible as it was beginning to harden and be different from the other breast with feeling some discomfort tightening of the capsule.

  Your plastic surgeon will examine you to determine if indeed you have a capsular contracture or not. The review of each breast is ranked on a scale of I to IV according to Baker:

  • Stade I: The breast is soft and normal
  • Stade II: The breast is less flexible than normal, and the implant can be palpated.
  • Stade III: The breast is hard, the implant can be palpated and an asymmetrical shape distortion can be seen.
  • Stade IV: The breast is hard and painful on palpation, and shape distortion is pronounced or severe.

It is often possible to visualize the capsular contracture radiologically with echo-mammography or MRI.

Breast implants are composed of an envelope and a filling material.

• The envelope continues to be a silicone elastomer.
• The contents of breast prostheses with differing content: they are either filled with silicone gel or a saline.

Currently, the most asked breast implants are pre- filled with silicone gel. These prostheses were able to prove themselves since more than 40 years of use:

• Safety
• Excellent adaptation to this type of surgery
• Consistency very close to a normal breast

Dr. Chiraz Bouzguenda prefers to use pre-filled breast implants new generation of silicone gel and are characterized by their high cohesion and their textured envelopes that prevent kinking, and meet the CE standards.

The shapes of breast implants vary from one prosthesis to another: round or anatomical implants and their profiles: low profile, moderate or high.

The availability of various forms of prostheses and a wide choice of volumes, which allows you to adjust an almost "tailored" choice, of breast implants.

In preparation for surgery of breast implants changes, you are invited to:

• Perform a blood test
• Stop smoking
• Avoid taking aspirin and some anti
• Inflammatory drugs as they can increase bleeding.
• Make a mammogram or ultrasound-possibly an MRI to diagnose the failure.

• Type of anesthesia:
  The change of breast implants surgery can be performed under local anesthesia or general anesthesia if capsulotomy is necessary in case of hull.
• Hospitalization:
  The change of breast implants surgery can take place in an outpatient setting.

The change of breast implants is a separate surgery, first because it is often better tolerated than the first implementation.

The surgeon generally uses the same incision as the first surgery during the operation of breast implants change: periareolar or inframammary way.

Sometimes, the surgeon cobines breast lift with breat implants replacement or removal.

Sometimes he can change plan (from subglandular to submuscular).

In case of a fibrous shell, you must perform a capsulotomy.

Your breast implant change surgery is likely to be close to your initial breast augmentation surgery.

The surgery will take place in an outpatient if there is a breast implant change, without other associated acts.

Surgery requires an overnight hospitalization for monitoring if there has been a capsulotomy or a change in the position of the breast implant.

Strenuous activity should be avoided and it may take several days to two weeks to return to normal activities.

It is standard to feel pain and have bruises; your cosmetic surgeon can prescribe painkillers to help manage discomfort.

It is advisable to carefully do the post-operative care: Keep dry and clean scar dressings.

The breast implants change presents the same risks and complications as the original breast augmentation surgery. Complications, although rare, include:

• Waves,
• The rupture of the imlant,
• The malposition of the breast prosthesis,
• Infection,
• A hematoma,
• Capsular contracture,

Because of these risks, it is recommended that women replace their implants when they have complications, or when they want to change the size of their breasts.

The price for a breast implant replacement in Tunisia is 1860 €.

For more information on changing breast implants in Tunisia, contact Dr. Chiraz Bouzguenda for a quote.