PRE-OPERATIVE CONSULTATION

Before deciding on an implant replacement, you must meet with our surgeon for a pre-consultation. During this meeting, you will discuss your expectations, and the surgeon will evaluate what will yield the best results for you.

You will also receive a thorough overview of your options, and the risks associated with each surgical option. The surgeon will ask about your health to ensure you are suitable for surgery.

Based on your expectations and the surgeon’s recommendations, you will plan your surgery together. You are welcome to bring another person to the pre-consultation, as there is a lot of information to consider.

According to the law, you must have a 7-day reflection period after the pre-consultation before you can give your final consent to cosmetic surgery.



EXPECTATIONS

Implant replacement is often more complex than the original breast augmentation surgery. In many cases, additional corrections are required, such as removal of capsule tissue and selection of new implants, which may lead to changes in the implant pocket. The surgery thus involves increased risks, and the result may not match the original outcome.

It is important to be aware that the results of cosmetic surgery are not permanent. The natural aging process and the rate of body aging are influenced by both genetic factors and lifestyle factors such as smoking, sun exposure, and weight changes.

Additionally, it is important to understand that surgery always carries a risk of complications, and the result may not always match your or the surgeon’s expectations completely.

If you are significantly overweight or underweight, there is an increased risk of complications with anesthesia and wound healing. If your BMI is over 30, we may not be able to offer you surgery.

PREPARATION

Before the surgery, you must:


Stop taking medication containing acetylsalicylic acid such as Magnyl, Aspirin, Ibuprofen, and Treo one week before the surgery.

Avoid natural medicines, especially fish oil, ginger, and vitamin D, as they can increase the risk of bleeding. Stop all natural medicines three weeks before the surgery.

Any blood-thinning medication may need to be paused. This will be discussed with the surgeon during the pre-consultation.

Smoking must be paused least 4 weeks before and 6 weeks after the surgery. Smoking can negatively affect the cosmetic outcome, increase the risk of infection, and is generally bad for your health. We often choose not to offer surgery to active smokers.

Avoid getting tattoos, piercings, or having major dental work done, such as fillings, 1 month before and 1 month after the surgery. This is because bacteria can form in the blood during tattooing, piercing, and dental work, which may settle around the implant.

It is a good idea to shop and prepare meals before the surgery, so you can focus on your recovery afterward.
On the day of the surgery, you should take a shower with thorough cleansing of your body and hair. Avoid using body lotion or other products on the area to be operated on.

Wear loose, comfortable clothing, preferably a zip-up blouse, loose fitting pants, and flat shoes. Remove all jewelry and any piercings and leave them at home.



MAMMOGRAPHY

If you are over 40 years old or have a family history of breast cancer, a mammography is recommended before the surgery.



ANESTHESIA

The surgery is performed under general anesthesia. You must fast for 6 hours before the surgery (no eating, chewing gum, smoking, or similar). You may drink clear fluids like water and sugary drinks in small amounts until 2 hours before the surgery; do not drink milk, juice, etc.

It is crucial to adhere to the fasting rules, as anesthesia can be dangerous if you are not fasting, and the surgery is canceled, if you are not fasting.



SURGERY

On the day of the surgery, arrive at the clinic at the scheduled time. A nurse will greet you and you will be shown to your room, change clothes, and have an intravenous line placed. The anesthesiologist will discuss the anesthesia with you, and finally, you will meet with the surgeon, who will ensure you feel comfortable and well-informed. The surgeon will also mark the area to be operated on.

The surgery is performed under general anesthesia and lasts 1-2 hours.
During the surgery, the old implants are removed. They are checked for leaks. If leaks are present, the space where they were located is thoroughly cleaned. Capsule tissue is removed if necessary, and the cavity is adjusted to fit the new implant.


In some cases, the surgeon may place one or two drains (small plastic tubes). These are placed through the skin to remove any blood and wound discharge from the wound surfaces that need to heal.

To reduce the risk of infection, you will receive antibiotics during the surgery.
The wounds are sutured with self-dissolving sutures, and tape is placed over the wounds along with an absorentdressing.
Finally, you will receive a bra and a mamma strap.



AFTER THE SURGERY

After the surgery, you will be taken to the recovery room where the nurse will monitor you. You will receive something to drink and eat and pain reliefers if needed. Depending on the extent of the surgery, you may be discharged after a few hours.

Before you go home, the plastic surgeon and nurse will review the post-operative precautions with you and answer any questions you may have to ensure you feel comfortable. You should arrange for someone to pick you up, as you will not be able to drive yourself.

THE DAYS AFTER SURGERY

Since the surgery was performed under general anesthesia, you will be tired and sluggish on the first day, and you may experience nausea and dizziness. We recommend having an adult at your side for the first 24 hours.

It is important to take it easy for the first days after the surgery and generally listen to your body’s signals to reduce the risk of bleeding and swelling. Make sure to stay well-hydrated and consume a sensible protein-rich diet.



PAIN

After the surgery, the breasts will often feel tight and firm, especially in the first few days, which is normal. The breasts may continue to feel tight, swollen, and have a slightly different shape in the first few weeks as the tissue adjusts to the new implants. Additionally, you may experience itching, tingling, and burning in the scars.

Generally, this type of surgery is associated with less pain than the initial breast augmentation, as the tissue is already expanded.
It is important to take the prescribed medication. The medication will reduce pain, but you should expect some discomfort during the first 3-4 days.

Many people experience stabbing and sharp pain in the operated area. This is normal and occurs because the nerves are re-establishing connections. These sensations can last for up to 1 year after the surgery.

You will be prescribed Paracetamol tablets and Ibuprofen tablets to be taken together 4 times a day. Additionally, you will receive a stronger painkiller, a synthetic morphine tablet, which you can take if you experience severe pain.

The nurse will thoroughly review the medication with you before you leave, and you will also receive written material describing everything.



DRAINS

If drains are placed during the surgery, they are often removed before you are discharged. If they are not removed, you will be given detailed instructions on how to care for them and when they are to be removed.



ACTIVITY

In the initial days after the surgery, getting out of bed might be difficult, so having someone to assist you is a good idea. It is important to get up and move around quickly to reduce the risk of blood clots. Engage in light activity, such as short walks, but take breaks when needed. For the first 1-2 weeks, avoid any strain on the wounds.

Avoid strenuous exercise for the first 6 weeks after the surgery. If you have anatomically shaped implants, this restriction may be extended to 3 months. However, it is important to keep your body active with light activities, such as short walks.

We recommend not lifting more than 2 kg per arm in the first 6 weeks after the surgery and to avoid lifting your elbows above shoulder height during this period.

You must avoid driving until you can handle the vehicle safely and no longer need strong painkillers. Always use a seatbelt, whether you are driving or a passenger.



WORK

You can resume sedentary work after 1 week. For the first 6 weeks, avoid using your arms too much. Remember to move your shoulders to prevent stiffness.



SLEEPING POSITION

We recommend sleeping on your back for about 4 weeks after the surgery. You may lie slightly on your side, perhaps with a pillow behind one shoulder



BATHING

You can take a shower 24 hours after the surgery or when there is no longer any discharge from the wounds (unless you have drains). Before showering, remove the compressive bandage and the absorbing dressing.

The brown plaster must remain until your follow-up appointment. It can withstand water. Take a gentle shower, rinse the wounds to wash away soap residues (do not wash or scrub the wounds), and pat dry with a clean towel before putting the compressive bandage back on.

You should avoid taking baths, swimming in the sea, or going to a swimming pool and sauna until the stitches are removed and the wounds are fully healed.



BLEEDING

It is important to monitor for bleeding from the breast in the first few days. If there is bleeding around the implant, which is a rare complication, the breast will become hard and swollen. If you experience sudden or severe swelling and pain, contact us immediately.



BRA

After the surgery, you will receive a supportive bra anda breast strap to wear for 6 weeks. You can remove the bra and strap when bathing or when they need to be washed.
Underwire bras must not be worn for the first 3 months.

You can, of course, purchase an additional bra and strap at the clinic if you want more to switch between.



SCARS

The scars from the surgery will typically be red and swollen but will improve over 6-24 months. Over time, scars usually become narrow and lighter I color, but in some cases, they may become wide and darkly pigmented.

You may apply a soothing cream to the scars once they are completely healed. Avoid smoking, as it increases the risk of infection, slow healing, and unsightly scars.



CONTACT WITH THE CLINIC

You will receive a phone number upon discharge so you can contact the clinic 24/7 in case of an emergency.

The day after your surgery, a nurse will call to check on your well-being and answer any questions you may have.



FOLLOW-UP

Approximately 14 days after the surgery, you will have a follow-up appointment with the nurse. The dressings will be removed, and the wounds will be examined. There is no need to remove ssutures, as they are self-dissolving.

New tape will be applied and provided, which you should change yourself every 10-12 days for about 3 months after the surgery. The tape helps keep the scars narrow, flat, and level with the rest of the skin.

We will discuss how to care for the scars, any potential pain, etc. You will be offered an appointment with the plastic surgeon 3-6 months after the surgery. If you experience any issues before then, feel free to contact us.

COMPLICATIONS

Capsular Contracture: Occurs when the capsule that the body naturally forms around the implant tightens around it, resulting in a hard and possibly painful breast.

Hematoma: Rarely (less than 1% of cases), bleeding may occur after surgery. This may require temporary removal of the implant during a subsequent operation to stop the bleeding before re-implantation.

Infection in the Wound: Rare but an infection may occur in the wound. This is treated with antibiotics.

Infection around the Implant: Can occur at any time but is most often seen within the first 14 days. Treated with antibiotics, it may be necessary to remove the implant temporarily (about 3 months) before placing a new one.

Implant Rupture: If a silicone implant ruptures, it will need to be replaced. If this happens, the product warranty will be activated.

Sensory Changes: The nipples may become more or less sensitive, and in rare cases it looses sensitivity completely.

Rippling and Visible Implant Edge: In very slim women with small original breasts and little subcutaneous fat, the implant edge may be noticeable and sometimes visible under the breast and to the side. Wrinkles or folds in the skin over the implant, known as rippling, may also occur. The risk of this is lower with cohesive implants compared to those with liquid silicone or saline.

Implant Rotation: With anatomical (drop-shaped) implants, there is a risk of rotation. If this occurs, another surgery may be necessary to reposition the implant.

Swelling and Discoloration: This is normal and expected in the first few months after surgery.

Pain: Post-surgical pain is normal and expected. While it typically subsides gradually, in rare cases, it may be long-lasting or even chronic.

Stretch Marks: Rarely occur but can happen when the tissue is expanded.

Scarring: Thickened or widened scars can occur. Scar formation is individual and unpredictable. Initially, most scars will be prominent and red but will fade and become lighter over time. Some people tend to develop red and thick scars, known as hypertrophic scarring. Scar maturation can take several years for some patients.

Symmastia: When the breastsmerge into one across sternum. This is extremely rare.

Seroma: Fluid accumulation that may sometimes require drainage.

Tissue Necrosis: Refers to parts of the skin losing their blood supply and dying. If this occurs, it may require surgical removal or waiting for the body to heal the area from within. This is extremely rare but more likely in individuals who are overweight or smoke.

Breastfeeding: Generally, you are able to breastfeed without issues after breast augmentation with silicone implants, though a small percentage may find they are unable to breastfeed.

Blood Clots: There is always an increased risk of blood clots associated with surgery. This risk increases if you take birth control pills, are over 40 years old, have a BMI over 25, or have a genetic risk factor (e.g., Factor V Leiden mutation).

Breast Implant-Associated Lymphoma (ALCL): ALCL may present as persistent swelling of one breast, typically several years after surgery. It can also present as nodules in the capsule around the implant or swollen lymph nodes. If you experience these symptoms, consult a plastic surgery clinic or your doctor. However, most symptoms are likely due to benign conditions.

Please note that the risk of all the above complications increases with the size of the implant.