What Is Revisional Breast Surgery
There is no such thing as a simple breast augmentation. This procedure must be approached with the utmost care and planning. Even when it does, there is a potential for complications. When breast augmentation does not achieve or sustain the desired outcome, a revision may be considered.
Why Would Someone Need Revisional Breast Surgery?
Revisional breast surgery may be considered for many reasons. Each fits into one of three general categories:
- Problematic placement or position
- Problems with tissue characteristics
- Implant problems
Problems after breast augmentation are carefully examined to understand the origin. Often, a patient fits into more than one category, posing surgical challenges that can be met by an experienced surgeon.
Surgical placement or position problems may include:
- Asymmetry between implants, with one sitting higher or farther to one side than the other.
- Synmastia, often referred to as “uni-boob.”
- Bottoming out, in which implants sit too low on the chest wall.
- Implants fail to drop into the correct position.
- Implants are too widely spaced, preventing the desired cleavage.
Problematic tissue characteristics may include:
- Areolas appear too large and are not corrected during initial breast augmentation.
- Tuberous breasts, where the base of the breast is narrow, causing breasts to sag.
- Breast sagging due to aging skin and the loss of elasticity.
- Breast tissue thinning due to age, making breast implants more visible and less natural-looking.
- Pre-existing asymmetry that was not corrected during breast augmentation.
Breast implant problems may include:
- Capsular contracture. This thickened scar tissue around the breast implant can alter the shape of the breasts and also cause persistent discomfort.
- Deflation or rupture of one or both breast implants.
- Breast implant size is not satisfactory to the patient.
The Revisional Breast Surgery Procedure
Breast augmentation is performed as an outpatient procedure. Revisional breast surgery looks different in every scenario. In general, certain techniques are performed to correct specific problems. During a revisional procedure, the surgeon may employ one or more of the following techniques:
- Breast implant replacement. This may be done to increase or decrease the size or to change the type of implant (saline to silicone or vice versa).
- Breast implant removal called explantation.
- Breast lift. This may be conducted when breast implants are removed and not replaced.
- Replacement or correction of displaced implants, including bottoming out, synmastia, and other problems.
- Correction of asymmetry, which may involve placing two different sized implants.
- Placement change, such as above the muscle to below the muscle.
- Capsulectomy, which removes some of the scar tissue that is causing one or both breasts to feel too firm.
- Correction of breast implant scars may be possible during revisional surgery.
Benefits Of Revisional Breast Surgery
The primary advantage of undergoing revisional breast surgery is that the dissatisfaction or complications that have occurred should be resolved. Revisional surgeries may not make the breasts one-hundred percent perfect. However, the results of corrective measures typically restore a patient’s sense of satisfaction and connection with her body. Self-confidence may improve significantly as clothing fits as it should and a woman can observe her naked body with appreciation. In cases such as capsular contracture, revisional surgery can also dramatically improve comfort
Who Is A Good Candidate For Breast Revision Surgery?
Patients who have experienced complications from breast surgery or are unhappy with the outcome of breast augmentation may be candidates for a revisional procedure. Ideal candidates for surgery do not smoke and are in good general health. We perform a thorough consultation and examination with each patient to make sure they are good candidates for revisional surgery.
Breast Cancer Reconstruction Revision
Dr. Patel uses the latest techniques of both implant revision surgery and flap reconstruction to restore the natural shape of the breast and achieve the best result.
Implant Removal After Irradiation
Radiation treatment can cause implants to harden and become uncomfortable. Dr. Patel is skilled at using DIEP flap reconstruction or other flap methods to reconstruct the breast with an eye towards comfort and a natural shape.
Revisional Breast Surgery Recovery
Patients can expect to stay in the recovery area for approximately one hour following revisional breast surgery. As the anesthesia wears off, patients are released to a friend or family member to be taken home.
Post-surgical care includes wearing the applied surgical bra as directed. Patients may shower but should not rub incisions. Pat the skin to dry and replace the surgical bra. For the first few days after revisional breast surgery, patients should plan to rest. Strenuous activities and lifting any objects over 20 pounds must be avoided. No swimming, hot tubs, or saunas for two to three weeks.
Patients may be prescribed antibiotics to take after surgery to prevent infection. All prescribed medications should be taken as directed. Antibiotics must be taken until they are gone. Pain medication should be taken regularly for 24 to 48 hours or longer. Waiting to assess the comfort level is not recommended. Within about five days, most patients no longer need prescription pain medication and can manage comfort with Tylenol or another approved over-the-counter medication. No driving while taking prescribed pain medication or muscle relaxants.
Improved breast size and shape are immediately visible after surgery. The breasts may feel tight at first, but this side effect typically resolves rapidly as muscles relax around the implants. Mild swelling diminishes over several weeks. Many patients feel well enough to resume normal (light) activities the day after surgery.
Cost Of Revisional Breast Surgery
Most breast implants are covered under warranty. If a rupture occurs, implant costs may be covered by the manufacturer. Surgical fees and surgical center fees still apply. The cost of revisional breast surgery varies based on factors such as the type of implants used to replace old devices and the techniques involved in the surgery. Patients can expect to receive cost information after their consultation for revisional surgery.
Risks Of Breast Revision Surgery
The risks of revisional breast surgery are similar to those of a primary breast procedure. However, the risk of complications is slightly higher for those undergoing a revisional procedure. For this reason, it is imperative to choose an experienced plastic surgeon who is familiar with the techniques that are common to revisional procedures. Common surgical risks include:
- Reaction to anesthesia
- Blood clot
- Seroma or hematoma, accumulation of fluid or blood beneath the skin
- Loss of nipple sensation
- Capsular contracture
- Implant rupture or leak