Breast implant revision surgery typically involves removing and/or replacing your breast implants to correct any complications from your primary breast augmentation. This procedure also includes the process of resolving any issues that occurred as you (and your implants) age. Many women undergo revision breast surgery to change the size, positioning or type of their implants, to correct asymmetry or deal with leaks, ripples or scar tissue. Breast revision surgery has a high satisfaction rate when you choose an experienced surgeon to advise you and perform your procedure. As an aesthetic and reconstructive procedure, breast implant revision helps women regain natural, youthful breast contours and attain the appearance they desire.

Breast Revision Surgery Can Help If…

  • You need to change or correct problems with prior breast implant surgery. If your prior surgery was done more than one year ago you may want to make revisions or corrections. You should remember that it may take at least a year after your initial breast surgery for the swelling to dissipate and for your true, new breast size and positioning to become apparent.
  • You have the desire to change implant size. Your body changes physically as time goes on and your taste may change as well. Some women have gained or lost weight and feel they now need a larger or smaller implant. If sagging has occurred with age or weight changes, NJ women may want a breast revision surgery with new implants and/or breast lift.
  • You experience the ripple effect. Older or improperly positioned implants may ripple under the breast tissue creating an unnatural look. This may be less noticeable in some women who have thicker skin or more breast tissue (or muscle) over the implants. There are surgical techniques and implant size recommendations that can help decrease the chances of this happening in the future.
  • You have noticed shifted implant position. Breast implants may become displaced, moving up, down, in toward your breastbone or outward toward your armpit. This problem is often due to a scar contracture or the inability of your body tissue to support a certain size implant without reinforcement. Implants can be shifted into a better position or supported in a more secure fashion. You can also change the size, shape or type of implants.
  • You have experienced deflation of saline breast implants. This is normally very noticeable as the saline is absorbed by the body and the deflation becomes obvious to the eye. It is suggested that you replace both implants, even if only one has leaked. This can help to avoid coming back for a second surgery if the other aging implant begins to leak.
  • You have experienced silicone implant deflation. Silicone deflation may be detected initially by a routine breast exam or mammogram or it may be seen as a change of shape or an irregular feel to the implant. When silicone leaks it often will stay in the pocket area so the breast may not change size. It is important to note that a leaking implant should often be replaced but this is not an emergency. Usually, a full exam and possibly an MRI can be used to diagnose this type of rupture. Leaked silicone can be cleaned out of the breast pocket during corrective breast surgery and new silicone or saline implants placed.
  • You have noticed breast asymmetry and feel that your breasts are different sizes.
  • You experience the “snoopy” deformity where the natural breast sags around the implant.
  • You have the “bottoming out” or the “double bubble” deformity where your implants fall too low and your nipples appear too high due to poor prior surgical technique.
  • You need to correct symmastia (or synmastia) where breast pockets have merged into one due to poor implant placement.
  • You want your breast implants to look more natural. You may have received bad advice on implant sizing or shape for your initial breast implant surgery. Alternatively, you may have been given saline implants when silicone might have better achieved your goals. In some cases, the placement technique contributed to an unnatural look of your breast implants. For some patients, under-the-muscle placement works best and for others, over-the-muscle is the preferred solution. When you’re planning your revision breast surgery, choose a surgeon who explains his or her strategy for meeting your goals for your post-surgery look. This type of discussion will also help you determine if the surgeon truly understands the outcome you’re seeking and whether or not it is realistic.
  • You experience pain, hardness and/or a misshapen breast. This is often due to scar tissue that has grown around the implant (capsular contracture). There are a number of techniques to treat this problem, depending upon how long it has persisted. Often, the entire capsule is removed and implants replaced. A fibrous sheath, (acellular dermal matrix) may be used to provide a sterile scaffold around the new implant that can guide the growth of body tissues and possibly prevent future contracture.
  • You want a breast lift after significant weight loss, gain or pregnancy and/or breastfeeding altered the appearance of your implants.
  • Your breast implants and nipples are sitting too low on your chest. This may mean that you should have undergone a breast lift with your primary breast augmentation or you may have some sagging due to aging or weight changes.
  • You would like to have more or less cleavage. Sometimes your primary implants were placed too close together or too far apart.
  • You want to have your breast implants permanently removed. A good corrective breast surgeon can help ensure a good aesthetic outcome.
  • You had a misunderstanding or surgical misjudgment occur in the original breast surgery. If communication between the surgeon and patient was not clear prior to the primary breast surgery, the patient may end up with the wrong size implant (or the wrong shape or type of implant) for their frame or their personal taste. Implants may appear too large or feel too heavy, for example. (Patients should wait for healing to complete and swelling to abate – perhaps one year – before deciding this.) An experienced breast surgeon should be able to avoid misunderstandings and exercise sound judgment by:
    • Listening carefully to the patient’s goals
    • Coaching the patient if the requested implant choice is ill-advised in the surgeon’s professional opinion
    • Planning surgery carefully in advance to achieve the patient’s desired goals and helping the patient weigh any options
    • Explaining surgical risks
    • Helping the patient envision the probable outcome of the breast revision clearly
    • Ensuring the patient’s expectations/goals match the likely outcome
  • You are looking to fix surgical errors by the original surgeon. Many women seeking breast implants (and many surgeons as well, unfortunately) think that breast augmentation or other breast surgery is run-of-the-mill and simple. The best surgeons for breast revision, however, realize that just because a procedure is popular and many thousands are done daily across the world, does not mean it requires little attention and no personalized planning.

Why Do Surgical Errors Occur in Breast Implant Surgery?

Perhaps the most common thing that goes wrong in a breast augmentation surgery (or related procedures) is the above-mentioned misunderstanding between what the patient wants and what the surgeon intends to do.

A top NJ breast revision surgeon will help you avoid this problem. The most dedicated and experienced breast surgeons will never go forward with corrective breast surgery until there is a clear understanding between patient and surgeon about the goals and strategy of the surgery. This is the reliable formula for all successful breast surgery, including breast revision surgery.

When a breast implant procedure is truly botched, with an unacceptable outcome or unnecessary complications, typically the surgeon should have been more careful or acted differently in some way. (Only occasionally are complications unpredictable and unavoidable.)

At Cohen/Winters, we avoid such issues by realizing that it is the surgeon’s responsibility to select patients who are good candidates for the procedure. In addition, the surgeon must ensure understanding of what the patient wants and also ensure that the goal is realistically achievable.

The NJ plastic surgeon must help the patient achieve their desired goals, but be honest enough to manage expectations. Your surgeon must let you know if your goals are not possible or not medically advisable.

In short, the surgeon must tell the patient what to expect, including the risks involved and how risks are managed. If the expectations of the surgeon and patient match, breast surgery, including breast revision outcomes, are typically excellent.

Are Risks Inevitable? How Breast Revision Risks are Mitigated

There is always some risk associated with any penetration of the skin, including all types of surgery. Your breast surgeon should make sure you understand completely about the types of risk and the likelihood that any particular risk or complication may occur in breast revision surgery.

The surgeon will talk about any risks specific to anesthesia, surgery, breast implants and your specific health profile. At Cohen/Winters, as with other top breast reconstructive surgeons, our surgical planning, years of experience and meticulous technique allow us to reduce the possibility of surgical complications. Still, complications can occur.

That’s why your research and surgeon selection is so crucial. When you choose the best NJ breast surgeons available, you can feel assured that their finely-tuned surgical judgment, honed over time, enables them to deal successfully with any complications that occur.

This is the key difference that a top surgeon can make in your breast revision outcome. You can also count on honesty from top breast surgeons – if your surgeon feels any risks outweigh the benefits your breast revision surgery will provide, he or she will not go forward.

How Are Top NJ Surgeons Different?

The very best and most experienced breast implant surgeons use expedient and gentle techniques when planning and conducting your surgery.

The very best plastic surgeons help you to understand the surgical options involved to create a personalized surgical plan to meet your specific goals.

Take time to search out a top surgeon who can help to ensure that:

  • Your entire breast implant revision experience is positive.
  • You heal quickly.
  • You delay or avoid the need for revision or replacement in future.
  • Your result looks great and achieves the goals you set out to achieve.

Make sure to research your surgeon’s background and state licensure. Look for years of experience devoted primarily to corrective breast surgery.

Avoid any breast revision surgeons who have basically one surgical method that fits all and who doesn’t take your goals into account.

How Can You Tell a Top NJ Surgeon from the Rest?

Beyond checking with the state (provided those basics check out) take a look around your surgeon’s website. There you may find further qualifications you might want to research, like professional affiliations.

This will help you to get an idea of his or her surgical philosophy. And help you decide if you would like to meet with the surgeon about your breast revision surgery.

During your consultation, you can ask questions to confirm your online research, find out about hospital affiliations and how many surgeries are done annually. Discuss complication rate and risks. Look at photos to see what you think of prior patient results.

One of the most important deciding factors when selecting an expert NJ breast surgeon (who is also the right surgeon for you) is rapport.

  • Do you get a sense that you and the surgeon are “on the same page” about what looks good or bad aesthetically
  • Do you and the surgeon communicate well?
  • Do you get a sense of honesty and dedication?
  • How the surgeon explains details to you.
  • Does he or she offer information freely? Or do you have to try hard to get clear answers?
  • Does the surgeon take time to focus on you, rather than rushing you or brushing off questions?

Also, Is the surgeon building a surgical plan around you specifically or do you get that assembly line feeling? Does your surgeon understand your goals? Or are you being ignored or “talked at”? You can get a sense of all this in your consultation about breast revision surgery.

Hold out for a surgeon who truly cares about you, and your outcome.

Get a sense whether he or she will partner with you and support you throughout the entire surgical journey. The key, once you’ve checked credentials and experience, is to choose the surgeon you trust.

Choose an NJ Surgeon Who Partners with You Through Revision Breast Surgery

Your breast implant revision surgeon should provide very personalized and thorough care to ensure your corrective surgery is a success. If you feel your questions or concerns are being glossed over, listen to your intuition and choose another surgeon. Your plastic surgeon should listen to your goals, ask lots of questions, provide expert advice, discuss the trade-offs between different surgical approaches and different implant options. Without clear communication, your implant revision could end up being a waste of time. You owe it to yourself to find the best breast revision surgeon.

Key Decisions You and Your Surgeon Will Make about Your Breast Revision

  • Implant type:
    • Saline implants are filled with sterile salt water. They may be filled at the time of surgery to allow for ease of insertion (with typically smaller incisions) and for minor size modification.
    • Silicone implants come pre-filled with soft or cohesive gel in many shapes. They may require a longer incision but typically feel more natural than saline.
  • Implant shape:
    • Round is the most common breast implant shape, with varying amounts of projection (see below).
    • Teardrop/contoured/elliptical shape variations are also available to suit different purposes and situations. For example, if you have little breast tissue, a teardrop-shaped implant may be the right option to fill in the upper portion of the chest, creating a gradual increase in size around the main breast mound. If your ribcage is prominent above your breasts, round implants may look “stuck on” rather than blending in naturally with your overall upper body shape. Again, an experienced and attentive breast surgeon will pay attention to such details and provide guidance as necessary to ensure that you have the best, most natural-looking breast revision outcome.
  • Implant projection: Higher profile breast implants offer a more pronounced “bump” (they project out from the chest wall more) than do moderate or low profile breast implants.
  • Implant size/volume: Implants are sized in cubic centimeters (cc’s as in volume) and don’t correspond to a cup size. Women who want large implants should have significant natural breast tissue and thick skin in order to accommodate the implant, although placement choice also affects the size options. Your surgeon will help you visualize the size and weight.
  • Implant texture: Implants can be smooth on the surface or textured. Depending on placement, texture can help an implant stay in position on the chest rather than twisting or rippling. In some cases, texture can reduce the chance of capsular contracture.
  • Implant placement:
    • The decision to place your breast implants above or below the pectoralis major muscle is based on a number of unique factors. Placement below the muscle (submuscular) may be to create the most natural feeling breast if you are opting for saline implants. For those with little natural breast tissue, this placement can make breasts appear more natural, avoiding the “half-coconut” look. (Although teardrop shaped implants can help, too.) In addition, under-the-muscle placement may make mammograms clearer and help preserve breastfeeding capability.
    • Placement above the muscle (but below the natural breast tissue, called subglandular placement) may help you to heal faster. If you are going with saline implants, they will likely feel very natural even when located above the muscle. There are even more variables involved in making the optimal choice, which your surgeon will explain.
  • Whether a breast lift is also needed.
  • Whether nipples will be moved.

Consider Size and Weight When Replacing Your Breast Implants

The desire to change implant size is a common reason why women in NJ seek revision breast surgery. If you are in this category and are considering going up in size, don’t forget to consider the weight of your larger breast implants and the related implications. Keep in mind that:

  • Larger breast implants will weigh more. If you choose a significantly larger implant for your revision surgery, you will notice the increased weight. You will become more accustomed to it over time and as the swelling goes down you may have no complaints. Still, you should remember to consider weight as well as size so that they are comfortable with all aspects of their new breast size after breast implant revision surgery.
  • Larger implants may overwhelm a small frame. If you have a small bone structure and rib cage, with a shorter torso and/or stature, be sure to carefully consider how much larger you want to go with your new implants.
  • Very large breast implants (in relation to your size and weight) may sag more and sooner. It is a given that even breasts with implants sag as you age and in response to a number of other factors, including body weight changes, varying hormone levels over the course of years and habits like smoking. Choosing moderately sized implants may increase the longevity of your new look.

Put Your Surgeon’s Expertise to Work for You

None of the above is meant to say that smaller-framed women should never choose large implants, but it pays to consider all the ‘side effects’ that come with larger breast implants. An experienced surgeon can help you by sharing the feedback they have received from prior patients over the years. In addition, your surgeon can help you choose the right shape implant and plan the correct placement on the chest to help ensure your implants look and feel like they are a natural part of your body. Be sure to choose an experienced surgeon whom you can easily communicate with to ensure that your larger implants are properly integrated into your body. The best NJ plastic surgeon to perform your breast revision is one with the experience, skill, and dedication to provide the individualized planning and care that breast revision patients need.

Recovery from Breast Implant Revision: How a Top Surgeon Makes It Easier

Not only will a true specialist in breast revision surgery make your procedure itself go smoother, your recovery experience will also be improved. Patients of an expert NJ breast surgeon often recover from the revisional surgery faster than they did form the original breast surgery!

Top breast surgeons won’t leave you with a page of self-care instructions, remove your stitches and say goodbye. An expert breast surgeon will be available to you throughout your healing process and recovery.

Your surgeon will customize your recovery instructions to fit your type of surgery and adjust them as you progress. Also, the best surgeons won’t nickel and dime you. They typically include all aftercare visits, no matter how many you might need or how long the visits are, in the total cost of your surgery.

How Much Will My Breast Revision Surgery Cost?

Since breast revision is a very personalized surgery, prices cannot be quoted until your needs are identified. At Cohen/Winters Aesthetic & Reconstructive Surgery in Bergen County, NJ, we are happy to examine you and discuss your needs for breast implant revision at no charge. Once we ensure that you are a good candidate for the procedure and make a plan to achieve your desired outcome, an accurate price can be determined.

Remember the Importance of Reconstructive Experience for Breast Revision

Allow yourself time to find a surgeon with board certification in both general surgery and plastic surgery who is also a reconstructive surgeon. Experience in breast reconstruction means that your surgeon has a deep understanding of the form and function of the breast tissues. Revision breast surgery requires skills that go way beyond just placing implants. A reconstructive surgeon has honed their skill over years and is concerned not just with implants but with the final overall look, feel and function of your breasts. For a free, personalized consultation about revision breast surgery, contact Cohen/Winters Aesthetic & Reconstructive Surgery in Bergen County.

breast surgeon NJ

Dr. Cohen

About Dr. Cohen

Dr. Cohen specializes in breast lifts, augmentations, revisions and reductions as well as breast cancer reconstructions. A long time dream of Dr. Cohen’s was to travel to developing countries and provide expert surgical care to those who have no other possible access to medical care. This became a reality in 2007 when she became a founding member and Vice President of ISMS Operation Kids.