Breast Revision Surgery
Breast revision surgery is a broad term for any surgical procedures designed to correct unsatisfactory results from previous breast surgery. Patients seek revision surgery to restore a more youthful and or more natural appearance of their breasts. Common reasons for breast revision are capsular contracture, rupture or leakage of breast implants, rippling, sizing, and asymmetry.
Capsular Contracture refers to hardening of the capsule which is generally formed around the implants. This can happen with both saline and silicone implants at a rate of around 10%.
Capsular contracture can cause distortion of implant appearance, breast hardness, discomfort, and even pain. Symptomatic capsular contracture causing misshaped breasts, hardness, and or pain is an indication for revision surgery. During surgery, capsulectomy (removal of the capsule) can be performed with old implant removal and possible replacement with new implant. Placement of a dermal matrix over the new implant is the most effective method to prevent recurrence.
Malposition of breast implants, too high, too low, or too lateral (outward) on the chest wall, is another reason for revision. Depending on the extent of displacement and the cause, treatment may involve implant pocket modification with sutures and/or with dermal matrix support, reposition of implant pocket (from behind to in front of the muscle or vice versa).
Implant Deflation or Rupture can be a distressing cause of breast revision surgery. Saline implants may rupture and become deflated. Although this does not cause a health concern as saline would get absorbed naturally by the body, patient however will have significant asymmetry of their breasts. The revision procedure may be as simple as replacing the deflated implant or removal of both implants. Depending on the manufacturer of the implant; if still under warranty, the cost of the implant replacement may be covered by the manufacturer.
Dissatisfaction with Breast size after initial breast augmentation may lead to breast revision surgery. Patients may feel that the implants are too big or too small. Downsizing of implant may require additional breast lifting if the skin is too stretched out.
Rippling refers to folding of the implants that is sometime obvious in certain positions or all the time. This occurs more often with saline and older generation silicone implants. If the implants are the major cause, replacement of the implants can resolve the problem. However, If the breast skin and subcutaneous tissue are too thin, fat transfer may be necessary to provide the optimal result.
Who are Candidates for Breast Revision?
The best candidates are healthy people with realistic expectations of surgery. Often patients with moderate to severe deformity would benefit the most from surgical correction.
How is Breast Revision performed?
Depending on the breast deformity, different procedures can be tailored. If capsular contracture is the main issue, capsulectomy is necessary.
What is Recovery Like?
Downtime from surgery is between 1-2 weeks. Moderate swelling and minor bruising are expected in the first week. In rare occasion, small tubes may be placed underneath the skin during surgery and remain for 1-2 weeks after surgery. Majority of the swelling will resolve by one month after surgery. Discomfort from swelling and pain along the scar are the major complaints after surgery. There also may be change in nipple sensitivity after the surgery.