Breast Revision

breastscoveringBreast augmentation is one of the most popular procedures for women in the United States and abroad. Unfortunately, the revision rate after primary breast augmentation can remain quite high. Achieving the desired result is often dependent upon choosing a highly qualified and experienced plastic surgeon for your original operation. If you do suffer from problems related to your breast surgery performed by another physician, Dr. Hankins and Dr. Sohn may be able to help. At Hankins & Sohn Plastic Surgery Associates, we have performed hundreds of revision breast augmentation procedures for patients from all over the United States and internationally.

There are many different reasons why patients come to us for their breast revision procedure. Examples of motives include experiencing capsular contracture (a condition in which the scar tissue around a breast implant hardens), bottoming out, implant rupture, or lateral displacement of implants, as well as an interest in implant exchange or the desire to increase or decrease the implant size. Regardless of the reason or need for your breast revision surgery, we will customize a treatment plan that best addresses your needs and goals.

For more information about breast revision surgery, or to schedule a complimentary consultation with Dr. Hankins or Dr. Sohn, please contact our office today.

Breast Revision Consultation

At our plastic surgery practice, we ask our patients to list all of the things they like about their breasts as well as the concerns they would like to see changed. 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 surgeon and patient, and typically results in realistic expectations and higher satisfaction with the outcome. Through this pre-operative discussion, we are able to head into surgery with a clearer and more attainable plan designed with your needs and goals in mind.

Candidates for Breast Revision

Capsular Contracture

One reason for revision breast augmentation can be the development of capsular contracture. Scar tissue that forms around the implant can, over time, become hard, visible, or painful. This has been one of the most frustrating complications of breast augmentation, for both patients and their surgeons. In general, placement of implants above the pectoralis (chest) muscle can result in a higher capsular contracture rate, and we see lower rates when implants are placed below the pectoralis muscle.

In certain instances, a capsulotomy or capsulectomy may need to be performed, which refers to the release of the scar tissue or the removal of the scar tissue, respectively. If a patient experiences a recurrence of capsular contracture, we have been getting excellent results through the use of dermal matrices, both human and porcine. We are especially excited about this newfound ability to treat this complex problem.

Bottoming Out of Implants

Gravity can affect all things, including your breast implants. Over time, the implants can stretch the breast skin and cause lowering of the breast fold, leading to a bottomed-out appearance. If you do not wear supportive bras on a frequent basis, this can worsen over time. This issue can be corrected using a technique that lifts and anchors the breasts in a higher position. By placing sutures into the breast capsule surrounding the implant, the surgeons can elevate the fold and reposition the implant. This will often improve your “cleavage” and help to reshape the breast as well.

Lateral Displacement of Implants

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 capsulorrhaphy sutures. These specialized sutures help to recreate the lateral demarcation of the breast, preventing sideways movement of the implants. We have been able to achieve long-lasting results with this technique, finally helping this group of patients obtain the outcome they desire.

Implant Rupture

Although the newest generation of silicone and saline breast implants have low rupture rates, implant leaks can still occur in rare cases. There are many different reasons for tears, and one of the most common is the fold-flaw. In this situation, the implant folds on itself repeatedly, which can lead to weakness at the fold point and eventually result in rupture. If you experience a rupture, you should replace the implant in the near future to reduce the amount of scar tissue or contracture that can occur. The scar tissue that may form from this event can make removal and replacement of the implant more difficult, and it also can be harder to recreate an aesthetically pleasing shape.

Desire to Increase or Decrease Implant Size

A desire to change implant volume is one of the most common reasons why patients consider breast revision surgery. Perhaps the size that was originally chosen is now too small, and you would like to go larger. We will consider your body size and shape and recommend the implant we believe can help achieve your cosmetic goals. There may also be an opportunity to exchange the implant type, most often from saline to the next generation of silicone cohesive-gel implants. These are often referred to as “gummy bear” breast implants due to their more solid, yet natural-looking and feeling consistency and shape.

The opposite can also be true, where there is a desire to change the implants to a smaller size. This is often accompanied by changes in lifestyle or age, in which the implants no longer fit with the body image a woman is trying to project. There may be secondary issues generated by the downsizing of implants, including skin laxity, and/or a need to internally tighten the pocket or capsule surrounding the implant to better fit the smaller implant. Our plastic surgeons are extensively trained in the latest techniques, and they will help you find an approach that can optimize your results.

Implant Removal

If the breast implants are removed or explanted, you may or may not require a breast lift to restore the appearance of the breasts, reduce breast droop, and address any skin laxity. This depends on individualized factors, including the size of the existing implants, texture and quality of your skin, and the amount of breast tissue that you had prior to the placement of the implants.

There are numerous factors to consider when determining whether a breast revision is right for you. To learn more about your options, or to schedule a complimentary consultation with Dr. Hankins or Dr. Sohn, please contact our practice today.