Breast Revision

Breast augmentation is a common cosmetic procedure. The majority of patients who undergo this surgery are extremely satisfied, and the risk of major complications is extremely rare. But all surgeries, aesthetic or otherwise, carry risks.

The most common risk of breast augmentation is “capsular contracture,” a condition in which the scar tissue that forms around the breast implant tightens, causing the breast to become hard and potentially misshapen. This condition can lead to discomfort or pain and might require additional surgery to correct.

Other undesired outcomes can include visible scarring, implant rupture or leakage, changes in breast and nipple sensation, and the need to replace the implant. Breast lifts, reductions, and reconstruction can also occasionally have undesired outcomes that may require correction.  Even when a surgeon performs breast surgery successfully, it’s possible for the tissues or  implants to settle over time, leading to nipple positions that don’t look symmetric or a shift in the position vertically or horizontally.

Revision breast surgery requires expertise, as it usually presents a higher level of complexity than primary surgery. However, some people choose to remove an implant and not have it replaced, for personal, cosmetic, functional, or other medical reasons. In this case, the surgery is a relatively simple and quick procedure.

Aesthetic breast revision surgery can help correct previous issues, enhance the appearance of the breasts, and achieve your current aesthetic goals.

Revision surgery differs from first-time surgery in several significant ways. The presence of scar tissue from the initial procedure can complicate the surgical process, requiring meticulous technique and planning. Additionally, your surgeon must consider any changes in your anatomy or the condition of your skin and tissue since the first surgery.

During breast implant revision surgery, your surgeon will assess the condition of your current implants. If you have experienced issues such as implant leakage, deflation, shifting, or capsular contracture, your surgeon will remove and replace the implants. This process may also involve adjusting the implant pocket to better position the new implants and ensure a natural appearance. Before surgery, you and your surgeon should decide on the type (saline, silicone, etc.) and implant size. You may also discuss alternatives such as fat-grafting.

For patients seeking breast lift revision surgery (mastopexy), your surgeon will address changes such as scar tissue or sagging that may have occurred since the initial surgery due to aging, weight fluctuations, or pregnancy. The procedure involves removing excess skin, tightening the surrounding tissue, and repositioning the nipple and areola to enhance the overall breast shape and projection.

In cases where breast reduction revision surgery is needed, your surgeon will remove additional excess breast tissue and skin to achieve a more proportionate breast size. This procedure can alleviate physical discomfort such as back, neck, and shoulder pain, while also improving the aesthetic balance of your figure.

Challenges unique to revision surgery include managing scar tissue, achieving symmetry, and ensuring the new implants (or breast reshaping) meets your revised aesthetic goals. Your surgeon will conduct a thorough evaluation and discuss your expectations to develop a personalized surgical plan.

Before you go

Prior to your breast revision surgery, make sure you go over not only your aesthetic goals but also your full medical history, including any family history of breast cancer and details about your current exercise routines. Be sure to give your surgeon details about any prior surgeries.

During a pre-surgery examination, your surgeon will evaluate the shape of your breasts and the quality of your skin and make sure that there are no active infections or skin rashes around your breasts. Your surgeon will also provide specific pre-surgery instructions, such as avoiding certain substances or medications. It is vital to adhere to these instructions carefully to ensure the best possible outcome.

During the procedure

Most revision surgeries are performed under regional or general anesthesia.

If your goal is to have an implant removed electively and nothing else done, the surgery usually takes around an hour and is done as an outpatient procedure. The surgeon will simply reopen the same incision that was used to place the implant, remove the implant, and close the skin.

If your surgeon is revising your prior breast lift surgery, they will trim excess skin and reshape the breast tissue to improve the position of the breasts. Revision breast augmentation and lift surgeries are often performed together. For a revision breast reduction, additional breast tissue is removed to achieve the desired size and shape.

Aftercare 

Most revision breast procedures are done as same-day surgeries in an outpatient center. After surgery, you are observed for a period of time and can go home. You may or may not have drains inserted, to deal with excess blood or fluid, depending on the revision surgery you are getting. Drains are usually removed within a few days depending on your surgeon’s protocols.

Mild bruising and swelling are common, and pain can typically be managed with over-the-counter acetaminophen (Tylenol). For additional comfort, prescription pain medication may also be provided, if needed; your surgeon may also prescribe antibiotics and other medications to make you comfortable after surgery. You will also be given detailed post-operative car instructions. Be sure to follow them closely.

The timeline for returning to routine daily activity and strenuous exercise will depend on the revision and should be discussed with your surgeon.