– Old age of prostheses (breast prosthesis break). Prostheses used before require a replacement approximately 10 years. Today we have final prosthesis that do not require replacement.
–Not aesthetic result. The breast augmentation increasingly must be seen as an isolated increase, that is to say, we must consider that we are going to increase the size of breast knowing that there are proportions to maintain if we want a natural result. In many cases the result is not satisfactory to the patient by the choice of an inadequate prosthesis in her previous surgery.
–Change the volume of the prosthesis. It is not simply a question of volumes or sizes. Put one higher prostheses required a largest prosthetic pocket, something not too difficult, but reduce the size of our prosthesis requires a technique known as capsulorrhaphy which is more complicated.
– Capsular contracture. We know that the capsular Contracture is consequence of subclinical infections in primary surgery, that is to say, that small infection on the surface of the implant that do not give rise to an apparent infection but that does generate a capsule anomalous and excessive. In these situations you should perform a capsulectomy, that is, remove the old capsule and introduce some new breast prostheses to form a new capsule of quality.
–Need for a lift in addition to augmentation, that is to say, additional Mastopexy. The old implants,those which are smooth, have the problem of not adhering to the capsule that is formed to her around and also by the effect of gravity. Therefore, in many cases it also requires replacement of a mastopexy (breast lift).
–Unsatisfactory result after Mastopexy or breast reduction. In these cases it is essential a revision surgery retaining blood vascularization, that is to say, different surgical techniques must be mastered to improve the result without altering the blood risk of the breast.
–Asymmetries. The complementation of different techniques and types of breast prosthesis is required in these cases.
The technique of prosthetic replacement is even more sensitive than to an augmentation in primary surgery. In these cases, the breast has suffered a relative atrophy by the pressure of the prosthesis and therefore surgery will be more demanding.
In almost all these cases a capsulectomy should be performed, that is, eliminate the old capsule to generate a new one according to the new implant to introduce. The formation of this new capsule should be controlled initially with lymphatic drainage and ultrasounds and helping us with a special bra for the first two months.