Some women need to have adjustments made to their breasts or breast implants after their breast augmentation, breast lift, or breast reduction procedure. In some cases, revisionary breast surgery is performed in the first year after breast augmentation, but most revisions are performed years after the initial augmentation.
Breast Implant Exchange For Size
A woman may find that her original breast implant selection does not give the look and breast size she desired. In some, this decision is made in the first year after breast augmentation. In others, this decision may be in response to changes that have occurred to the breasts with time and aging. Some women decide to have their breast implants replaced with smaller implants, and some decide to have their breast implants replaced with larger implants. In addition, some women decide to change the implant type. For example, if a woman does not like the feel of a saline breast implant, she may have saline implants exchanged with softer, silicone gel implants. The exchange procedure is much easier to experience than the original breast augmentation. The old breast augmentation scar is used to access the implant, and the implant is simply removed and replaced with the desired type and size. The breast augmentation incision is then closed, just as it was originally.
Breast Implant Exchange For Implant Failure
Unfortunately, breast implants can break. To replace a broken breast implant, revisionary breast augmentation surgery is needed. The old augmentation scar is usually used, and the failed breast implant is simply removed and replaced with an identical implant.
Correction Of Breast Implant Position
In some cases, breast implants do not sit in an optimal position on the chest and under the breasts. In some cases, the breast implants are too high and in some the implants sit too low. Breast implant position changes can also usually be performed using the original augmentation scar.
Correction Of Capsular Contracture
Capsular contracture formation around breast implants can be bothersome to women and lead to the need for revisionary breast augmentation surgery. A capsular contracture is when the scar tissue around a breast implant thickens and contracts around the implant. This can lead to a firm breast implant and breast distortion. In some cases, capsular contractures are painful.
For advanced capsular contractures, surgery is needed to either incise the breast scar tissue (capsulotomy) or to remove the breast scar tissue completely (capsulectomy). The breast implant is then replaced. The existing augmentation scar can usually be used for this procedure. But, if an axillary breast augmentation scar is present, we would usually recommend another approach (and scar) to treat this problem.
Breast Augmentation Scar Revision
Overall, breast augmentation scars heal well and are generally well-accepted by patients. However, if a breast augmentation scar is particularly thick and wide, the scar can be removed. However, another scar will form, and there is no guarantee that a revised scar will be better than the original breast augmentation scar.
Correction Of Breast Ptosis
In some cases, revisionary breast surgery is needed to lift the breasts following breast augmentation. This may occur soon after breast augmentation in patients with excess breast skin and low nipple position that probably would have benefited from a breast lift during the original augmentation. In others, the breasts sag over time due to aging and possibly from the size and weight of the breast implants. In such cases, revisionary surgery in the form of a breast lift, or mastopexy, is needed.
Removal Of Undesired Breast Implants
Though rare, some women elect to have their breast implants removed and not replaced. The implants are removed using the original breast augmentation scar. The appearance of the breasts after breast implant removal is variable, depending on the amount and elasticity of the remaining breast skin. In some cases, a breast lift will be needed, following breast implant removal.
Revision Of The Breast Lift For Recurrent Sagging
Revisionary breast lift surgery typically involves re-lifting, or re-tightening of the breasts. One of the drawbacks to mastopexy surgery is that the breasts often stretch and sag again after original breast lift surgery. This can occur in the first 6-12 months or years later. Though the sagging is rarely as severe as the pre-mastopexy ptosis of the breasts, it can be bothersome enough to warrant revisionary surgery. If this occurs, then revision of the breast lift may help.
Breast lift revision is typically done by using the existing scars and essentially repeating the original breast lifting technique. In some cases, less extensive surgery is needed and only a portion of the old breast lift scar is used.
Breast Reduction Revision
In some cases, following breast reduction, adjustments in the skin may be needed as the breast tissues stretch and settle over time. Or, if significant asymmetries in breast shape or areolar position are present additional breast surgery may be helpful. Such revisions usually involve using the old breast reduction scars to open the tissues and to tailor and reposition the breast skin. In some cases, mild size differences between the breasts warrant additional breast surgery. Sometimes, mild volume adjustments can be made with breast liposuction only.
Scar Revision After Breast Lift
The scars created from a mastopexy and reduction are significant. Though these scars typically heal well and are tolerated by most patients, on occasion the scars may thicken and warrant revision. With a scar revision, the old breast scars are removed and the incisions are closed as they were originally. There is no guarantee that a scar revision will lead to improved scars, as new breast scars can be as poor, or worse, than the original scar.