Breast augmentation surgery is an extremely satisfying surgical procedure for women. However, patients must realize that breast implants are not permanent lifelong devices and most women will eventually pursue breast implant revision surgery during some point in their lives. Patients may desire to change the volume of the implants, treat capsular contracture caused by abnormal scar tissue around the implants, fix asymmetries that have occurred over time, or simply to remove the implants once and for all.
Whatever your reason, Dr. Ross and Dr. Holmes will thoughtfully design a surgical plan to address your goals.
Is Breast Implant Revision Surgery right for me?
Although some women may keep their breast implants permanently, the majority of women who have breast implants desire revision surgery at some point in their lives. There are many reasons women seek revision surgery. These include capsular contracture, rupture or leaking of the implant, changes in the shape or size of a woman’s breast tissue, desire to change the implant volume or type (saline or silicone), correction of a double bubble deformity or synmastia (lack of normal separation between the breasts), visible rippling, or simply to remove the implants.
Capsular Contracture: Capsular contracture occurs when abnormal scar tissue forms around an implant, causing the breasts to feel hard and look distorted. Although, it is a natural and normal process for a woman to form a capsule around her implants, in some women these capsules can abnormally thicken causing contracture. Dr. Ross and Dr. Holmes address this problem by removing the abnormal scar tissue and changing the implant pocket if needed.
Implant Rupture: In women who have had saline implants, implant rupture is easier to detect, because the breast becomes visibly smaller as the body absorbs the leaking saline. On the other hand, silicone implant rupture is more difficult to detect, however many women feel a change in the implant or breast that may clue them to a problem. MRI or Ultrasound may help diagnose silicone implant rupture. Regardless of the type of implant, once ruptured it is important to replace the implant. Each of the breast implant manufactures will replace your implants at no cost, depending on the amount of time that has passed since your original surgery. Some may even help cover surgical costs to replace the implants.
Changes in Breast Shape: Over time, despite the placement of breast implants, a woman’s own breast tissue may change shape and size as the result of pregnancies and breast-feeding, normal aging, or fluctuations in weight. As this occurs, the placement of the implants and overlying breast tissue may appear aesthetically unpleasing as the breasts appear saggy and are no longer centered over the implant. Depending on the amount of skin laxity of the breasts, this can be remedied either placing larger implants, or performing a breast lift. During your consultation with Dr. Ross or Dr Holmes, they will careful assess your anatomy and devise a surgical plane that is unique for you.
Double Bubble: Double bubble occurs in rare situations and can be avoided by precise surgical technique. A double bubble deformity occurs when an implant slips below the normal under crease of the breast, creating an unnatural result. This deformity can be difficult to treat, but can be done through changing the implant pocket position or the use of acelluar dermal matrices (also called slings), which are often used in breast reconstruction.
Synmastia: As with double bubble, synmastia rarely occurs when precise surgical technique is used. Synmastia is when there is no normal separation between the breasts. Changing the implant pocket position and use of acellular dermal matrices (also called slings) are surgical techniques used by Dr. Ross and Dr. Holmes to remedy this problem.
Rippling: Rippling occurs when surface irregularities of the implant can be seen through the skin. This is most common with saline implants and can occur due to underfilling of the saline implant or thinning of the skin. Changing implants from saline to silicone, changing to a totally submuscular pocket are solutions, or a combination of these techniques help treat rippling.
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Techniques for Breast Implant Revision
There are many ways revision surgery may be performed, and it must be customized to the patient. In some cases, Dr. Ross or Dr. Holmes will need to remove scar tissue from capsular contracture before replacing the implants. Revision surgery may also involve a breast lift, implant exchange, pocket change, or use of slings. Dr. Ross or Dr. Holmes will help you through the many decisions that must be made to create a tailored surgical plan that will give you the results you are looking for.
Most patients find that the recovery process is easier than it was during the first surgery. As with any other breast surgery, some bruising and discomfort is to be expected in the first few days after surgery. However most patients find that the recovery process is easier than after their first surgery, as space already exists in the tissue for the implants and then muscle don’t need to be stretched. The only exception is if the implant position is changed to under then muscle for the first time, which usually results in a recovery process similar to breast augmentation.