BREAST IMPLANT REVISION AT POWER PLASTIC SURGERY

Are you considering breast implant revision? Perhaps you have a desire to change the size of your implants or have concerns about your results from previous augmentation.  No matter the reason, Dr. Power can help you to achieve the look that is right for you! Our team uses leading techniques and equipment to help you achieve your aesthetic goals.

"My patients are real women.
Mothers and next-door neighbors, not models."

What is Breast Implant Revsion?

Breast implant revision is performed to modify the outcome of previous augmentation surgery.  It may involve implant exchange – replacing your original implants with new ones of a different size and/or type – or to address complications of previous surgery.  This may involve releasing or removing scar tissue around the implants, repositioning, or adjusting the implant pockets.  Breast implant revision may be performed in combination with a breast lift.  In other cases, patients may wish to undergo removal of breast implants.

There are many reasons why a patient may wish to undergo breast implant revision. These may include:

  • Capsular Contracture: This develops when the scar tissue surrounding an implant – which is referred to as the capsule – tightens over time.  In mild cases, there are no symptoms or changes in appearance.  As the scar tissue becomes tighter, this may change the appearance of your implant and become painful in advanced cases.  Your implant may feel quite firm and appear high on your chest wall.
  • Asymmetry: Implants may heal or settle differently between sides.  This may also relate to surgical technique if the pockets were created with different dimensions during your original surgery.
  • Rupture or Leakage: When the silicone shell of an implant tears or breaks apart, it is called a rupture. Imaging is generally required to detect rupture of a silicone implant, particularly of the “gummy bear” or cohesive gel implants.  It may be noted on mammogram, ultrasound, or MRI.  A saline implant deflates when ruptured, which is most commonly noticeable without imaging given change in breast appearance.
  • Wrinkling/Rippling: This is seen more often in thin patients, particularly with saline as opposed to silicone implants.  Large implants also carry higher risk of wrinkling and rippling in the long-term since they may cause thinning of the overlying skin and breast tissue.  Implants placed above the muscle in the subglandular pocket are also at greater risk for rippling.
  • Shifting of Implant: Over time implants may shift from their original position.  They may migrate more towards the sides extending under the arms or lower on the chest wall related to gravity.  It is important to wear a supportive bra in the long-term to lower risk of implant shifting and malposition.

Revision surgery will be based on your specific concerns and appearance. Options may include capsulotomy (scar tissue release), capsulectomy (scar tissue removal), capsulorrhaphy (tightening or resuspending the capsule to alter implant position), or implant exchange to a different size, type, or placement.

How is Breast Implant Revision Performed?

Breast implant revision is performed under general anesthesia and usually takes about 2-4 hours depending on the extent of surgery.  When performing this procedure, Dr. Power most commonly recommends an inframammary approach, using incisions hidden within the breast folds.  It is generally not recommended to exchange implants through an axillary (underarm) incision given limited exposure.  If your primary breast augmentation was performed using periareolar incisions – along the lower border of the areola – it is not recommended to use the same scars given risk of developing nipple retraction.  This may lead to a tethered appearance of the nipple due to increased scar tissue.  During breast implant revision, implants will then be placed above or below the muscle depending on your original implant placement and what is determined to be the best choice for you.  The existing implant pockets will be modified to ensure implants can move naturally. Patients can choose between saline or silicone gel implants, depending on your personal preference and clinical examination.  In cases where a breast lift is also being performed, Dr. Power will remove loose breast skin then reposition and lift your breasts to a more youthful position.  Incisions will be closed with dissolvable sutures.

Who is a Good Candidate for Breast Implant Revision?

You may be a candidate for breast revision surgery if you wish to improve upon results from previous breast augmentation.  Your implants may have dropped over time due to changes during pregnancies, breastfeeding, or weight fluctuation.  Your preferences may have changed relating to implant size or position.  Your concerns may also relate to capsular contracture, which results in varying degrees of scar tissue surrounding the implant. This may range from a somewhat tight implant to one that is high on your chest wall and painful.  If you are considering breast implant revision, it is generally the safest recommendation to defer surgery until you have completed pregnancies and breastfeeding and have achieved a stable and healthy BMI.  Smoking cessation is also important to lower risk of healing complications.

Breast Implant Revision Recovery

Recovery from breast implant revision surgery is similar to what you experienced following your primary breast augmentation.  Implant revision surgery is performed as an out-patient procedure.  A surgical bra is recommended to be worn full-time except when showering over the first 6 weeks.  Mild to moderate discomfort can be alleviated by prescribed pain medication and by performing cold compresses over the first 48 hours. Patients are generally able to return to work within one week, depending on the nature of your work. It is necessary to refrain from strenuous activity or heavy lifting for one month post-operatively. Dr. Power will give you specific instructions on when you can safely return to rigorous exercise, including lifting/straining, physical labor, sex, and other daily activities.

Breast Implant Revision FAQs

Can breast implants be reduced in size?

Breast implants may be reduced in size by exchanging the implants in a surgical procedure.

Can breast implants be removed and not replaced?

Breast implants may be removed and not replaced. This procedure is called explantation. Depending on the appearance of your breasts after implant removal, breast lift may be an option.

Can breast implants change shape over time?

Implants typically drop over the first few months, particularly when placed under the pectoralis muscle. To lower the risk of further drooping related to long-term effects of gravity and aging, a supportive bra should be worn. There is a risk that implants may become firmer and higher on the chest wall over time related to capsular contracture.

Can breast implants last 30 years?

It is possible that implants may last 30 years. If you do not have any aesthetic concerns and there are no concerning findings on imaging, breast implants may remain safely in place with routine monitoring.

Can you feel a ruptured breast implant?

It is possible that you may feel discomfort related to a ruptured breast implant, but a silent rupture is also possible. A ruptured saline implant will become noticeable as it loses volume. The latest generation of cohesive gel silicone implants will not lose volume or change shape and rupture may be incidentally noted on imaging (e.g. ultrasound, mammogram, or MRI).

Does insurance cover breast revision?

Insurance may cover breast revision. You should discuss your case with your board-certified plastic surgeon. The implants are often covered by manufacturer warranty over the first 10 years.

How do you fix capsular contracture?

Capsular contracture may be fixed through different surgical techniques, which vary based on the degree of contracture. Options include capsulotomy (releasing the scar tissue) and capsulectomy (partial or complete removal of scar tissue) to repositioning or replacing the implants.

How soon after breast augmentation can I get a revision?

You should generally wait one year after breast augmentation to consider a revision. It takes that long to achieve the final outcome and for scars to fully mature.

Is it dangerous to have breast implants removed?

Although every surgery has risks, breast implant removal is not considered a dangerous procedure if you are healthy and undergo surgery by a board-certified plastic surgeon.

Is there an alternative to breast implants?

Fat grafting may be an alternative to breast implants. It uses your own fatty tissue to add volume to the breasts. It may not be an alternative if you are thin or seeking a large augmentation.

What are the early signs of capsular contracture?

Early signs of capsular contracture are increased firmness or tightness around the implant. There is generally no change in cosmetic appearance at this stage.

Can breast implants last a lifetime?

It is possible that breast implants may last a lifetime, but generally you will require further surgery in the future. You may have cosmetic concerns about the implants becoming droopy over time following pregnancies or breastfeeding. You may prefer to go with a bigger or smaller size at some point. If there is an issue relating to implant rupture or capsular contracture, further surgery may also be required. It is a myth however, that implants require replacement every 10 years.

Can capsular contracture get worse?

Capsular contracture may progress over time. It ranges from mild tightness with no change in cosmetic appearance to an implant that is firm, potentially painful, and high on the chest wall.

Can capsular contracture go away by itself?

Capsular contracture does not go away by itself, but may remain stable and asymptomatic. It may be monitored in these cases. Implant massage may also be of benefit.

Can I have my breast implants removed?

Likely yes, you can have your breast implants removed. It is important to see a board-certified plastic surgeon to ensure you are a healthy candidate and to discuss your options.

How long do breast lifts last?

Breast lifts are typically long-lasting as long as you maintain a stable body weight and have completed pregnancies and breastfeeding. Wearing a supportive bra is also important to lower risk of further drooping in the future.

How long does it take to recover from breast revision surgery?

Recovery from breast revision depends on the extent of surgery. Breast implant removal is typically not very painful and patients may even resume light office work the following day. Following other types of breast revision surgery, patients usually recover within a week or so and may resume exercise in one month.

How much is a breast implant revision?

The cost of breast implant revision varies based on the extent of surgery and whether replacement implants are required. Breast implant removal is $5500 on average. You will receive a customized surgical quote after your consultation.

How often should breast implants be replaced?

There is no set time for replacing breast implants. It is a common myth that breast implants should be replaced every 10 years. You may leave your implants in place as long as you are pleased with them cosmetically and there are no concerns medically or based on imaging.

What is breast revision surgery?

Many procedures fall under breast revision surgery. This refers to repeat surgery after a primary procedure has already been performed. Examples include revision breast augmentation, revision breast lift, and revision breast lift with implants.

What is the most common breast implant size?

In my practice, women are typically interested in natural and proportionate results and the most common breast implant size falls in the 300-350cc range.

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If you are interested in learning more about breast implant revision, contact us today! As a board-certified plastic surgeon, Dr. Power has performed many breast implant revisions and has advanced training to help you achieve your goals while prioritizing your safety.  We will be happy to schedule your consultation to give personalized recommendations.  We hope to improve your satisfaction with your breast implants and boost your self-confidence.

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