Prosthesis replacement

At Gooimeer Clinics, we work almost exclusively with biocompatible nanotextured implants by Motiva. These implants have a very favourable safety profile and a demonstrably low risk of capsular contracture.

In the past, surgeons often used aggressively textured implants. The idea was that they would “grip” the surrounding tissue—almost like Velcro—helping to reduce the risk of implant displacement over time. In recent years, however, it has become clear that some of these rough-textured implants can:

• show microfragmentation

• trigger a pronounced immune response in the body

• and be associated with rare but serious complications

For this reason, Dr. Van der Pot and Dr. Ahmed consciously switched to nanosurface implants in 2017—among the first in the Netherlands to do so. These implants provoke significantly less inflammatory response and are therefore often described as biocompatible.

Every advantage has a trade-off: because these implants adhere less to the tissue, proper internal support becomes even more important. Our surgeons are highly specialised in these advanced breast surgery techniques and are invited worldwide to give live surgery demonstrations and lectures.

A breast implant has weight. That weight needs support to help prevent the implant from gradually dropping over time, rotating outward, or overstretching the lower pole.

That is why, during an implant exchange, we almost always use a form of an internal bra technique. This technique is designed to:

• provide better support for the implant

• position it more stably

• and gently guide it towards the cleavage

How does it work?

In most cases, we use your own tissue (such as capsule, connective tissue, or a small portion of muscle) to create internal support. In some situations, this is supplemented with a resorbable support material that provides temporary extra strength during healing. Over time, the body gradually takes over this supportive role.

The result is:

• a lower risk of recurrent sagging

• a more refined, stable décolleté

• and longer-lasting aesthetic results

This approach requires more experience and surgical precision than simply “swapping implants,” but it makes a significant difference in long-term outcomes.

No two situations are the same. During the consultation, we assess, among other things:

• the quality of the skin and supporting tissues

• the position of the current implant

• any capsular contracture

• the desired size and shape

• the position of the nipple

In some cases, an implant exchange alone is sufficient. In other cases, a small breast lift is needed to improve nipple and breast position. We always discuss this openly and carefully: the goal is a beautiful breast, with scars that are proportionate to the improvement you gain.

Een prothesewissel vindt plaats onder algehele narcose. In de meeste gevallen is het een dagbehandeling. Afhankelijk van de uitgebreidheid (bijvoorbeeld combinatie met een lift of uitgebreide inwendige BH) kan een overnachting soms wenselijk zijn.

Het herstel verloopt vaak vergelijkbaar met – en soms zelfs soepeler dan – de eerste borstvergroting:

• 1–2 weken: meeste dagelijkse activiteiten weer mogelijk

• 3–4 weken: voorzichtig starten met sporten

• 6 weken: meestal volledige belasting toegestaan (in overleg)

U krijgt een ondersteunende BH, duidelijke instructies, pijnstilling en zo nodig antibiotica mee.

The same applies to a breast implant replacement: every operation carries risks, although serious complications are fortunately rare.

Possible complications include:

• postoperative bleeding (haematoma)

• infection

• capsular contracture (again, despite replacement; the risk is lower with modern implants)

• neuropraxia: temporary sensory disturbance or nerve irritation of the skin or nipple area. This occurs in approximately 1 in 30 patients and usually resolves spontaneously within a few weeks to around 6 weeks

• asymmetry or displacement of the implant

During the consultation, we always discuss these risks openly, including what you can do yourself to help minimise them.