Have you had prior Breast Enhancement surgery and now need some refining or lifting? Do you want to change the size of your implants or just want to have them removed? Did you have a complication after previous breast surgery? Revision breast surgery may be the right choice for you. Revision breast surgery is one of the most complex areas in the field of cosmetic plastic surgery, and the surgeons at Restore SD Plastic Surgery are experts with over a decade of experience in cosmetic and reconstructive breast surgery.
The Best Candidates
- Have an identifiable and correctable abnormality in breast look or feel with current implants
- Have realistic ideas and expectations of what can be accomplished with surgery
- Are healthy and a stable weight
- Have experienced implant rupture, capsular contracture, sagging or asymmetry
- Are motivated to improve breast appearance through a multi-modal approach
- Are not taking blood thinner medications or using nicotine products
Revision breast surgery is a constantly evolving niche in plastic surgery and your Restore SD surgeons are highly trained experts in the field of revision breast surgery.
Capsular contracture is a common condition that affects women with breast implants at a rate of approximately 10%. Implants are a foreign object and your body’s natural response is to create a scar tissue capsule that surrounds the implant. Over time, the capsule can begin to tighten and can affect the way the implant looks and feels on your chest. Treatment for capsular contracture involves removing the implant and the scar tissue capsule, then placing a new implant and letting your body begin the healing process again. Certain adjunctive maneuvers during surgery and medication after surgery can help decrease your chance of having another capsular contracture.
Sometimes implants are too big and heavy and other times they may be a bit too small and you want to upsize. Sometimes implants rupture. In any event, implant exchange is an excellent way to change the size and projection of your breasts to achieve the look you desire. Breast implants are not designed to be forever devices and they will eventually fail. If you have an implant rupture, implant exchange with or without removing the surrounding scar tissue is the treatment of choice.
Acellular Dermal Matrix/Absorbable Mesh
In the last decade, the introduction of acellular dermal matrix and absorbable mesh products have revolutionized the approach to revision breast surgery. These amazing products allow surgeons to enlarge, decrease, modify, and soften the implant pockets to achieve an improved breast appearance. These products do carry an increased cost and it is very important to realize that revision breast surgery is often more expensive than an initial breast augmentation or lift due to the complexity of the surgery as well as the expense of the materials used.
Fat grafting, as an adjunctive procedure, is a wonderful addition to revision breast surgery. Using the SAFELipo™ technique, fat from your own body allows your Restore SD surgeon to sculpt the breast into an improved shape and can address small volume asymmetries very nicely. You also get the bonus of a little liposuction at the fat harvest site!
Occasionally a patient comes to us with a problem so complex that the best solution calls for a reconstructive approach. Whether it involves a completion mastectomy, use of tissue expanders, or just patience, hand-holding, and listening, the surgeons at Restore SD Plastic Surgery are here for you. Time and patience are great allies in correcting significant cosmetic breast issues. Frequently, a staged approach with multiple procedures spaced by 4-6 months can lead to a significantly improved appearance.
I’m Done – I just want them out!
The decision to permanently remove your implants may arrive someday. It is good to know that you are not alone and many women will reach a point where they are happy to leave heavy implants behind and downsize to a smaller breast size. The surgery that best accomplishes this will differ from person to person. Some women have enough residual breast tissue that simply removing the implants and scar capsule is all they need. Other women have experienced the effects of gravity and may have some natural drooping of the breast skin that occurs over time. The surgery in this case may involve removing the implant, the scar capsule, and performing some form of breast lift. Your Restore SD surgeon will discuss with you the safest way to achieve your desired look. In certain circumstances, everything can be done at once while other circumstances may dictate that the safest approach requires two separate surgeries spaced by 4-6 months.
Breast implant revision surgery is performed in the outpatient setting in an accredited ambulatory surgery center. There are many complex variables regarding revision breast surgery. If possible, we will use your previous breast surgery incisions. The surgery can take from 1 -3 hours depending on the severity of the case. Your Restore SD surgeon will tailor the approach to your individual circumstances and goals. Once your surgery is over you will be placed in a post operative compression bra.
After surgery is completed you will be able to go home with a responsible adult. Ideally, this loved-one or friend will be able to stay with you during the first few days of recovery. Some postoperative surgical pain is expected and you will be prescribed pain medication to help ensure a comfortable recovery. Initially the area around the nipple and most of the breast skin is numb but sensation returns over the next few months. Most women can return to work after 2 weeks. Normal daily activities like showering, eating and light activity such as walking can be resumed within 24 hours after surgery. Some postoperative swelling is normal and generally resolves within the first 4 weeks after surgery. You should refrain from intense physical activity for 4 weeks. During the recovery period, you will have follow-up with your Restore SD surgeon and will be guided back to your usual activities. Most complications occur from getting too active too early, so select a surgical date that allows an appropriate amount of time to heal and gradually return to your more vigorous activities.
The Combined Procedures
Revision breast surgery can be performed as a stand-alone procedure or can be combined with abdominoplasty, liposuction, or certain facial rejuvenation procedures. Your Restore SD surgeon will partner with you to develop an effective plan designed to optimize your results, recovery, and safety.
- What happens at my breast implant revision consultation?
When you arrive at Restore SD Plastic Surgery to discuss breast implant revision surgery, your Restore SD surgeon will perform a detailed examination as well as review your medical history and any medications you are taking. If you are over 40 years of age or have a strong family history of breast cancer a recent mammogram will be requested. At your consultation, you will have photos taken with our Vectra 3D imaging system and discuss treatment areas and options while viewing your photos series. With our state of the art Canfield software, potential surgical results can be viewed and adjustments can be made, helping you to visualize possible outcomes.
- Why should I choose Restore SD Plastic Surgery for my breast implant revision surgery?
The surgeons at Restore SD Plastic Surgery have over a decade of experience with cosmetic and reconstructive surgery. Drs. Douglas and Gallus are both board certified by the American Board of Plastic Surgeons and active members of the American Society of Plastic Surgeons and the American Society for Aesthetic Plastic Surgery. In addition to being fully credentialed, we take the time to listen to your goals and partner with you to develop the best and safest surgical plan that will optimize your results and leave you looking and feeling your best.
- Why is breast implant revision surgery for me?
Revision breast surgery is a uniquely individual decision. Maybe you are unhappy with the results of your previous breast enhancement surgery or maybe gravity has been at work and your prior surgery needs a little tune up. Revision breast surgery can yield dramatic and durable results that will keep you looking good for years to come!
- How do I choose a surgeon?
It is important to ask if your surgeon is Board Certified by the American Board of Plastic Surgery. As Board Certified plastic surgeons at Restore SD, we have years of training and expertise in revision breast surgery that cannot be imitated by short courses and alternative certifications. Ensure that your surgeon is proficient in revision breast surgery and capable of handling any complications that may arise. The American Board of Plastic Surgery is one of 23 members of the American Board of Medical Specialties. These specialties represent the traditional core of fully trained specialists. Alternative boards have cropped up over the last several years to lend legitimacy to incompletely trained or poorly trained practitioners. Accept nothing less than a surgeon certified by the American Board of Plastic Surgery and who is a member of the American Society of Plastic Surgeons (ASPS) and the American Society for Aesthetic Plastic Surgery (ASAPS).
- How much time off work should I take after breast implant revision surgery?
Depending on your profession, you should expect to take 1-2 weeks off from work. You will not be able to lift anything heavier than 10 lbs. or perform strenuous activities for 2 weeks following surgery. Patients cannot drive while taking narcotic pain medication and should plan to have a friend or family member drive them to and from appointments during the early recovery period.
- How do I minimize post-operative scarring after breast implant revision surgery?
Unfortunately, scarless surgery does not yet exist. Your Restore SD surgeons will educate you about scar management postoperatively. A surgical scar will take 9-12 months to fully mature. Your scar will go through changes during the healing process and your Restore SD team will help you manage this part of your recovery. This can consist of sun avoidance, scar massage, scar cream, and fractionated laser treatments.
- What should I do to prepare for breast implant revision surgery?
If you have close friends or relatives who have had breast surgery – start there! A personal story of their journey may guide you to questions to ask your surgeon, and having someone with a shared experience is invaluable. Educate yourself by reading our procedure page and viewing our educational videos. Other sources of information include RealSelf and WebMD. Remember to wear a button down front opening shirt on the day of surgery so that your post-operative experience does not include wrestling a shirt over your head!
- I am a smoker – can I have a breast implant revision surgery?
At Restore SD Plastic surgery, we pride ourselves in delivering safe, consistent, and reproducible results. Smoking tobacco or using any nicotine products has adverse effects on wound healing. Your risk of tissue or nipple loss, infection, and prolonged incision healing are much higher if you use nicotine. We recommend a nicotine free period of 8 weeks prior to surgery and at a minimum 4 weeks post operatively. We have a simple urinary nicotine test that we complete in the office to help you on your journey to a safe and gratifying surgical experience with us.
- I have Diabetes – what do I need to know about having breast implant revision surgery?
If you have diabetes it is important to work with your medical team to maintain an ideal HbA1C. Diabetes can increase your risk for prolonged wound healing and certain types of infections. Surgery can be safely performed but requires a coordinated effort from patients, surgeons, and medical doctors to attain outstanding results. There are some instances where your Restore SD surgeon may want to postpone surgery until your diabetes is under better control.
- How soon can I travel after having breast implant revision surgery?
Having surgery means a commitment to an appropriate recovery. We recommend scheduling your surgery at a time that allows enough time to recover and gradually return to your normal activities. Flying, driving long distances, or leaving the immediate area are not recommended until you have been cleared by your surgeon. If you have specific travel needs or require advice for emergency travel soon after a procedure, please let us know and we will be glad to discuss the details with you.
- Will I need drains?
Maybe. Advances in techniques over the last few years now allow many patients to enjoy a drain-free recovery. Each surgery is unique and your Restore SD surgeon wants the best and safest outcome for you. We try our very best to do this surgery without drains, but don’t hesitate to use them if it is the best and safest course of action to optimize your result and safety. If liposuction or the use of an acellular dermal matrix is part of your breast revision procedure, then drains are more likely to be used.
- What about liposuction at the same time as breast implant revision surgery?
Liposuction and revision breast surgery are frequently done together to complement the results. Fat grafting may be part of your revision breast surgery to smooth and refine the results. We utilize the SAFELipo™ technique that maximizes results and safety. The sides of the chest, hips, flanks, and thighs are the most common areas treated at the same time as breast revision surgery.