Most of the thousand of women who choose to have breast augmentation are pleased with their plastic surgery results, some patients will decide to have the implants removed or replaced. Breast revision surgery can include correcting implants, removing unwanted or ruptured implants, and replacing current implants for a different size or newer type of implant. Some women may decide their implants are no longer what they want soon after their surgery or years later when their lifestyle is different. Dr. Paresi of Dr. Robert J Paresi, Jr. MD in Chicago recommends that plastic surgery patients consider having their breast implants checked regularly for ruptures and consider replacing implants every 10 years.
Reasons for Revision Surgery
There are various circumstances as to why a woman may decide to undergo breast revision surgery. The most common reasons are listed below.
If a saline implant ruptures, the implant device will deflate due to the leakage of saline. This will result in an obvious deflating of the breasts. Silicone implants will not deflate visibly, however a break in the shell may still occur. The only true way to detect a shell break is through an MRI, which is why routine check-ups are recommended throughout the years.
Breast rippling and/or wrinkling can occur along the side of the breast, or underneath it. This occurs within saline implants resulting in an unnatural appearance under the skin. This is most common in women who are extremely thin.
Double Bubble Implants
“Double bubble” is a rare complication with women who have breast implants. This occurs when the implant drops down behind the natural breast crease, or it has risen and now over-drapes (double folds) the breast. When this occurs, an unnatural indention will result in a “double” breast appearance. This is usually caused by improper breast placement from the original surgery, or severe capsular contracture, which shifts the implant from its position.
Breast Implant Removal
Some women may decide later in life they no longer wish to have breast implants in place. Breast implant removal is a procedure that removes the implants and tightens the skin around the breasts to create a natural look.
Some women will be unhappy with their breast size following breast augmentation surgery. They may desire a secondary surgery to replace the implant with one of a different size, texture or shape. Some women may want to go from saline to silicone, or vice versa to achieve the results they desire.
Scar tissue that has formed around the implant may create a capsular contracture. When this occurs, excessive tightening of the capsule will result in a hard feel of the breast. Sometimes, in order to correct this, a capsulectomy must occur. This is the removal of scar tissue from around the implant. In general, silicone implants have a higher incidence of capsular contracture (approximately 10-15% chances) than saline implants (5% chance).
Implant Bottoming Out
This can occur post-surgery when an implant shifts or moves from its original location. This can also occur with aging, gravity, trauma to the chest area, or with excessive scarring.
Some women are not good candidates for breast augmentation surgery. Instead, they should first have a breast lift. Women who have sagging breasts and undergo breast augmentation surgery alone will not have strong results. The breast will continue to sag further due to the increase weight of the implant.
Breast Revision Reviews
Patients who wish to have their implants replaced will undergo a procedure where an exchange of one or both implants may occur. These revision surgeries are generally straightforward. If scar tissue does exist around the implant, an additional step will be taken to remove this. Some patients may require a breast lift during the revision surgery. In addition, a tissue matrix device known as a strattice may be used if added support is needed. The goal of the revision process is to resolve or overcome issues in a way that satisfies the patient’s aesthetic goals.
Breast revision surgery is performed under general anesthesia as an outpatient procedure in an accredited surgical facility. The ease of recovery will depend on exactly what was being done during the revision process. Most women are able to resume their normal work activities after a full week of rest. Exercise will be a gradual process. It may take up to a full year for the scars to begin to fade and for the newly revised breast or chest area to look and feel natural.