The risk profile and recovery period associated with a breast implant revision surgery are similar to that of your original breast surgery, but the incidence of complications may be increased. Once an area of the body has been operated upon, surgical complications are more likely to occur and may be more severe than on an initial surgery. However, when you choose an experienced breast revision plastic surgeon you can expect a safe procedure, well-supervised recovery and an aesthetically pleasing outcome.
What are Common Types of Breast Revision Surgery?
Breast revision covers a wide range of surgical tasks and is planned to suit your physical condition and goals specifically. Breast revision surgery can involve one or more of the following:
- Breast lift: Women often get breast implants or a breast reduction in their primary surgery, when they might have been better served by having a lift at the same time. In this case, a breast lift may be done as a revision. (In some cases, simultaneous breast augmentation and breast lift can create problems that require revision, so it is sometimes advisable to do the augmentation and lift separately.) A woman may want a lift due to excess skin or sagging after removal of implants, or drooping that has returned due to weight loss or pregnancy after the first procedure.
- Removal of breast implants: Explantation of the breast implants can be done without replacement, due to leakage, accident/trauma or personal preference. If implants are not replaced, a breast lift may be advisable.
- Replacement due to rupture or leakage: Your saline breast implant(s) may have deflated noticeably or a recent imaging scan may have shown a possible silicone implant leak. Your breast revision surgeon may need to remove the surrounding capsules of scar tissue along with a leaking implant. The plastic surgeon could replace one or both implants or take this opportunity to make other changes you might desire.
- Correction or replacement of displaced implants: Old implants may move or rotate in the breast pocket, causing visible rippling or asymmetry. A skilled breast revision surgeon can correct or improve on these all-too-common implant breast implant displacement problems:
- Synmastia: When implants (and pockets holding them) are positioned too close to the center of the chest or breastbone. Breasts can move so close together that they connect, becoming one.
- Waterfall effect: Ptosis of natural breast tissue (when natural breast tissue begins to sag) around or over the edge of the implants. The natural breast tissue may now need a lift.
- Bottoming out: When implants were placed too low (or slipped down and/or too far to the side) on the chest wall, making the nipples appear too high and the breasts bottom-heavy.
- Double bubble: Where the implant slips down behind the breast tissue, sitting partly below the crease.
- Placement of new implants: You may desire new implants, larger or smaller than the originals, or a different type; like switching from saline to silicone for a more natural feel. Your surgeon will likely need to increase or decrease the size of the breast implant “pocket” in your chest, to ensure that a smaller or larger implant stays in place. The procedure may be referred to as implant exchange.
- Capsulectomy: Capsular contracture (the growth of scar tissue around the perimeter of breast implants) can cause unnaturally tight breasts that look strange and become painful. The procedure to remove the scar tissue “capsule” around the breast implants is known as capsulectomy. You are likely to need a breast implant replacement with new implants of the same or different type and size (as you prefer).
- Correction of breast or implant asymmetry: It is often ideal to place implants in two slightly different sizes to achieve symmetry. If this customization was not done in your first surgery, the breast implants may have only increased any natural asymmetry, making it more noticeable. This is a common reason for revision.
- Change of placement: If the original breast implants were placed below the muscle, some women find they want to revise to a subglandular placement. Many women prefer the (subglandular) over-the-muscle breast implant placement for a more natural breast feel.
- Breast implant scar revision: In some cases, your surgeon will re-use the location of the incision made during your primary breast augmentation for your secondary revision surgery. An experienced breast revision specialist may be able to improve the look of your old scars during the new procedure.
Breast Revision Risks and Complications
Risks are similar to your primary breast procedure. The key difference with a secondary breast implant surgery is that the chance of complications is greater, so make sure your breast revision surgeon is an expert who can successfully manage a complication. Examples of complications include:
- Anesthesia risks
- Blood clot
- Hematoma or seroma (build-up of blood or clear liquid beneath the skin)
- Excess scar tissue formation leading to capsular contracture
- Loss of nipple sensation
- Implant rupture
- And additional risks specific to your condition and the details of your breast revision procedure, which your surgeon should discuss with you for your consent.
Breast Implant Revision Recovery
Similar to the healing process from your first breast implant procedure, your revision will produce bruising, inflammation, soreness and pain controlled with medication. Following your breast augmentation revision, you can begin walking around the house as soon as you feel able–with a friend at your side the first day or two.
Your NJ plastic surgeon will monitor the progress of your recovery, checking your incision for signs of infection at every follow-up visit. You’ll watch for anything unusual, such as fever, excess swelling, increasing pain, nausea, excess bleeding, etc., and contact your surgeon immediately with any concerns.
You’ll keep your upper body relatively still and sleep with your torso raised. You may be able to drive after a week or two, depending on the extent of breast revision surgery you’ve undergone. You can go back to (non-physically demanding) work in a week or two. Strenuous exercise or lifting will be off-limits for several weeks.
Wait a Reasonable Time Before Revision
You should wait at least six months to a year for the swelling from your primary breast implant surgery to abate and for your new breasts settle to before considering a revision. You may also need time to adjust and get used to your new size before undergoing a revision. In some cases, your breasts may appear asymmetrical until the swelling goes down. If you suspect infection or another health-threatening problem, however, you should not wait to get care and should contact your original surgeon right away.
Talk to an Expert Surgeon about Breast Revision
Breast revision is a more difficult surgery than the initial implant procedure. Many plastic surgeons are qualified to put implants in, but it takes an expert to remove them and/or correct problems from the prior procedure. If you’d like to learn about your options for a breast revision to improve the look or comfort level of your breasts after an earlier augmentation, reduction or reconstruction–we’re happy to help. Please contact Cohen/Winters Aesthetic & Reconstructive Surgery in Bergen County for a personalized consultation.