Problems related to breast surgery range from immediate postoperative complications such as hematomas, infection, or delayed healing to long-term problems such as capsular contracture and implant malposition. Breast augmentation remains one of the most commonly performed cosmetic procedures, which is a testament to the high patient satisfaction rate. Nevertheless, complications and unsatisfactory results occur, and revisions may be necessary to correct them. Also, patients must be informed that when they undergo a more complex initial surgery such as simultaneous breast lift and augmentation, then there is a greater chance they will need a breast revision procedure.
When the decision is made to have breast revision surgery, it can be technically challenging and often demands innovative solutions to achieve a successful outcome. Some surgical revisions are due to a complication of the initial surgery such as infection or capsular contracture. More commonly, however, the sources of dissatisfaction are linked to aesthetic problems such as volume undercorrection or implant malposition. Overall, studies performed by the implant manufacturers reveal reoperation rates of 13 to 21 percent at three years and 20 to 26 percent at five years.
Reasons for Breast Revision:
- Dissatisfaction with implant volume
- Desire for a new type of implant (e.g., exchange saline for cohesive gel)
- Capsular contracture
- Implant malposition
- Loss of breast shape due to pregnancy or normal aging
Breast Revision Surgery
Change in Implant Size
The desire for larger implants is one of the most common reasons for breast revision surgery. Dr. Peters will likely use the same incisions that were used during your initial surgery to remove and replace the implants. In most cases, the pocket will need to be modified to accommodate the new implant volume.
Change in Implant Type
Following the introduction of the new generation of silicone gel implants, there has been an increase in procedures to exchange from saline to silicone gel. Rippling is a common cause of dissatisfaction encountered with saline implants, especially in patients who are thin or have little breast tissue. Changing to a silicone gel implant requires a longer incision than used for saline and is usually placed using an inframammary incision.
Capsular contracture remains a focus for the plastic surgeon performing augmentation. Its cause and definitive strategy to prevent it remain elusive. The treatment of capsular contracture requires removal of the capsule and implant. Use of a biologic tissue scaffold is commonly recommended to provide support and reduce recurrence of the capsular contracture.
Malposition can result in the implant being too high, too low, and too far laterally. It may not become apparent until after the capsule matures, which is about six months postoperatively. There are many factors such as implant size, type, and quality of the patient’s tissue that contribute to implant malposition. Correction requires adjustment of the capsule as well as consideration of changing implant type and size.
Aging and Augmented Breast
One of the most common types of revision are women who have changes in their breast tissue due to pregnancy or aging and want to restore the aesthetic shape of their breasts. For patients who have saline implants, Dr. Peters may recommend deflating the implants in the office before making a plan to revise the breast. A mastopexy is usually necessary as part of restoring the desired shape of the breast. Changing the implant type to silicone gel or changing the implant volume may also be part of the re-operative plan.
The purpose of the consultation is to evaluate the source of your dissatisfaction and determine your goals and expectations. Dr. Peters will discuss his recommended plan and answer all your questions. You will also receive an estimated cost for the procedures during your consultation.
If you are interested in breast revision surgery, please call Dr. Peters at (985) 227-4325 to schedule your consultation today.Back To Top