Question:
Is it true that implants can make sloshing or squeaking noises after surgery? Why is this and how can this be fixed?
Answer:
Yes, it is true that implants can make sloshing or squeaking noises early after surgery. In fact, this is a common complaint of patients following surgery. It is really more of an observation than a complaint. It usually causes some concern to patients but once they are reassured that it is only temporary and that it is a benign consequence of the surgery, any sense of distress is relieved. This is usually less of an audible sloshing or squeaking than it is the sensation of rubbing or friction. This sensation is caused by the silicone shell surface rubbing against freshly dissected tissue surfaces in the implant pocket. Again, these are almost always temporary symptoms. As the implant capsule develops over the first few weeks following surgery, these symptoms usually resolve. The implant capsule is made of fibrous connective tissue on the outer surface but the inner surface of an implant capsule is lined with specialized cells which actually secrete a sort of lubricating fluid. Once this lining develops and the lubricating fluid is secreted, the implant can then glide over this lubricated and somewhat slippery surface with less friction.
Sometimes these symptoms, especially the sloshing sensation, can persist. There are a few possible explanations for this. One of those would be air contained in a saline implant along with the saline that fills the implant. This can result in some sloshing of the saline inside the implant. Any air in the implant can be detected by a simple x-ray or ultrasound. Another explanation could be an under-filled saline implant that has some residual potential space inside and a loose or lax external shell. Under-filling can allow the contained saline to slosh around a little more than if the implant is filled to within the recommended volume range. Air in a saline implant can be fixed by simply accessing the implant with a fill tube and evacuating the air. Under-filling of an implant can be fixed with the addition of further saline solution. Both these procedures would require at least local anesthetic and would have to be performed under sterile conditions.
Another possible explanation for persistent symptoms of perceived sloshing or squeaking would be if the implant pocket was originally dissected to a size greater than the dimensions of the implant, which would allow excessive mobility of the implant inside the pocket. This could be perceived as sloshing or bumping of the implant as the patient moved and the implant moved from one side of the pocket to another. This problem can be addressed with a surgical procedure to manipulate the dimensions of the implant pocket. This procedure would be described as a capsulorrhaphy or a capsulectomy where a portion of the pocket is excised and the cut edges re-approximated to decrease the dimensions of the space.
