Breast Implant Exchange (Breast Prosthesis Exchange) or (Prosthesis Exchange)
Some women who have previously had prostheses/implants inserted in their breasts may, after a while, want something else, such as either increasing or decreasing volume, changing shape, or combining prostheses with their own fat, the so-called hybrid procedure. See own information here.
The reason for this can be among several, such as after breastfeeding, weight change or when the breasts are sagging, where a breast lift is then also performed. Asymmetry can occur, the prosthesis has been incorrectly positioned or a hard membrane has formed around the prosthesis, so-called capsule formation/capsular contracture.
The degree of capsule formation varies from 1 to 4, and the strongest type (3 and 4) occurs in 5-8% of women who have prostheses. The reason for this has to do with how the body reacts to silicone as a foreign object. This can also be both cosmetically and physically troublesome such as tenderness and pain. Capsule formation is not dangerous, but the breasts can become hard, tender and in some cases cause pain. If the breast implants are to be removed in the event of a severe capsular contracture, the surgeon would like to remove both the implants and the scar tissue (capsule) around the prosthesis. Some may experience silicone leakage in the form of knots or reduced volume which can be examined with ultrasound or MRI.
For more information about our expertise and publications on breast implants, please see 4 attachments under treatment: Breast augmentation with implant.
How does the replacement of the prosthesis take place?
The procedure itself takes approx. 1-1 ½ hours, under deep sedation. Depending on the type/grade of the capsule, it is considered whether to remove the entire capsule or only parts of the capsule – which is easier. As a rule, the incision is made where the old scar is, this is to avoid creating new scars.
After removing the old prosthesis, the same cavity will be used for the new prosthesis, possibly also filled with the patient’s own fat. In some cases where you only remove the prosthesis or replace it with a new one, it may be enough to only split the capsule from the inside, which gives you more space for the new prosthesis. During surgery, thorough homeostasis is done to stop bleeding, as capsule removal can cause small bleeding.
Replacing a prosthesis can easily be combined with fat grafting with fat or a breast lift. Whether this should be carried out at the same time is discussed in consultation with the surgeon during the consultation. A drain is often placed in the pocket, which is usually removed 1-2 days after surgery.
About our implants
Oslo Plastikkirurgi clinic uses the renowned Mentor Memory Gel prostheses. They are available with smooth or textured surface and with moderate to ultra-high profile. You will, in consultation with the surgeon, decide which implant is right for you.
Mentor Memory Gel breast implants feel like natural breast tissue without compromising on reliability or safety.
Mentor has been one of the world’s leading manufacturers of quality implants for over 30 years and has been a trusted choice for millions of women worldwide. Founded in 1969, Mentor Worldwide LLC is a leading manufacturer and supplier of medical products for over 100 countries. Mentor’s activities include research, development, and production at several plants in Europe and the USA.
The prosthesis usually consists of silicone, but there are also other types of prostheses consisting of saline, or a combination with saline and silicone. The exterior of the prosthesis contains silicone. Regarding the shape, the prostheses may be round or drop-shaped, the latter giving in some women a more natural form of breast enlargement.
The implant consists of silicone, but it is also possible to use other type of implants such as saline and a combination of saline and silicone, when the outer part of the implant consists of saline. Your surgeon will explain all the options available to you in detail.
You can read more about Mentor implants here: http://www.breastimplantsbymentor.net/en-EMEA/
You also have choices about shape. You can select a round or anatomical shaped
implant, which look more natural. Sometimes we can combine a breast enlargement with a breast-uplift (Mastopexy) if the breast tissue has sagged. See more information about this procedure on the BREASTLIFT COMBINED WITH BREAST IMPLANT details.
To get the optimal results and avoid complications, we recommend your weight to be as normal as possible. If you are a smoker you must refrain from smoking at least 2 weeks before surgery and 2 weeks after surgery.
Breastfeeding will be possible after surgery and mammography screening. Reports of Silicone implants damaging general health, causing auto-immune disease to have not been scientifically proven despite many international studies being carried out in the past 20 years.
Pick-up and accommodation
If you live some distance from the clinic, we recommend that you spend one night in or near Oslo Plastic Surgery Clinic so that our caring staff are on hand to reassure you should any issue arise, that will cause you concern.
You must agree in advance with a person to pick you up at the clinic approx. 1 hour after the end of the operation, as you cannot drive, take public transport or taxi alone. You should also have someone with you the same day and the first night.
If you live far from the clinic, we recommend that you spend the night in Oslo, either with family / friends or at a hotel.
Hotels near Oslo Plastikkirurgi clinic
-Frogner House Apartments, Bygdøy Allé 53. Website: https://frognerhouse.no (We have an agreement with Frogner House Apartments).
-Hotel Gabel’s Hus in Gabel gate 16. Website; www.nordicchoicehotels.no
To get optimal results and avoid complications
Avoid stress, stay out of the sun, eat healthily, keep your weight within a normal BMI range, exercise regularly, and refrain from alcohol for 2 days prior to surgery and 2 weeks after surgery. Please refrain from smoking/snoozing for at least 2 weeks before surgery and a minimum of 2 weeks after surgery as smoking can interfere with the result.
You must ensure your personal health on the day of surgery. Please contact us as soon as possible if you are in doubt, as we may have to postpone your surgery therefore saving you a journey to our clinic.
Prior to surgery you will have received a prescription for antibiotics, pain killers and Hibiscrub 40 mg/ml which are all available from your local pharmacy. The day before surgery you must shower using the Hibiscrub and again on the day of the procedure immediately before surgery. Use a clean towel for drying and put on clean clothes when you leave home and change the sheets on your bed.
YOU MUST NOT EAT ANYTHING 6 HOURS BEFORE SURGERY, but you may drink water and light juice (not milk) and chew gum up to 4 hours prior to your surgery. You may take necessary medication/s with a sip of water on the morning of the operation.
Please decide for an adult friend to pick you up after surgery, as you will not be able to drive or take a cab alone. We also advise you to have a responsible adult person staying with you during the first 24 hours.
Taking medications prior to surgery:
It is very important that you stop using the following medications 2 weeks before surgery: Acetylsalisyre, Albyl, Albyl-E and other medications that cause extended bleeding as Ibux, Alka-Seltzer, Antineuralgica, Asacol, Artrizin Alka, Brufen, Butazolidin Alka, Codacetyl, Confortid, Dispril, Dispril med kodein, Doloxene Forte, Denobid, Felden, Fenylbutazon, Gamaquil Comp, Globentyl, Globoid, Indocin, Kodein-Magnyl, Kodifen, Licyl, Magnyl, Magnyl-Koffein, Mundisal, Napren, Naprosyn, Novid, Novid with koffein, Paraflex Comp., Tanderil, Vitamin E, and Selen, Tricycliske antidepressiva.
We also recommend you omit
Garlic, evening primrose oil, Gingko Bilabo, Aspirin and any drug containing blood thinners.
The above products are known blood thinners therefore not beneficial when you are having surgery.
For Marivan we have individual arrangement. Please request this information on your consultation.
Day of Surgery
After a final discussion with your surgeon the planning process will begin. You will be photographed, and markings will be made on your surgical areas. At this stage you will have time and the opportunity to ask any questions that you may have forgotten so that your surgeon can reassure you that he fully understands your goals and expectations.
You will be introduced to your anesthetist (who will be happy to discuss any fears or issues you have regarding your anesthetization). You will also meet your theatre nurse.
The sedation which you are given in your arm is a quick and painless procedure and you will fall asleep very quickly.
You should be ready to go home within 1 hour following surgery and remember to arrange for someone to pick you up. You should have adult company with you for the next 24 hours to assist you with general tasks, so that you can relax and take it relatively easy.
We will provide you with the cell phone numbers to call us should you feel the need, but this is very rare. We just need to reassure you that we are there for you 24 hours a day.
We will require you to come to the clinic for a follow up check. WITH ALL SURGERY THIS IS IMPORTANT AS YOUR SURGEON NEEDS TO SEE HOW YOU ARE SETTLING.
We do not recommend you fly for 48 hours post-surgery. You may feel nauseous and tired in the hours following surgery. It is important to take your painkillers and drink enough fluids.
We close the wound with stitches that dissolve on their own. We do not usually insert the drain (tube), only in very few cases is it inserted to remove blood and fluid from the wound area under the chest. These are usually removed at the clinic 1-2 days after the operation.
You may experience dizziness if you get up quickly from a chair or perhaps when you are lying in bed, so be sensible, take it easy and move slowly. This is quite normal following surgery and should pass within a couple of days.
The first 2-5 days following your breast surgery you may feel stiff and sore in the chest region. You should be calm and lie as still as possible, with your upper body raised. For the next five days, you can move gently. If you have an active job, it is a good idea to stay home.
After the operation, you get a special bandage that is removed after 2 days, the tape is kept on for 2 weeks. You will be required to wear a sports bra for approximately 6 weeks after surgery day and night and 6 more week at daytime. Your breasts may feel tight and sensitive to the touch and your skin may feel warm or itchy.
After the tape is removed (after 2 weeks) you can shower the area and put on new tape. It is recommended that you tape the scars with skin-friendly tape for at least 2 months. Surgical tape such as Micropore or Steri-Strip can be bought at the pharmacy, alternatively silicone tape.
Follow ups will be carried out at the clinic/alternatively through phone or video consultation:
1 day after surgery, after 1-2 weeks, after 3-6 months and finally after 1 year when our guarantee to you is completed.
Bleeding and infection are unusual and if they do occur, they may need to be treated with a small operation and/or an antibiotic. Asymmetry, incorrectly placed implants, or the formation of hard capsules” capsular contracture” can also occur. If corrections are needed, they will be scheduled free of charge within one year after your surgery. Anesthesia allergy is extremely rare.
If correction is necessary due to complications or unsatisfactory results, this is done free of charge within one year, if there is a medical indication and a clear potential for improvement. This is our warranty period.
Heavy physical exercise and strenuous body movement or lifting must not be undertaken for a minimum of 4 weeks following the surgery.
The results will emerge between 3 to 6 months following surgery.
On this page you will find:
If you want to know more or have questions, use the form and we will reply to you within a short time.
Dr. Amin Kalaaji
The responsible physician is Dr. Amin Kalaaji, senior physician MD, specialist in plastic surgery and head of clinic at Oslo Plastic Surgery, and head of the Norwegian Association for Aesthetic Plastic Surgery (NFEP) 2018-2020.
Dr. Kalaaji holds many positions and gives lectures and training around the world. This benefits all our patients as he is always up to date on the latest and most advanced treatments and surgical techniques.
Patient safety, high quality and individual treatment always weigh the most at Oslo Plastic Surgery.
Oslo Plastikkirurgi answers here frequently asked questions, and we hope that this will give you good information. We want to be helpful in the process before an operation. If you have more questions, just write or call us.
When you are in need of new implants.
During the operation, a pocket is prepared under the mammary gland, alternatively under the pectoral muscle. A third and even better alternative for most people is to place the implant under the membrane of the pectoral muscle, then you will also achieve protection of the prosthesis with the fascia itself (the membrane around the muscle) and at the same time avoid using the muscle itself.
The reports of possible short- or long-term damaging effects of silicone inserts have not been scientifically confirmed. Inserting breast implants is today considered a safe procedure in accordance with strict EU / EEA rules.
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare type of lymphoma associated with textured implants that are largely unused today. Characteristic of breast implants with BIA-ALCL is that malignant cells are found either in the fluid (swelling) around the prosthesis or as an infiltrate in the prosthesis capsule that has been added no earlier than one year after surgery. The risk of developing or dying from BIA-ALCL is minimal, but it is always important to take risks and findings seriously. There is also curative treatment in the detection of the disease in good time. We offer our patients via the prosthesis company lifelong advice if they have questions about their implants from us.
All patients must have a consultation before the operation. The consultation is conducted by our experienced plastic surgeon who will confer with you and your medical condition and motivation for surgery. An examination is then performed, and the surgeon assesses a possible operation.
If you are suitable for the procedure, you will receive information about the procedure, precautions for the time before and after the procedure, and you will receive answers to your questions. We then photograph the breasts and take important distance measurements to assess the need for an implant. You then get to test a special bra prosthesis, both sizes and shapes. We show several before and after pictures and if desired we can make 3D animation of the result. Feel free to tell us about this before the consultation so that we can calculate well in time.
In a consultation you get a prescription for antibiotics, possibly painkillers and Hibiscrub solution 40 mg / ml which you can buy at the pharmacy.
A silicone prosthesis is inserted of a size and type that you have chosen in collaboration with the patient before the operation. The scar goes either under the breast (most commonly), around the nipple or through the armpit.
You must be healthy on the day of surgery. If you are in doubt about whether you have a cold or the like, you must contact us. The operation is not performed when you have the flu and / or fever or cough or other infection in the body. Our staff will receive you and together complete you for the operation, the surgeon looks at you before the procedure and draws up the planned procedure, as well as answers your questions. Anesthesia staff also come to greet you and answer your questions. After the operation, you will be served food and plenty of drinks in the form of bread, yoghurt, and juice (tell us if you want another diet / have allergies).
In Norway, it is not allowed to show before and after pictures from cosmetic procedures during marketing or on the clinic’s website. However, we can show great pictures from previous patients when you come for a consultation with the surgeon. This can be very helpful when choosing the shape and size of the implant, and it can make it easier for you to imagine a result. We do not send photos.
We have a 1-year warranty. If correction is necessary due to complications or unsatisfactory results, this is done free of charge within one year if there is a medical indication and a clear potential for improvement. This is our one-year warranty agreement.
Oslo Plastikkirurgi clinic uses the renowned Mentor Memory Gel prostheses. They are available with a smooth or textured surface and with a moderate to ultra-high profile. You will, in consultation with the surgeon, decide which implant is right for you.
You can get the implants with different types of gel. Mentor implants are available in sizes 100cc. Mentor is CE and FDA approved implants. The implants have a lifetime warranty in the event of a leak (ie they replace the implant itself), and they also provide a subsidy for the operation in the event of a leak within 10 years.
Feel free to read our own publications about breast implants (Norwegian and English).
1 – Survey of Breast Implant Patients: Characteristics, Depression Rate, and Quality of Life
Amin Kalaaji, MD, PhD; Cecilie Bergsmark Bjertness; Cathrine Nordahl; and Kjell Olafsen, MD
Aesthetic Surgery Journal, Volume 33, Issue 2, February 2013
3 – Quality of Life After Breast Enlargement With Implants Versus Augmentation Mastopexy: A Comparative Study
Amin Kalaaji, MD, PhD; Cecilie Bergsmark Bjertness; Cathrine Nordahl; and Kjell Olafsen, MD
Aesthetic Surgery Journal 2018, Vol 38(12) 1304–1315 © 2018
4 – Det er trygt å legge inn brystimplantater | Amin Kalaaji
Amin Kalaaji overlege, Dr Med, spesialist i plastikkirurgi. Leder, Norske Forening for Estetisk Plastikkirurgi (NFEP)
Aftenposten 12. desember 2018