Breast implant revision surgery, which commonly involves removal and/or replacement of saline or silicone breast implants, is performed to change the size or type of your implants and to correct any complications from your primary breast augmentation. The overall goal is to restore a youthful breast contour and appearance.

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

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.

How is a breast revision procedure performed?

The exact procedure your surgeon will use for breast implant removal and replacement varies depending on the reason for your breast revision.

Change in implant size: If you decide to change your implant size, your surgeon will frequently use your original incision for implant removal and replacement. If you want a larger implant, your doctor will surgically enlarge the "pocket," or space in the breast, surrounding your implant to accommodate a larger implant. If you want smaller implants, you doctor may surgically reduce the size of the pocket with sutures to properly fit smaller sized implants. A breast lift may be done at the same time.

Capsular contracture (hardening of the capsule and implant): Your doctor will probably use the same incision used to insert the original implants to remove the hardened capsule and implant. He or she will then insert a new implant.

Implant rippling: When the edges of saline breast implants are visible and palpable (able to be felt), your surgeon may use the same incision to remove or reposition the implants as was used to originally insert them. Other options include using a different type of implant or placing the new implant into a different breast pocket that either has thicker muscle coverage or uses other tissues to cover the implant edge.

Implant malposition: Sometimes implant pockets are created too far apart or too close together, resulting in poorly positioned breasts. To correct this, using the prior incision, your surgeon will manipulate the scar tissue from the capsule surrounding the implant and reconstruct the pocket in the appropriate position using suturing techniques. Your surgeon may need to utilize other tissues to reinforce this new implant pocket and may recommend using an acellular dermal matrix product to add additional support.

Implant removal: If your implants are large and your skin has stretched, your surgeon may recommend a breast lift in addition to implant removal, but implant removal alone may suffice. The original incision created to insert the implant will almost always be the same one used to remove it. The lining around the implant, or "capsule," is often surgically removed at the same time to facilitate rapid healing.

Elevation of nipple and areola position: If it is necessary to elevate the position of your nipples and areolas (pigmented skin surrounding the nipples), you will need additional incisions. Incisions around the upper portion of the areola will be adequate in cases where not much elevation is needed. When more lifting and tightening is necessary, an incision all the way around the areola, including a vertical scar extending down from the areola to the crease under the breast, may be necessary. For cases where significant excess skin needs to be removed (such as in women who have had massive weight loss), a third incision may be necessary that will extend horizontally beneath the breast, following the natural curve of the breast crease. If your nipples need lifting, the nipples and areolas remain attached to underlying mounds of tissue and this usually allows for the preservation of sensation and the ability to breast-feed.

The goal of your aesthetic plastic surgeon and the entire staff is to help you achieve the most beautiful and natural-looking results, as well as making your surgical experience as easy and comfortable as possible.

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