Unfortunately, the revision rate for breast augmentation remains quite high. This rate could be lowered substantially by choosing the right surgeon for your primary breast augmentation, but that is another article! At Hankins and Sohn Plastic Surgery Associates in Henderson and Las Vegas, Nevada, our revision rates for our primary augmentation patients are well below 3% over a five year period. However, we have performed hundreds of revision breast augmentation procedures for patients from all over the United States as well as other countries. Some of the more common reasons for revision augmentation include desire for a different size implant, desire for a change in implant type, e.g changing from saline to silicone, desire for change in shape, especially the desire for “more cleavage”, and capsular contracture, or hardening of the breast due to scar tissue.
Regardless of the reasons a woman desires a revision breast augmentation, it is crucial to take a systematic approach to the procedure, from the consultation with your revisionary surgeon to the post-op care. At Hankins and Sohn Plastic Surgery Associates, Dr. Hankins and Dr. Sohn take these revisionary procedures very seriously, and you should as well. First, it is extremely important for you and your revisionary surgeon to be on the same wavelength regarding the changes you desire. It is all too common for a woman to focus on only one aspect of the revisionary surgery and forget to convey to the surgeon the other things that she would like to change about her breasts. For example, a woman might desire to change from saline to silicone implants to get a more natural feel, but she may fail to mention to the surgeon that her breasts fall to the side when she lays down, or that her breasts have never been symmetric since her first surgery. The revisionary surgery may then fall short of the patient’s expectations due to lack of communication of the woman’s desires. Although this communication is also extremely important for primary augmentation patients as well, it becomes especially crucial for revision augmentation patients.
At Hankins and Sohn Plastic Surgery Associates, we start the revision augmentation consultation by having our patients list all of the things they like about their breasts, as well as the things they would like to see changed about their breasts. This list then serves as a preliminary template for the rest of the consultation, and ultimately, for the revision breast surgery. This important step improves the communication between our surgeons and our patients and invariably results in realistic expectations and satisfaction for both patient and surgeon with regard to the outcome of the revisionary surgery. Often listing the “pros and cons” of the current breast augmentation helps patients to understand that some goals for their revisionary procedure may not be compatible with each other, or that certain goals might not be attainable given the limitations of either their anatomy of their previous surgery. Through this discussion pre-operatively, we (surgeon and patient) are able to head into surgery with a clear and realistic plan for the desired outcome.
Dr. Hankins and Dr. Sohn have performed hundreds of revision breast augmentations, and through this experience, have learned that some of the most common reasons for breast augmentation are inadequate communication between patients and their surgeons about the goals of the primary breast augmentation. Therefore, it is crucial to not repeat this with the revisionary surgery. Each operation on your breast carries risk and should be approached with the utmost care and forethought. It is extremely vexing to see patients who have been treated by surgeons who have not taken the time to listen to the patient’s desires, thus resulting in numerous operations, each of which is more difficult than the last. Even celebrities fall victim to this approach and one only has to remember Michael Jackson’s nose after multiple operations by supposedly “celebrity plastic surgeons” to see the outcome of multiple poorly planned operations. At Hankins and Sohn Plastic Surgery Associates, we consider your health and well-being of the utmost importance, as well as your desires – you can expect honest answers and advice as we discuss your desires for your revisionary breast augmentation.
One of the primary reasons for breast augmentation revision is a desire for change in the shape or size of the breast. This can sometimes be as simple as changing the implant size, or possibly changing the implant from saline to silicone. However, Dr. Hankins and Dr. Sohn have found that through the pre-operative discussion process, it is quite often discovered that the patient’s goals might not be achieved by a change in size alone. For example, placing a larger implant for “more cleavage” without sutures to help support the implant (called capsulorraphy sutures) may result in only a larger, “saggier” breast, with very little added upper pole fullness.
Another reason for revision breast augmentation can be the development of capsular contracture. This has been one of the most frustrating complications of breast augmentation surgery, for both patients and their surgeons. Through Dr. Hankins’ participation as a LEAD member of the Mentor Advisory Board, he is able to share ideas and strategies for this complex problem with some of the busiest breast surgeons in the country. This combined vast experience enables our practice to utilize the most cutting edge techniques to deal with this complex problem. We have been getting excellent results in even the most recalcitrant, or recurrent, contracture patients through the use of dermal matrices, both human and porcine, and are especially excited about this newfound ability to treat this complex problem.
The laterally displaced implant can in most cases be avoided by careful pocket dissection at the time of the primary breast augmentation. However, this is unfortunately another common reason that patients desire revision breast augmentation. The implant that “disappears into my armpit when I lay down” can be treated very effectively with lateral capsulorraphy sutures, and we have been able to achieve long lasting results with this technique, finally giving this group of patients the outcome they desire.
In summary, revision breast augmentation can be a challenging procedure for both patients and surgeons. At Hankins and Sohn Plastic Surgery Associates, you can rest assured that we have both the experience and the technical expertise to deal with even the most difficult cases and we take pride in finally giving hundreds of revision breast augmentation patients the breasts “they had always imagined”.