Assuming you have silicone implants, you need an MRI to tell if there is a rupture. If they are submuscular, I recommend waiting 4 weeks before resuming full activity--anything that requires contracture of the pectoralis muscle. Costs vary widely. For our BA patients, we accept the manufacturer's payment. For others, we charge $3,000.

Published on Jul 11, 2012

It is important to have an exam with your plastic surgeon, and he may order an ultrasound. Do you have silicone or do you have saline? Other important factors: Are they under the muscle or under the tissue? Your pilates should not interfere with your augmentation. Make sure you consult with your doctor on when to start again after augmentation.

Published on Jul 11, 2012

First, seek a professional opinion from your surgeon or another board-certified plastic surgeon. Typically, in this situation, I would start with an exam, MRI of the breast, and then discuss any necessary intervention. Although implant rupture is very unlikely, they can happen. In my practice, the cost would depend on the extent of the rupture and need for repair. It is hard to give a figure without an exam. The modern silicone implant is very well-made, so safety in my opinion is not an issue. Good luck and be safe.

Published on Jul 11, 2012

Thank you for your question. You would need to see a plastic surgeon urgently to address this. Manufacturers typically cover the cost of the implants, as well as portion of anesthesia and facility fees. In my practice, I don't charge a surgical fee for patients if I have placed them.

Published on Jul 11, 2012

Unilateral replacement could be $2,300 - $2,500, with the thought that your implant may be under warranty and this would be free. Depending upon the maker of your implant, some companies offer at least a partial reimbursement toward surgical fees.

Regarding your profession in Pilates, your job and activity should not be a problem for having breast implants.

Published on Jul 11, 2012

Our charge for implant exchange is $5,000 for silicone, and almost all of that is reimbursed to you by the implant company.

Published on Jul 11, 2012

First, you need an MRI to confirm your suspicions. If the implant is ruptured and you need a replacement with capsulectomy, the recovery is about 3 weeks before returning to Pilates.

Published on Jul 11, 2012

Rupture of a silicone gel implant that is a newer gummy bear type is very rare and usually wouldn't occur, but it sounds like you may have one. I would suggest getting an ultrasound. If you are only several years after your surgery and you have a rupture, we are able to get a new implant free of charge for you as well as a good portion of the replacement cost. I would not recommend doing any exercising until you determine what is going on, for if the implant is ruptured, you could spread the silicone beyond just the breast!

Published on Jul 11, 2012

If you feel as though your implants might be ruptured, you should see either your plastic surgeon who performed the initial procedure or another board-certified plastic surgeon. In any event, the operation to correct the problem involves the removal of your old breast implants, partial or complete removal of the entire capsule of the breast pockets, then replacing them with new implants. Typically, since the pocket has already been created, the downtime for this is usually 4 to 6 weeks. After this time, as long as everything is healing well and you're feeling well, you can resume being a Pilates instructor. As far as as if this is going to happen every three years, it is difficult to tell. However, chances are you may have a further issue down the road related to capsular contracture and/or possibly another episode of implant rupture. Having said that, I DON'T believe that your days of being a Pilates instructor and/or having breast implants are over. Good luck.

Published on Jul 11, 2012

I am sorry to hear what you are experiencing. To determine if silicone gel breast implants have ruptured, you would need to get an MRI.
Cost and return to pilates is something you need to speak to your surgeon about. Online consultants cannot give good advice without an examination.

Published on Jul 11, 2012

The first step for you is to see your surgeon or another experienced board-certified plastic surgeon to evaluate you. You may need to get an MRI to confirm rupture, unless it looks like you need surgery regardless. A rupture at 3 years is fairly uncommon but is possible. If you have Mentor, Allergan, or Sientra implants, they are covered (you get 2 free implants) and the company will give you approximately $3,500 toward your surgery. The cost varies depending on the surgeon, but will likely be similar to what you paid the first time, unless the surgeon who put them in gives you a discount. You should be able to do all activities, including Pilates, without fear that the implants will rupture. It should not be an every 3-year thing. Most implants today should last significantly longer...probably more than 20 years on average. Best of luck.

Published on Jul 11, 2012

The cost of breast implant exchange depends on the surgeon chosen, the facility, the manufacturer's warranty, and the cost of anesthesia. Additionally, there may be some cost associated with an MRI or lab work. Schedule a consultation with your board-certified plastic surgeon ASAP. You'll be glad you did.

Published on Jul 11, 2012

Hello, it is possible but unlikely you have an implant rupture. If in fact there has been a breach, it is more likely it was injured at the time of surgery than a true implant failure. Still unlikely. Silicone gel implants frequently last decades.

If you and your surgeon feel strongly enough, you should get either an MRI (FDA recommendation, but not necessarily the only or 'best' option), or a high definition ultrasound to confirm. If there is a rupture and you have surgery, you will need to take about 4 to 6 weeks off from Pilates of the upper body, but may do lower body work or instruct within a week.

Best of luck!

Published on Jul 11, 2012

You should not have to change them every 3 years. The manufacturers are now saying that 50% will break at 10 years, so that seems to be a good time to think about replacing them. You will get some financial assistance for redoing your surgery (if they are silicone) within that 10 years, and if they are broken you will get a new implant. The problem is not knowing if you just need a replacement, or if you need a capsulotomy, or capsulectomy. This varies how many hours of work will need to be done. The range in hours is from one to 3 1/2. So the overall cost would be between 9K and 16K would be a good range. But how much assistance you will get from the manufacturer will be harder to figure, but it may be as high as 4K. Hope this helps.

Published on Jul 11, 2012

Thank you for your question. If you suspect a silicone implant rupture, I recommend you have an MRI, with and without contrast, of your breasts to confirm if the implant is leaking. Depending on the implant manufacturer, the typical financial reimbursement for replacement of a ruptured implant is 3500.00 dollars plus the implant costs. I recommend avoiding upper body and chest exercise for a minimum of 2 months postoperatively. This is not a three-year thing, and don't feel you need to remove your implants to continue as a Pilates instructor. I have many patients with breast implants who are Pilates instructors. Take care.

Published on Jul 11, 2012

Thank you for your question. If you believe that you have a ruptured breast implant, I would highly recommend following up with your operating surgeon or your gynecologist for clinical follow up. At this time, your physician will likely send you for a MRI of the bilateral breasts to confirm whether or not you have a breast implant rupture. Surgical fees associated with a breast implant exchange is variable and depends upon location of facility, surgeon experience and expertise, as well as the extent of what in fact needs to be performed. The average cost for a breast implant exchange in New York ranges from $5,000.00-$8,000.00, but keep in mind that fees in Manhattan are typically a little higher. The good news is that the downtime a patient can expect with a breast implant exchange is usually a day or so, as there is not the same discomfort or soreness as you probably had with your initial breast augmentation. With that said, I request that my patients refrain from any exercising, heavy lifting and/or physical activity for 4 weeks. Is it possible to instruct your Pilates clients without doing the exercises yourself? Many of my personal trainers and athlete patients will return to work within a couple of days but avoid demonstrating the necessary exercises and modify their routine. I would strongly recommend that you follow up with a board-certified plastic surgeon at your earliest convenience for a complete evaluation of the breasts. I would also recommend getting a MRI of the bilateral breasts to confirm or refute your suspicion of a rupture. I hope this helps and best of luck!

Published on Jul 11, 2012

Your unique situation would clearly require a consultation. There are many issues to discuss, such as removal only or removal with replacement. If removal only, the appropriate procedure may require capsulotomy or capsulectomy. Removal with replacement may also require capsulectomy or capsulotomy, plus the additional concerns for implant choice. This may require either saline or silicone implants, and either smooth or textured surfaces, and either round or contoured/anatomic implants with either moderate or high profiles. Post-operatively adjustable implants can be used but are more costly and require two procedures. Placement of silicone implants would necessitate enrollment in the adjunct protocol. Implants may be placed above or below the muscle. Either removal and/or replacement may also require a mastopexy (breast lift) depending on your anatomy and desires. The effect of implant removal on your body is difficult to predict due to your unique breast anatomy, skin quality and elasticity, breast size & shape, implant size & shape, degree of ptosis (sagging), age, nursing history, weight fluctuations, associated conditions, and numerous other factors. Furthermore, is surgery needed on one breast or two breasts?

Published on Jul 11, 2012