Breast revision encompasses procedures performed on the breasts that have had implants placed previously or for prior breast reduction or mastopexy. It is frequently done because the initial operation did not produce the desired results or was impacted by difficulty healing. Even successful augmentations may require revision years later. Changes can naturally occur, such as pregnancy, weight fluctuation and aging that are unavoidable but may also result in a less than desirable appearance.
Dr. Lickstein has extensive experience with implant-based breast reconstruction, enhancement procedures and correction of congenital deformities of the breast. This foundation is essential when considering a revision of prior breast surgery. Before recommending a surgical plan, Dr. Lickstein carefully listens to each patient’s story and concerns. To help achieve their goals, he utilizes state-of-the-art techniques to ensure the best possible outcomes.
What is Breast Revision? Breast revision usually involves the removal or replacement of current implants. The most common reasons for revision surgery are changes in breast shape, implant position or volume. The procedure may be requested because a complication has occurred, or the patient has changed her mind about the body contour she wants to achieve.
Breast revision surgery is more complex than an initial breast enhancement procedure. It is imperative to choose a surgeon experienced in these procedures to ensure the best possible results. You will also want to communicate your concerns and goals clearly, so the surgeon you choose for your revision surgery has an accurate idea of your expectations for your procedures.
Common Reasons for Breast Revision Surgery
In addition to dissatisfaction with the appearance of the breasts, there are a variety of potential problems that can arise after an initial breast enhancement procedure that may necessitate revision surgery. In some cases, no complications occur, but the patient would like to change her appearance due to fluctuations in weight, lifestyle or other factors. Common reasons to consider revision include:
Bottoming out occurs when the breast implant descends below the breast crease after surgery, causing the breasts to lose volume in the upper portion. This may also cause the nipple to locate too high on the breast, which can produce an unnatural appearance.
As one of the most common complications after breast implant surgery, this is a frequent issue addressed with revision surgery. It occurs when the scar tissue surrounding the implant hardens, squeezing the implant and producing discomfort and sometimes a distorted appearance to the breast.
Double Bubble Deformity
This complication may happen when the breast implant slides below the breast crease and creates a second area of fullness or a bubble on the bottom of the breast. It is more common in women that have their implants behind the chest muscle and then experience significant ptosis (sagging) in the natural breast tissue.
Malposition of Anatomical Implants
Anatomical implants are known for their teardrop shape and are often desired due to the way in which they naturally create more fullness in the lower portion of the breasts and taper upward. Although rare, these implants can move inside the breast pocket, causing the breasts to appear oblong or misshapen if they are rotated within the breast pocket.
Sometimes breast implants are placed too close together or too far apart, creating an unnatural appearance in the body contour. Other times, the implants may not settle into the correct position once the final breast augmentation results develop, requiring further surgery to create the desired outcome.
The rate of implant rupture, which is a risk with both saline and silicone implants, has decreased significantly in recent years. If a saline implant ruptures, it will be noticeable quickly with a visible deflation of the breast. Silicone implant ruptures are not visible on the outside of the breast and require an MRI screening to detect. Dr. Lickstein’s staff will discuss implant warranty coverage with you at your initial consultation to determine if your eligibility before your revision surgery.
With this complication, patients may see the edges of the implant through their breast tissue, which leads to a rippling effect on the outside of the breast. This tends to be most common with saline implants placed above the chest muscle. A correction may involve repositioning the current implants or replacing them with implants that are a better fit for the patient’s body.
While not a complication, this is probably the most common reason women explore their options in breast revision surgery. Some patients may decide they want larger breasts than the primary augmentation achieved. Others may have a change in weight or lifestyle that might lead them to consider a smaller, more proportionate implant or even eliminate the implants entirely. During your consultation, Dr. Lickstein will assess your chest width and utilize bio-dimensional planning to help you meet your new expectations.
Preparing for Breast Revision Surgery
Your initial consultation for breast revision surgery will be used to identify your specific concerns from your previous breast augmentation and outline the goals you have for this new procedure. It is critical that you can discuss this information in detail with your revision surgeon to ensure a firm understanding of what you didn’t like about your first enhancement and what you would want to change with your second. Dr. Lickstein understands the importance of this initial meeting and will take the time needed, so you are confident and comfortable in your decision to pursue revision surgery.
Women considering breast revision surgery often have several concerns about their previous procedure or the one they are now contemplating. Questions that might come up in that initial consultation might include:
Am I a good candidate for breast revision?
Despite their dissatisfaction with their initial results, some women are hesitant to undergo additional surgery to improve their outcome. However, women that are in good physical health, do not smoke and are willing to take sufficient recovery time tend to do well after revision surgery. Dr. Lickstein will do a careful assessment of your health, concerns and aesthetic goals to determine whether a revision is the right choice for you.
Should I use the same surgeon for both procedures?
Some women feel compelled to return to the surgeon that performed their original augmentation for their revision procedure. While this may be a good choice in some circumstances, it is important to note that surgeons with experience in primary augmentation may not have the same level of skill or experience when it comes to revision procedures. When you choose an experienced surgeon for your revision, rest assured that doctor can contact your initial surgeon if necessary to get details of your procedure that might create even better results from your revision surgery. Sometimes a change is good, and provides fresh perspective and energy in a difficult situation.
Can I make changes to my appearance during revision surgery?
A breast revision is an opportune time to alter the appearance of your breasts in terms of size, shape or profile. Some women also opt to undergo a lift with their revision augmentation to restore breasts to a more youthful, perkier position on the chest wall.
How much does breast revision surgery cost?
The cost of revision procedures will vary dramatically, depending on the type of implant used, the extent of the correction needed and whether a breast lift will be performed at the same time. Dr. Lickstein and his staff will discuss all of the variables with you at your initial consultation so that they can provide you with a detailed quote on the price of your procedure.
Details of breast revision surgery will vary based on the techniques used and whether implants will be removed and replaced. Patients usually receive general anesthesia before the procedure begins so they are comfortably asleep throughout the operation. Dr. Lickstein will do his best use the same incision locations to eliminate additional scarring after your second procedure. However, there are times when that will not be possible, and Dr. Lickstein will need to create new incisions to achieve the best results. In these situations, Dr. Lickstein will take care to minimize visible scarring after your revision surgery.
During your revision surgery, Dr. Lickstein will remove your current implants, replacing them with new implants if that is a part of your treatment plan. Any concerns, such as tightened scar tissue associated with capsular contracture, will also be addressed during the procedure. The time of the procedure will fluctuate depending on the amount of improvement requested.
The Recovery Process
The recovery after breast revision surgery may be slightly longer than it was for your first breast enhancement. Bruising, swelling and some discomfort should be expected, but we will give you medication and instructions to minimize these side effects. Patients are advised to take at least one week off work and other activities to ensure they have sufficient time to rest and recuperate. Most can resume their schedules within one to two weeks. Strenuous exercise is usually allowed after about six weeks.
The full results of a breast revision procedure may not be evident for several weeks, due to residual swelling that may linger for some time. Once the outcome is apparent, it will also be long-lasting. Breast implants are designed to last about 10 years, although many women find they can endure much longer. You should enjoy increased satisfaction with your appearance, a better fit to your clothes and a higher level of self-confidence over the long term.
If you are not completely happy with the results of your initial breast augmentation, breast revision surgery might be a good choice for you. To learn more about your revision options, contact Lickstein Plastic Surgery today at 561-571-4000.