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Breast Revision - Iranian Society of Plastic and Aesthetic Surgeons

Breast Revision

BREAST REVISION

Breast revision is a surgical procedure designed to correct unsatisfactory results from a previous breast enhancement surgery. This revision surgery can improve the shape, size, projection, and symmetry of the breasts. Depending on your condition, breast revision may involve the removal or replacement of your breast implants.

When to Consider Breast Revision

  • Your saline breast implants have deflated or an X-ray or MRI suggests your silicone implant has a shell leak
  • If you want to change your implant/breast size
  • If you have tightening of the scar tissue around the implant (capsular contracture) or your breast implants have shifted in position
  • If your breast tissue has changed as a result of skin stretching or weight loss/gain

CONSIDERATIONS

PROS

  • Restores a more youthful, attractive breast appearance
  • Improves self-image and confidence
  • Clothing fits better, allowing a wider variety of clothing options

CONS

  • Gravity and aging will eventually alter the size and shape of your breasts.
  • The weight of your implants will also affect your breast appearance with time.
  • Your surgeon will need to have the surgical details of your first breast surgery.

These are the top three pros and cons to weigh when considering breast revision. If you wish to focus on what is unique to you, please consult with your aesthetic plastic surgeon.

Breast implant revision surgery is not a standard or routine procedure and needs to be tailored specifically to the patient’s goals and desires. Therefore, this surgery should be performed by a board-certified plastic surgeon who is well-trained and experienced in all types of breast surgery and who will listen to the patient’s goals and desires and will develop a surgical plan specifically to address all of the issues at the time of surgery.

Are you a good candidate for breast revision?

Even if your breast implant surgery was perfectly planned and beautifully executed, changes can occur over time.

The following are some common reasons why you may want to consider breast revision:

  • You are in good health.
  • You are not a smoker.
  • You wish to increase or decrease the size of your breasts.
  • You wish to correct breast asymmetry.
  • You want to address problems that have developed with your implants and/or surrounding breast tissue.
  • Pregnancy and/or breast-feeding has changed the appearance of your implants.
  • Weight loss or weight gain has negatively affected the appearance of your breast implants.
  • You should have undergone a breast lift with your initial augmentation, but did not.
  • You are unhappy with the results of previous surgery due to poor implant placement or other aesthetic problems.
  • You wish to remove your breast implants permanently.

If you are in good general health, have a positive attitude and realistic expectations, you are most likely a good candidate for this procedure.

Consultation

During your breast implant revision consultation, be prepared to discuss:

  • Your surgical goals
  • Medical conditions, drug allergies and medical treatments
  • Current medications, vitamins, herbal supplements, alcohol, tobacco and drug use
  • Previous surgeries

Your plastic surgeon will also:

  • Evaluate your general health status and any pre-existing health conditions or risk factors
  • Examine your existing breast implants
  • Take photographs
  • Discuss your options and recommend a course of treatment
  • Discuss likely outcomes of breast implant revision surgery and any risks or potential complications

The success and safety of your breast implant revision procedure depends very much on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle.

Be sure to ask your plastic surgeon questions. It’s very important to understand all aspects of your breast implant revision surgery.

Preparation

In preparing for breast implant revision surgery, you may be asked to:

  • Get lab testing or a medical evaluation
  • Get breast or implant imaging, such as a mammogram, ultrasound or MRI
  • Take certain medications or adjust your current medications
  • Stop smoking
  • Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding

Breast implant revision surgery is typically performed in a hospital or licensed ambulatory surgery setting, and will likely use general anesthesia. If your breast implant revision is performed on an outpatient basis, be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.

Procedure steps

Step 1 – Anesthesia

Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.

Step 2 – The incision

The type of incision used in breast implant revision surgery will vary depending upon the type of procedures that will be performed. The incision can include, but is not limited to, any of the following:

  • Inframammary incision – in the crease under the breast
  • Breast lift incision – either vertical incision or Wise pattern incision
  • Peri-areolar incision – incision part way or all the way around a areola

Step 3 – Closing the incisions

Sutures, skin adhesives, tapes or clips close the skin incisions.

Step 4 – See the results

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.

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 hospitalization and additional treatment.

Recovery

The patient should be able to return to work within seven to ten days depending on the type of work. Special care must be taken to be gentle with your breasts for at least one month after surgery.

Results

Depends on the patient’s breast laxity or sagginess after having had children or losing weight. Generally stable. However, gravity and the effects of aging will eventually alter the size and shape of virtually every woman’s breasts.

Risks and safety

Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedures you will undergo and any risks or potential complications.

The possible risks of breast implant revision surgery include, but are not limited to:

  • Bleeding
  • Infection
  • Poor healing of incisions
  • Hematoma
  • Anesthesia risks
  • Fluid accumulation (seroma)
  • Skin loss
  • Numbness or other changes in skin sensation
  • Skin discoloration and/or prolonged swelling
  • Unfavorable scarring
  • Recurrent looseness of skin
  • Fatty tissue found deep in the skin might die (fat necrosis)
  • Deep vein thrombosis, cardiac and pulmonary complications
  • Asymmetry
  • Suboptimal aesthetic result
  • Possible need for revision surgery
  • Persistent pain

These risks and others will be fully discussed prior to your consent. It’s important that you address all your questions directly with your plastic surgeon.

Risks and safety

Capsular contracture

The scar tissue that forms inside the body, around the implant, that can sometimes become thick or tight resulting in a hard-feeling or -looking breast implant.

General anesthesia

Drugs and/or gases used during an operation to relieve pain and alter consciousness.

Hematoma

Blood collecting beneath the skin.

Intravenous sedation

Sedatives administered by injection into a vein to help you relax.

Local anesthesia

A drug injected directly to the site of an incision during an operation to relieve pain.

What questions should I ask my plastic surgeon about breast implant revision?

Use this checklist as a guide during your breast implant revision consultation:

 

  • Are you certified by the American Board of Plastic Surgery?
  • Were you trained specifically in the field of plastic surgery?
  • What specific training do you have in breast implant revision techniques?
  • How many years of plastic surgery training have you had?
  • Do you have hospital privileges to perform this procedure? If so, at which hospitals?
  • Is the office-based surgical facility accredited by a nationally- or state-recognized accrediting agency, or is it state-licensed or Medicare-certified?
  • Am I a good candidate for this procedure?
  • What will be expected of me to get the best results?
  • Where and how will you perform my procedure?
  • What surgical technique is recommended for me?
  • How long of a recovery period can I expect, and what kind of help will I need during my recovery?
  • What are the risks and complications associated with my procedure?
  • How are complications handled?
  • How can I expect my breast implant revision to look over time?
  • What are my options if I am dissatisfied with the outcome?
  • Do you have before-and-after photos I can look at for this procedure and what results are reasonable for me?
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