Breast augmentation is one of the most common plastic surgery procedures performed today. In most cases, women achieve the results they want, and they are happy with the outcome for many years to come. However, some women do not have such a positive experience. When breast augmentation does not go as planned, it can result in distortion of the breasts, a less than satisfactory aesthetic outcome and even physical pain in some cases that involve capsular contracture. Even if the first surgery went as planned, a woman’s desires for her body could change over time, leading to requests for changes in the original outcome. When either of these situations occurs, breast augmentation revision is the best way to address the concerns and create a more pleasing appearance.
Dr. Barrett says “Breast Augmentation revision requires an in-depth investigation and understanding of the previous operation(s) and current condition of the breasts. The surgical incisions made can affect blood and nerve supply to sensitive parts of the breasts and any future incisions need to be planned accordingly. Breasts heal differently the second or third time around. Implant type and surgical plans are chosen to provide predictable results in these complex scenarios. A board certified and experienced breast revision surgeon should be your top priority if you are considering breast implant revision.”
BEFORE AND AFTER PHOTOS
Breast implant removal and replacement with pocket revision and repair. Donut Mastopexy on the right and Lollipop Mastopexy on the left.
Patient suffered from Mastoma and Capsular Contracture from previous breast augmentation.
Bilateral Capsulectomy. Removal of implants and replacement. Neo-Submuscular Pocket Creation.
Keller Funnel used for minimal incision
What is Breast Augmentation Revision?
Breast augmentation revision is a surgical procedure designed to address concerns left behind after an initial breast augmentation or problems that developed later on. It may involve removing or replacing implants, removing scar tissue or restoring symmetry to the breasts. Revision surgery tends to be more complicated than the original breast augmentation and requires a higher level of expertise to perform correctly. The blood supply to the nipple and breast can be put at risk after multiple operations. However, when the procedure is done correctly and safely, it can provide a woman with the type of results she had wanted when she had her initial surgery performed.
Is Breast Augmentation Revision Right for You?
While there is no ideal candidate for breast revision surgery, the majority of women that come to Dr. Barrett for breast revision have complaints or concerns related to the following:
- Poor Cosmetic Results – Women seek out breast augmentation for a variety of reasons, but all want to enhance the shape, size and appearance of their breasts. Unfortunately, that is not always the outcome of these operations, leading women to pursue additional surgery to correct poor cosmetic results that occurred with the first surgery. The most common problems in this category are due to implant malposition, bottoming out of the implant, poor scarring and incorrect implant size.
- Capsular Contracture – This condition occurs when the tissue surrounding the implant area tightens and contracts around the implant. This tightening can result in unnaturally firm, distorted breast shapes that are sometimes quite painful. Correction generally requires removal of the implant, removal of the scar tissue, pocket repair, and fat grafting or new implant placement. If caught early enough, capsular contracture can sometimes be improved with medication and massage techniques. We do not know what exactly causes capsular contracture, but we do know several evidenced-based methods that can be used to prevent it from happening in the first place and to help prevent it from coming back for revision cases.
- Implant Rupture – Implants are extremely safe but do not last forever. Both the FDA and implant manufacturers recommend that they are exchanged every 10 years to avoid rupture. In rare instances, implants can rupture before the 10-year mark and should be removed. When an implant ruptures, any surrounding free silicone and scar tissue should also be removed. At that point, a new implant can usually be placed in the breast pocket, if the patient wants that option.
Choosing a Surgeon for Your Breast Augmentation Revision
Because breast revision surgery is one of the most challenging plastic surgery procedures performed, your choice of surgeon for your operation will make all the difference in the success of your procedure. Dr. Barrett is known as an expert in breast revision. In fact, many other surgeons often refer to Dr. Barrett for the most challenging breast revision cases. Botched breast surgery alters normal tissue planes and laxity, the ability of breasts to heal correctly, and leaves scar tissue that dramatically affects the level of difficulty of the corrective surgery. We see a variety of women who require Dr. Barrett’s expertise in correcting complications that arose from previous breast augmentation surgeries. His background in reconstructive breast surgery and breast revision experience makes such difficult operations possible and ensures the best possible results in most cases.
Benefits of Breast Augmentation Revision
There are a variety of reasons why women might pursue breast augmentation revision. Advantages of this procedure might include:
- Ability to enhance the size or shape of the breasts
- Treatment of capsular contracture
- Removal of implant that has ruptured
- Repositioning of implant that has migrated
- Correction of asymmetries left from the first surgery
Dr. Barrett will take the time to listen to your concerns and weigh your options to determine whether breast augmentation revision is the right choice for you.
Choices in Breast Augmentation Revision
Your decisions in breast augmentation revision will depend on your specific surgical plan. If replacement of your implants will be part of the process, your options are:
- Saline or silicone implants
- Textured or smooth shell (outer covering of implant)
- Round or teardrop shape
- Moderate or high profile
Dr. Barrett will also help you select the implant size that will maintain your proportion and balance while providing you with the look you want. Placement of the new implant might also vary, with options including above the chest muscle and underneath the breast tissue, or underneath a portion of the muscle as well. Dr. Barrett typically uses textured implants often in revision cases because of their added stability over smooth implants.
Creating Your Surgical Plan
Each woman has a unique aesthetic goal when it comes to breast augmentation and the revision process if it becomes necessary. It is essential to select a surgeon that not only has the expertise and experience to handle your revision well but who will also listen to your concerns and discuss your goals with you to ensure your outcome for your procedure meets your expectations. Dr. Barrett maintains a daily schedule that allows him to spend ample time with each of his patients, so he can help them design a surgical plan to meet their needs and desires as precisely as possible.
Preparing for Your Surgery
Since you have already been through one surgical process, you want to do everything possible to ensure this second surgery has a better outcome. Those efforts can begin before your revision procedure, by following Dr. Barrett’s pre-operative instructions carefully. Those directions might include:
- Stopping medications and supplements that could cause additional bleeding
- Quitting cigarettes at least six weeks before surgery
- Filling prescriptions, so they are ready for you when you arrive back home
- Arrange for a ride home and assistance for the first day or two
Dr. Barrett will advise you as to whether there are other steps you can take to create the best surgical experience and recovery process possible.
Dr. Barrett will likely recommend general anesthesia for your breast augmentation revision, although local anesthesia with IV sedation may be appropriate in some cases. He will create incisions in the locations discussed during your consultation, using the same incisions as the original surgery whenever possible to minimize scarring. Dr. Barrett will then remove the current implants if necessary, leaving the breast pocket empty or replacing them with new implants in the size and shape you select. Scar tissue will be removed if appropriate, and the incisions will be closed using a layered approach that reduces tension during healing and promotes better scar formation. Breast revision surgery can take anywhere from one to three hours, depending on the complexity of the correction needed.
After Your Breast Augmentation Revision
The typical recovery period for a breast revision is about six weeks. For the first two weeks post-surgery, it is normal to experience some soreness and swelling. Medication and cold compresses can be used to ease these side effects during the early portion of the recovery process. Some revisions involving extensive pocket repair may or may not require the use of specialized external bras as well. Dr. Barrett will provide specific instructions on how to best care for yourself during the recovery period customized on your condition and surgery.
Minimizing the appearance of scarring is a top concern during the postoperative period. Dr. Barrett meets with all patients once a week for six weeks to monitor the recovery process. Stitches are removed at weeks one, and two and tape is placed over the incision once the stitches are gone. After the taping period is done, you will be prescribed a patented silicone scar gel to apply twice daily for three months to continue the healing process. When these steps are followed carefully, patients usually see positive results with less noticeable scarring within one year after their procedure.
Superior Results that Last
When an initial breast augmentation does not go as planned, it can be challenging to move forward with a revision procedure not knowing whether the second surgery will achieve the desired result. Rest assured Dr. Barrett has the expertise and experience necessary to correct problems left behind after a botched breast augmentation to create a more aesthetically pleasing outcome the second time around. He will also give you all the time and attention necessary to ensure your revision procedure is safe, positive and successful for you. Results should meet your expectations and be long-lasting. To learn more about your choices in breast augmentation revision, schedule your consultation with Dr. Barrett today by calling our office at 310-598-2648.