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Breast Revision

Home / Procedures / Breast / Breast Revision
What is breast revision surgery?

Breast revision surgery refers to corrective surgery performed on an existing breast augmentation or reconstruction. It’s essentially an enhancement procedure to address concerns with the initial outcome. Here’s a breakdown of why someone might consider breast revision surgery:

Reasons for Breast Revision Surgery:

  • Complications from Implants:
    • Implant rupture or leakage: This can necessitate replacement with new implants.
    • Capsular contracture: Scar tissue tightens around the implant, causing firmness and distortion. Revision surgery might involve capsulectomy (removal of scar tissue) or implant replacement.
  • Cosmetic Concerns:
    • Dissatisfaction with size, shape, or symmetry: The initial augmentation might not have achieved the desired aesthetic outcome. Revision surgery can involve implant adjustments (size, type), additional fat grafting for fullness, or repositioning for better symmetry.
    • Changes after pregnancy, weight fluctuations, or aging: These factors can affect the appearance of breasts after augmentation or reconstruction. Revision surgery can help restore a more desirable look.
  • Scar Improvement: While scarring is inevitable, some patients might desire improvement in the appearance of scars from the initial procedure. Revision surgery might involve scar revision techniques to minimize their visibility.

Who is a Candidate for Breast Revision Surgery?

If you have any of the following concerns after a breast augmentation or reconstruction procedure, you might be a candidate for revision surgery:

  • Noticeable asymmetry between breasts
  • Capsular contracture causing discomfort or distortion
  • Implant rupture or leakage
  • Dissatisfaction with the size, shape, or overall aesthetic outcome
  • Significant changes in breast appearance due to pregnancy, weight fluctuations, or aging
  • Unsightly scarring that you wish to improve
How is a breast revision surgery performed?

The Surgical Procedure:

  • Performed under general anesthesia.

  • The specific steps will vary based on the revision needed:

    • Implant Removal and Replacement:

      • An incision is made in a similar location as the original surgery (inframammary fold, around the areola).
      • The existing implant and any surrounding scar tissue (capsulectomy) are carefully removed.
      • The pocket for the new implant is meticulously prepared or adjusted as needed.
      • The chosen implant (size, shape, fill material) is inserted and meticulously positioned for optimal aesthetics and symmetry.

    • Implant Size or Shape Adjustment:

      • The approach might involve removing the existing implants through similar incisions as above.
      • The pocket might be adjusted to accommodate the new implant size or shape.
      • New implants are inserted and positioned for optimal results.

    • Fat Grafting (for volume or contour):

      • Liposuction might be performed on another area of your body to harvest fat cells.
      • The harvested fat is processed and carefully injected into specific areas of the breasts to improve volume or definition.
      • Techniques ensure even distribution and minimize the risk of complications.

    • Lift Procedures (combined with implant revision):

      • Techniques similar to a breast lift surgery might be used to address sagging or deflation.
      • Excess skin is removed, and the remaining tissue is repositioned to create a perkier appearance.
      • Implant revision (replacement or adjustment) might be performed simultaneously to achieve the desired outcome.
How can I select a trustworthy surgeon?

When choosing an aesthetic plastic surgeon, it’s essential to consider the following factors:

  1. Qualifications: Does the surgeon possess the necessary education, training, and certification?

  2. Experience: Does the surgeon have extensive experience performing ear surgery?

  3. Pediatric Experience: If the patient is a child, does the surgeon have experience operating on pediatric patients?

  4. Results: Do you find the surgeon’s before-and-after photos satisfactory?

  5. Comfort Level: Are you comfortable with the surgeon and their approach to your procedure?

  6. Membership: Is the surgeon a member of The Aesthetic Society?

After finding a board-certified plastic surgeon with significant experience in ear surgery, you’ll need to schedule a consultation.

What to expect during a consultation?

Typically, there may be a consultation fee due to the comprehensive nature of the appointment. During the consultation, you’ll have the opportunity to discuss your aesthetic goals. The surgeon will assess your suitability for ear surgery and evaluate the shape, size, and position of your ears. They may also take photographs for further analysis. Be prepared to provide your complete medical history, including past surgeries, medical conditions, allergies, and current medications.

Questions to ask your surgeon: It’s crucial to be proactive during your consultation. Here are some questions to consider asking:

  • Am I a suitable candidate for ear surgery?
  • Are my desired outcomes realistic?
  • Can I see before-and-after photos of previous ear surgeries?
  • How many ear surgeries have you performed?
  • Which surgical approach is best suited to my needs?
  • Where will the incisions be made, and will they be visible?
  • What type of anesthesia do you recommend?
  • What is the expected cost of the procedure?
  • What can I do to ensure optimal results?
  • What is the anticipated recovery period?
  • What are the potential risks and complications?

After the consultation: Following the consultation, your surgeon will provide personalized recommendations and information, including:

  • Proposed surgical approach
  • Expected outcomes
  • Financial considerations
  • Risks and complications
  • Anesthesia options
  • Preoperative preparation
  • Postoperative care instructions
  • Similar case studies
  • Answers to any additional questions

With thorough research and consultation, you’ll be equipped to make an informed decision regarding your surgery and surgeon. If uncertainties persist, don’t hesitate to seek further clarification or explore consultations with other surgeons.

How do I prepare for breast revision surgery?

General Pre-Operative Steps:

  • Once you decide to proceed, follow the surgeon’s instructions to prepare your body for surgery:

    • Healthy Diet: Maintain a balanced diet rich in fruits, vegetables, and lean protein in the weeks leading up to surgery. This ensures your body has the necessary nutrients to heal effectively.

    • Smoking Cessation: Stopping smoking ideally weeks or months before surgery is crucial. Smoking hinders healing and increases complication risks.

    • Medication Management: Discuss any medications or supplements you take with your doctor. You might need to stop taking certain medications (blood thinners) that could increase bleeding risk.

    • Weight Management: Maintaining a stable weight within a healthy range is recommended. Significant weight fluctuations can affect the long-term results of breast revision surgery.

    • Logistics: Arrange transportation to and from the surgical facility, as you’ll likely be unable to drive yourself after anesthesia. Prepare comfortable post-surgical garments as instructed by your doctor (surgical bra or loose clothing depending on the procedure).

How long does it take to recover from breast revision surgery?

Immediately After Surgery:

  • You’ll experience some swelling, bruising, and discomfort in the chest area. Pain medication will be prescribed to manage these. Depending on the extent of the surgery, you might stay overnight at the surgical facility or recover at home on the same day.

First Weeks (1-2):

  • Discomfort gradually lessens. Swelling and bruising will be most prominent during this initial phase. Wearing a surgical bra for support and compression is crucial throughout the day and night as instructed by your doctor. Limited movement and activity, especially those that strain the chest muscles (lifting objects, strenuous exercise), are recommended for the initial recovery phase.

Weeks 3-6:

  • Swelling and bruising progressively subside. You can gradually increase activity levels, but strenuous exercise should still be avoided. Sutures might be removed during follow-up appointments with your doctor.

Months 3-12:

  • Daily activities can be resumed with minimal discomfort in the breasts. Light exercise that doesn’t strain the chest muscles might be gradually incorporated as approved by your doctor. The final results of the revision surgery become progressively more evident during this period. Up to a year: By 6 months to a year after surgery, significant improvement in the appearance of the breasts should be evident. Most swelling will have resolved, and the implants (if used) will feel more settled in their final position.
How long will my breast revision results last?

The longevity of your breast revision results depends on the specific procedures performed:

Implant-Based Revision:

  • With a healthy lifestyle, you can expect to enjoy significant improvements in the appearance of your breasts for 5 to 10 years after implant-based revision surgery.

Factors Affecting Implant Longevity:

  • Implant Lifespan: Implants themselves have a finite lifespan. Over time, the silicone gel or saline fill can degrade, and the implant shell can rupture. This might necessitate replacement surgery.
  • Capsular Contracture: Scar tissue can tighten around the implant, causing the breast to feel firm and distorted. This can also necessitate revision surgery.

Autologous Tissue Flap Revision:

  • Flap revision results are generally considered more durable than implants. You can expect them to last for many years, often a lifetime with proper care.

Factors Affecting Flap Longevity:

  • Natural Tissue: Flap reconstruction uses your own body tissue, which is generally more durable and less prone to complications like capsular contracture compared to implants.
  • Aging: As we age, the skin loses elasticity, which can contribute to some degree of sagging in the reconstructed breast over time. Gravity also plays a role.
  • Weight Management: Maintaining a stable weight is crucial. Significant weight gain can stretch the skin and affect the appearance of the reconstructed breast.

Optimizing Long-Term Results (for both implant & flap):

  • Healthy Lifestyle: Maintaining a balanced diet and regular exercise, including exercises that target chest muscles, helps preserve the effects of breast revision surgery by promoting healthy weight management and muscle tone.
  • Sun Protection: Sun exposure accelerates skin aging. Consistent use of sunscreen with SPF 30 or higher protects your skin and helps maintain its elasticity.
  • Follow-up Care: Regular checkups with your plastic surgeon are important to monitor your reconstruction and address any potential concerns early on.
What type of breast revision incisions are there?

Inframammary Fold Incision:

  • This is the most common incision site for both initial breast augmentation and revision surgery.
  • The incision is made in the natural fold underneath the breast, offering good access to the implant pocket and minimizing scar visibility when healed.
  • It’s often used for implant replacement, capsulectomy (scar tissue removal), and adjustments in implant size or position.

Periareolar Incision (Around the Areola):

  • This incision is made around the edge of the areola, offering a more concealed scar location.
  • It’s typically used for smaller revisions or when combined with a breast lift procedure.
  • Scars in this location can be more noticeable depending on individual healing and pigmentation.

Transaxillary Incision (Armpit):

  • This incision is made within the armpit, providing access to the breast implant pocket without a visible scar on the breast itself.
  • It’s less commonly used in revision surgery due to the potential for increased difficulty in accessing certain areas of the breast pocket and the need for special tools for implant placement.

T-Shaped Incision:

  • This is a less common incision used in specific revision scenarios, particularly when extensive correction is needed or in combination with a mastopexy (breast lift).
  • The incision combines a horizontal inframammary fold incision with a vertical incision extending down from the nipple.
  • While it offers wider access for complex revisions, it results in a more noticeable scar pattern.

Lollipop Incision:

    • This is another less common incision used primarily for implant removal, especially when capsular contracture is present.
    • It resembles a lollipop shape, with a circular incision around the areola and a vertical extension down towards the inframammary fold.
    • Similar to the T-shaped incision, it offers good access for implant removal but results in a more noticeable scar pattern.
 
What are the risks associated with breast revision surgery?

General Surgical Risks:

  • Anesthesia Reactions: Reactions to anesthesia are uncommon with modern medicine, but still a possibility.
  • Bleeding: Bleeding is a potential risk during and after surgery, but controlled with surgical techniques and medications.
  • Infection: Infection is a risk after any surgery, but proper sterile technique and antibiotics help minimize this risk.

Potential Complications Specific to Breast Revision Surgery:

  • Scarring: As discussed previously, scarring is inevitable, but techniques minimize its appearance. Scars typically fade over time with proper care.
  • Swelling and Bruising: Swelling and bruising are common after surgery and resolve gradually over weeks.
  • Fluid Accumulation (Seromas): Fluid pockets can form under the skin after surgery, typically addressed with aspiration by your doctor.
  • Numbness or Changes in Skin Sensation: Temporary numbness or altered sensation around the incision sites can occur, usually improving over time.
  • Asymmetry: Minor asymmetry in appearance between the two breasts is possible, but a skilled surgeon works to minimize this risk.

Serious but Rare Risks:

  • Deep Vein Thrombosis (DVT): Blood clots can develop in the deep veins of the legs, potentially leading to serious complications. Preventive measures like compression garments and blood thinners help mitigate this risk.
  • Fat Necrosis: Fat cells can die after liposuction (sometimes used in revision surgery), leading to firm, tender lumps under the skin. This risk is less common if liposuction isn’t part of the procedure.
  • Implant Rupture or Leakage (Implant-based only): Implants can rupture or leak over time, potentially requiring additional surgery. Silicone gel implants can rupture silently, while saline implants feel deflation when ruptured.

Additional Considerations:

  • Dissatisfaction with Results: It’s crucial to have realistic expectations about the outcome of breast revision surgery. Discuss your desired results with your surgeon to ensure they align with what the procedure can realistically achieve.
  • Revision Surgery: In some cases, additional revision surgery might be necessary to address complications or refine the results.

Minimizing Risks:

  • Choosing a Qualified Surgeon: Selecting a board-certified plastic surgeon experienced in performing breast revision surgery is crucial.
  • Thorough Pre-Operative Consultation: A thorough pre-operative consultation allows the surgeon to assess your suitability for the surgery, identify any potential risks based on your medical history, and discuss strategies to minimize them.
  • Following Instructions: Following all pre- and post-operative instructions carefully is essential for optimal healing and reducing complication risks.

Source: Information adapted from theaestheticsociety.org