A breast implant revision or breast augmentation revision is a surgery that replaces your old breast implants with new ones, and at the same time, changes or improves the appearance of the breasts. This can include a lift or reduction, or simply increasing or decreasing the size of the implants.
You are a good candidate for implant revision if
- You have previously had breast surgery, and now wish to rejuvenate their results following a change in shape, volume, size or symmetry.
- If you are experiencing pain from capsular contracture of your current implants
- You have symmastia or “uniboob” which brings the breasts too close together in an attempt to build more dramatic cleavage.
- You are physically healthy and at a stable weight
- You are a nonsmoker
Your revision surgeon will do a full consultation, including history and exam, photos, and review of outside records if you have any. The surgeon will develop a surgical plan of action that specifically addresses all of your unique issues and goals for the surgery, then review it with you in detail before your breast revision surgery.
Implant Revision is performed under General Anesthesia. Regardless of previous incisions used for implant insertion, implants are often removed via an inframammary incision to allow visibility and access. The incision is made in the inconspicuous crease at the base of the breast to minimize visible scarring. The choice of incision varies based on the type of implant, degree of revision required, your particular anatomy, and patient-surgeon preference. Implants can be replaced after removal. The implant size and shape, as well as the pocket in which the implants are re-inserted are determined by the reason for removal in the first place.
Breast reduction surgery is usually performed under anesthesia in a hospital where you can expect to stay one or two days. It usually takes four to five hours. The procedure involves an anchor-shaped incision or only a vertical incision following the natural contour of the breast.
When the excess skin and breast tissue has been removed, the nipple and areola are moved to a higher position. The skin surrounding the areola is brought down and stitched together to reshape the breast. Stitches are usually located around the areola, in a vertical line extending downwards from the nipple area, and along the lower crease of the breast.
Is it Safe?
Secondary surgery is always more difficult than primary breast augmentation, for several reasons. The presence of scar tissue makes it more difficult to predict a good result. In addition, the surgeon is dealing with the stretching of tissues or anatomical changes caused by previous implants. For these reasons, many surgeons may charge higher fees for breast revision than for primary breast augmentation.
Is it painful?
The breast implants revision recovery stages involve some pain, although it is generally « manageable » with the right pain management treatment. The first 2-3 days require the vast majority of medications, particularly those used to control post-op discomfort.
Instead of relying solely on narcotics to control pain during the first few days of recovery, some surgeons recommend pain pumps or pain injections for additional comfort.
Patients can usually expect to return to work after 1 to 2 weeks, and they should avoid vigorous activities for 3 weeks. Visible bruising should subside within 2 weeks, and swelling should begin to resolve within 3 weeks. You will be given specific instructions that may include:
- How to care for your surgical site(s) following surgery
- Medications to apply or take orally to aid healing and reduce the risk of infection
- Specific concerns to look for at the surgical site or in your general health
- When to follow up with your plastic surgeon
When you go home, if you experience shortness of breath, chest pains or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require an additional treatment.
The final results of breast implant revision surgery will be initially obscured by swelling. It will take at least six weeks for the swelling to resolve and the breasts to feel softer and more natural. In some cases, it can take 6-12 months for the breasts to feel « normal. » Healing time is different for everyone and sometimes it can take longer for the breasts to soften, for normal sensation to return, for scars to fade and for the patient to get used to the feel of having an implant. Please discuss realistic expectations with your surgeon regarding healing.
The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary.
Things to keep in mind
Try before you buy
Since changing size is the number one reason for breast revision, it stands to reason that you would want to be sure about what size you want before having surgery. If you are considering breast augmentation, it is a great idea to “try before you buy.” The best way to accomplish this is to try on several different sizes and shapes of implants at your surgeon’s office. With the range of shapes, types, and sizes of implants available today, this is the only way to accurately judge which implant will work best for your body.
Finally, remember that it is of utmost importance to go into your surgery with realistic expectations. Perfection does not exist in nature or in plastic surgery. Your pre-surgery body is not completely symmetrical, and it won’t be perfectly symmetrical afterward either.