Breast Revision Surgery
Breast revision surgery encompasses the surgical correction of a wide-array of conditions which can potentially develop following implant and non-implant related cosmetic surgical procedures. Examples of revision surgeries of the breast include capsular contracture, double bubble, bottoming out, symmastia, and patient dissatisfaction with breast implant size.
Breast Implant Surgery and Implants
When considering a breast augmentation, it is worth noting that breast implants have a lifespan. In fact, most manufacturers offer warranties for implants no longer than 10 years. Therefore, over the course of a patient’s lifetime, it is reasonable to expect that some sort of breast revision surgery will be needed – this may be as simple as requiring implant replacement due to aging implants or other mechanical problems such as implant rupture.
According to FDA statistics, the most common reason for breast revision surgery in the United States, at roughly 37 %, is the patient’s desire to switch to larger implants ! Less commonly, other issues may develop secondary to breast augmentation surgery and other aesthetic breast procedures. These include hard breasts or capsular contractures, breast implant rupture and mal-position, double-bubble deformities, bottoming out and infra-mammary fold disruptions, symmastia, rippling and wrinkling, age-related changes, weight gain followed by weight loss, pregnancy-related issues, and combination issues.
Additionally, I occasionally see the patient with a long-standing history of a breast augmentation who – for various reasons – desires to have her implants permanently removed. In this patient population, the implants are generally removed and require a combination breast lift in order to create a more aesthetically pleasing breast mound.
The Challenges of Breast Revision Surgery
Breast revision surgery is to be distinguished from primary breast enhancement surgery or breast augmentation surgery. Intrinsically, the procedures are technically more difficult surgery to perform and there is often less predictability of outcome in contrast to primary breast surgery – This is primarily due to scar formation and soft-tissue changes ( such as stretching ) which come about as a result of the previous surgery(s)
It is important that the complexity of breast revision surgery be communicated to the patient, and that she closely follow all post-operative recommendations set forth, so that realistic expectations may be maintained ensuring the highest likelihood of a success and satisfaction.
Breast Revision Surgery Before & After Photos
Breast Implant Removal
Breast Implant Removal Overview
Breast implant removal may be required or desired for a variety of reasons, and involves the surgical removal of previously inserted implants. The FDA recommends that breast implant removal only be done when the risks of leaving them in outweigh the risks of removing them, which include:
- Capsular contracture
- Ruptured or damaged implant
- Fears of future health consequences from silicone implants
- Aesthetic concerns (such as changing implant size)
During this operation, the original incisions are reopened and the implant – along with any accompanying scar tissue – is removed. The implant is then either replaced or the breast is reconstructed with a breast lift to ensure that internal structure and shape of the breast are maintained.
- Preparation: It is important that patients follow all of Dr. Vallecillos’ pre-operative instructions prior to breast implant removal. This might include limiting any medications, vitamins, or herbs that can cause thinning of the blood for two weeks before surgery. Depending on the individual, Dr. Vallecillos might also prescribe a round of antibiotics to be taken as a measure to prevent infection. If you smoke, you should abstain for at least two weeks before and after surgery, and if you are over the age of 45, you may need to obtain medical clearance by an independent physician prior to undergoing breast implant removal.
- Anesthesia: Breast implant removal is usually done under general anesthesia. A local anesthetic with IV sedation may also be an option.
- The Surgery: In most cases, I utilize the same incisions from the initial breast enhancement surgery. Once access to the breast pocket has been established, the implant and any accompanying tissue (such as scar tissue, in the case of capsular contracture) will be removed.
In cases such as capsular contracture and implant rupture, the implant will be replaced with a new implant. During your consultation, we will discuss the options of replacing the implant with one made of a different material or make (silicone gel vs. saline, Allergan vs. Mentor), as well as the placement of the implant (submuscular vs. subglandular).
When the patient has elected not to replace the implant, we strive to reconstruct the breast’s original size and shape using a breast lift technique.
Once the surgery is complete, the incisions are closed and bandaged.
Breast Implant Removal FAQs
Who is a candidate for breast implant removal?
There are several reasons for undergoing breast implant removal. If you have developed capsular contracture, have suffered a ruptured or otherwise damaged implant, or have reason to suspect other health consequences, you may wish to consider breast implant removal and/or replacement. Breast implant removal may also be done for aesthetic reasons, such as changing the size of the implant or returning the breasts to a pre-operative state through implant removal and a breast lift.
What is the recovery time for breast implant removal?
Following breast implant removal, patients should allow themselves the same amount of recovery time as with breast augmentation surgery. Rest is vital during this period; strenuous exercise and heavy lifting should be avoided until otherwise indicated by Dr. Vallecillos. Bandages are usually removed during the first week after surgery, but you may be instructed to wear a special supportive bra thereafter. Soreness and swelling may persist for several weeks or months after surgery.
What are the risks and side effects with breast implant removal?
As with all surgeries, risks of breast implant removal include infection and bleeding. Breast implant removal also has a risk of excessive scarring, due to the reopening of original incisions or the creation of additional incisions. Rarely, implants may rupture during removal, which can cause problems later during mammography. Some patients report a loss of sensitivity in the breasts after breast implant removal. All risks and side effects should be discussed with Dr. Vallecillos prior to undergoing surgery.
How long do the results last?
Results from breast implant removal should be considered permanent, though the later development of complications such as capsular contracture, as well as the inevitable changes that occur as a result of aging, may render additional procedures necessary.