Breast augmentation is one of the most requested cosmetic surgery procedures in our country and has been documented with terrific outcomes. However, sometimes there are women who have issues with their surgery and want or need revision.
What Is Breast Revision?
Breast tissue ages just like the rest of us ages. Over time, implants that were perfect when you were younger now need revision. For others, scar tissue may thicken and distort the breast or cause pain. Implants may rupture or deflate. Some may just want a different size or look. There are also women who have a visible irregularity or a medical condition and would like to have their implants taken out altogether. Newport Beach, CA plastic surgeon Dr. Karen Leong offers breast revisions to her patients; she takes the time to consult with you and do a thorough examination to determine how best to address your concerns. She does take patients requesting en bloc capsule removal (with or without breast implant illness or capsular contracture). If you have concerns with your augmented breasts, please contact our office in Newport Beach for an appointment. Dr. Leong looks forward to meeting you and seeing how she can improve your condition with a breast revision.
What Is the Breast Revision Procedure Like?
Revision breast surgery is performed under general anesthesia in an accredited surgical facility and may take longer in the operating room than primary breast surgery. The surgical technique for breast revision surgery is determined by what needs to be accomplished. Dr. Leong will explain the steps, techniques, and more during your surgery planning session. She wants what is best for you and your health.
Common Reasons For Revision
Breast revision surgery either takes out an implant that no longer functions or is no longer wanted. It may include replacing the implants or going from an implant to a fat transfer (or vice versa). There are a few other common cases in which a revision surgery is desired or required:
Implant Rupture
Even though this is rare, implant rupture can occur. If a saline implant type ruptures, deflation will occur almost immediately, and a visible change will ensue. On the other hand, if the implant is silicone-based and ruptures, it may only be seen through an MRI or ultrasound. Whether silicone or saline, if a rupture happens, a revision procedure will be required.
Capsular Contracture
This is the term used for scar tissue hardening, occurring when the delicate tissue around the saline or silicone implant becomes hard and thickens. Although many implant surgeries do result in some internal scar tissue, most women will never see or feel it. In some cases, the scarring could interfere with implant placement, changing the breast shape and implant functionality and delivering an undesirable outcome. Capsular contracture surgery to remove scarring would be recommended in these cases.
Breast Implant Illness
Breast implant illness is a concern for women because of the possible illnesses and conditions related to or triggered by a silicone implant. Augmenting the breast with a silicone implant has been closely monitored and researched for decades. There is always a possibility of practitioner error or something happening during the surgery to impact the breast and implant. Also, breast implants are manufactured with labels warning women with preexisting autoimmune diseases. Why? It has not been determined if a silicone implant initiates or intensifies the symptoms of autoimmune diseases. Researchers are still working on the answer about what is behind breast implant illness. If you are concerned you may have an illness because of your implants, please schedule an appointment with Dr. Leong so that she can talk you through your symptoms and make recommendations to help you feel well again.
Implant Malposition
Implant malposition, sometimes called bottoming out, is a condition that happens when one or both breasts drop too low or “bottom out.” In some cases, this is due to positioning error from the first augmentation surgery. In others, implants may displace laterally in people who sleep on their bellies or who do a lot of chest exercises. To correct this, Dr. Leong meticulously tightens and reshapes the pocket, sometimes with added enforcement by using surgical mesh.
Symmastia
Symmastia or “uni-boob” is when implants are so close together it appears there is little to no separation between the breasts. In some cases, this is because the pectoralis muscle was released too aggressively during primary augmentation. In other cases, the implant used was the wrong shape and width. The revision will correct this problem by selecting an implant that fits your body type and by correcting the breast pocket to allow separation of the breasts.
Implant Rippling
This condition occurs when there are obvious rippling and wrinkles beneath the skin. Rippling is more common in patients who are of low body weight. Often, this condition can be fixed by simply changing to a more cohesive silicone implant.
Breast Size and Symmetry
There are times a secondary breast surgery is as simple as receiving a smaller or larger sized implant. With the original surgery, you may have opted to go too conservative or gone a bit too large. A new breast implant size may be the answer. Breast asymmetry may have several underlying causes. Breasts may become disproportionate after breastfeeding. There may be more scars around one implant; an implant may have ruptured or become displaced. Proper diagnosis is needed to determine the cause(s), and the appropriate surgery would be needed to correct the problem(s) and restore symmetry.
Pocket Revision
A breast augmentation pocket revision is about correcting the placement of the implant, whether because of capsular contracture or implant malposition. Scar tissue can be removed, and the pocket can be opened up or tightened, or even changed depending on the surgical plan, and reinforcement with meshes may enhance the longevity of results and prevent future complications.
Recovery and Results after a Breast Revision
Recovery from revision surgery varies based upon the complexity. Revision surgery that warrants complex revision techniques will need a longer recovery period that could possibly take up to several months. Patients will begin to see their newly revised outcomes once the swelling begins to disappear. The goal following breast revision surgery is to reach a result that is both natural-looking and healthy. Dr. Leong will follow up with you regularly after the procedure to help guide your treatment, monitor your healing skin, and answer your questions as needed.
Am I a Good Candidate for Breast Revision?
If you have any concerns (whether medical or aesthetic) about your breast implants, please schedule a consultation with Dr. Leong to go over your wants and needs and to develop your personalized plan for breast revision surgery. Whether it is scarring, drooping, sagging, rippling, or asymmetrical breasts, revision surgery can help correct the problem. This procedure can also help if you want to change the size, implant styles,or address any other aspect of your breasts.
The cost of breast revision surgery can vary greatly depending on what needs to be done but may start at an average of $8600. During your consultation, Dr. Leong will listen to your concerns and goals before performing a physical exam to assess your implants. Then, she can talk about your options before developing your surgical plan. The cost of revision surgery will depend on the complexity of the procedure and what you choose for your new implants. It is best to focus on getting the results you want and finding an experienced plastic surgeon rather than the cheapest option. To help make your surgery easy to afford, Dr. Leong accepts many different payment methods, and we can help you find low-interest financing.
Dr. Leong can perform your revision surgery even if she wasn’t the surgeon who did your original breast augmentation. Breast revision surgery can be more complex than the original augmentation if you want dramatic changes or have problems, so it’s best to find a plastic surgeon like Dr. Leong, who has the experience and advanced training in breast surgery. Dr. Leong provides the same level of care to her returning breast patients if they have a problem or want a change.
If you are having your implants removed or are changing to significantly smaller implants, you may need to have excess skin removed during your surgery. After listening to your goals and assessing your current implants, Dr. Leong can discuss the need for a breast lift to remove loose skin. If you lose a significant amount of weight, become pregnant, or breastfeed after augmentation surgery, a revision with a lift can help you get better results.
When possible, Dr. Leong will make incisions for revision surgery in the original augmentation incisions. However, if this is not possible, she will place the new incisions where they will be less visible. Breast revision surgery typically uses a periareolar incision (on the lower edge of the areola), an inframammary incision (under the fold of the breast), or breast lift incisions (lollipop or anchor). Dr. Leong or a member of her team will go over scar management, so your incisions heal smoothly and blend into your skin.
While implants can last a long time, they do need to be replaced at some point. After augmentation surgery, it is important to have your implants checked regularly so Dr. Leong can help you decide when your implants should be replaced. With so many advances in the medical field, you may want to consider the newest implant shapes and types to achieve your best look during breast revision surgery.
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