There are a number of reasons why a patient might seek out breast implant or breast augmentation revision surgery. In the majority of cases, a patient may simply wish to make a change, whether to the size of their implants, they may want to go bigger or smaller, or add a fat transfer to their original breast augmentation, or possibly change the placement of their implant from under the muscle to subfascial placement for instance. In these cases, breast augmentation revision surgery is a great option. In rarer cases, a patient may be seeking out a breast implant revision due to a complication with their original breast augmentation surgery, this can include capsular contracture, asymmetry, sagging or implant rupture or rippling.

At The Plastic Surgery Clinic, even if we didn’t perform your original breast augmentation surgery, we can in most cases see you for your revision breast augmentation. This is dependent on a number of factors that we will review with you prior to booking your complimentary consultation.

What is breast implant revision surgery?

Revision breast surgery is a highly specified procedure that is tailored to every patient’s specific goals and needs. These needs might be related to complications from an initial surgery. In other cases, a patient might require a breast lift or fat transfer alongside a change in implant size or style in order to create a perkier or fuller look or create cleavage. Sometimes we meet patients who are interested in breast implant scar revision if they’re unhappy with the appearance of scar tissue at their initial incision site.

In the case of complications, your surgeon will perform a breast augmentation revision to treat the underlying concern. To treat capsular contracture, the capsule may need to be removed and the breast implant may need to be replaced. If an implant has ruptured, it needs to be replaced.

There is a common misconception that, once you have breast implants, they need to be changed every 10 or 15 years. This is not the case. Medical device manufacturers provide a lifetime guarantee for their breast implants. Many patients undergo breast augmentation and experience no complications or problems and continue to love they way they look and feel for the rest of their lives. In those cases, no breast implant revision is required.

That said, some patients may be interested in changing their implant from saline to a cohesive gel implant, because they may prefer the look and feel of one implant over the other.

Detecting Breast Implant Rupture with HRUS

Thanks to advances in the design and manufacture of breast implants, when a cohesive gel silicone breast implant ruptures, the silicone remains in place within the the implant and doesn’t travel to other areas of the body. While this dramatically improved the safety provided to breast augmentation patients, it has made it more difficult for both surgeons and patients to determine when an implant’s shell has been compromised. And when an implant has been ruptured, it requires surgical replacement as a safety standard to prevent any further complications.

The FDA previously recommended that patients with cohesive gel implants have an MRI every few years to ensure that their breast implants are still intact. However, recently, they have modified that position to say that High Resolution Ultrasound (HRUS) technology is as sensitive as an MRI and can therefore be performed every 5 years instead.

At The Plastic Surgery Clinic, we offer HRUS technology to all of our breast augmentation patients. If you ever have a concern that there might be a problem with your implants, you can come see us for a breast exam. We will provide you with a physical examination and perform an ultrasound evaluation. That way our surgeons can easily detect if your implant has ruptured while also monitoring for any fluid accumulation.

As our surgeons are experts in revision breast surgery, if the examination reveals a problem with the implant(s), we can advise each patient on what should be done to best correct the situation.

This service is valued at $500, but is included free as part of every breast augmentation procedure we perform and is available to our patients for life. If you’ve had your breast augmentation performed by another surgeon elsewhere, we are still more than happy to provide you with a consultation and an HRUS examination. However, in those cases you will be required to cover the $500 fee for this service.

How Your Breast Implant Revision Surgery is Performed

The surgery itself will likely be fairly similar to your original procedure, and in most cases, your surgeon will opt to place your incisions in the same area you originally chose. Depending on the reasons for your breast augmentation revision, your operation may be structured a little differently.

In addressing capsular contracture, where the scar tissue your body forms around the implant becomes constricted and uncomfortable and affects the way your breasts move and feel, your surgeon will either remove or release the tightened capsule first. From there, they are able to insert your new breast implant.

If your breast implant has ruptured, the manufacturer will supply a replacement at no charge. Your surgeon will remove the damaged implant and simply replace it.

To incorporate a breast lift in your revision breast surgery, your surgeon will make a new incision around the circumference of the areola extending straight down in a vertical line from the nipple to the bra crease. This incision allows for tissue to be removed to address sagging and repositioned to create more lift, with the nipple sitting in a higher or perkier position on the breast.

To add a fat transfer to your original breast augmentation, your surgeon will need to perform liposuction on an area of the body where there are some extra pockets of fat, such as your thighs or abdomen. They will then harvest the fat and re-inject it into target areas of the breast in order to improve cleavage or breast spacing. This is an excellent procedure if you’re looking to remove some pockets of unwanted fat on other areas of the body.

To change the size, style or position of your implants, your surgeon will need to assess the size of the space where your new implants will sit, sometimes adjusting the breast pocket to accommodate more volume.

The operation itself usually takes between one and three hours depending on the complexity of the surgery. You will undergo general anesthesia and a dedicated anesthetist will be with you before your procedure starts, throughout your operation, and as you wake up after surgery to carefully monitor you. As with your first procedure, someone will need to pick you up and stay with you for the first 24 hours after surgery.

Recovery After Breast Augmentation Revision

The healing process after any surgery varies from patient to patient and, as outline above, may be affected by the different factors that go into each unique revision breast surgery. That being said, many patients report that recovery after revision surgery feels easier than their first experience. Typically this is because the tissues that stretch and adjust to accommodate your implants have already done so, and so it’s primarily the incisions that require healing time.

Some minor pain and tiredness is to be expected during the first 72 hours following your operation. You will need to avoid any heavy lifting or raising your arms above your shoulders, so if you are caring for any small children, you’ll need to plan for assistance following your surgery.

It’s essential to follow your surgeon’s recommendations closely after any medical procedure. By carefully following their advice, you can lower the risk of complications, have a more comfortable recovery process and create the best possible result.