Breast augmentation isn’t a perfect science, and there are times when a patient desires implant revision surgery. Whether she decided she would simply like larger implants or whether there has been some other issue, revision surgery is generally easier than the original surgery. This is because in most cases the incisions can be made on the same spot as the original incisions.
Here are some reasons Dr. Low and Dr. Cheung perform revision surgery, and the approach taken for each.
Besides possible rupturing of the implant, this is the main side effect of breast augmentation. When an implant is placed into the body, there is a reaction, as you would assume. This reaction is called the “capsule” and it is made up of calcified cells and scar tissue. If this capsule becomes very thick and causes the implant to shift or the breast to feel very firm, or if there is pain from the constricting scar tissue, this is called capsular contracture. When this occurs, surgery is required. If the capsule is very calcified, Dr. Low or Dr. Cheung will remove it along with the implant. If that hasn’t happened, we may leave the capsule. If there is a rupture of a silicone implant, the capsule may contain silicone shell fragments, silicone gel, and inflammatory cells that all need to be removed prior to placing new implants.
Changing the implant size
Sometimes a woman decides she would like a different size implant. This isn’t a decision that should be made soon after surgery, however. We advise patients to wait one full year before deciding to make a change. This will allow the implants to fully settle into their final position, and any residual swelling will have passed by then. If the patient still wants to change her implant size, Dr. Low or Dr. Cheung will enter through the original incision, if possible. If a larger implant is desired, we will increase the size of the pocket, the space in the breast to hold the implant. If the patient seeks smaller implants, the size of the pocket is reduced with sutures to fit the smaller implants. In cases of reduction, a breast lift may need to be done in conjunction with the implant revision to remove any sagging tissue and possibly relocate the nipples.
Sometimes a less experienced surgeon will place the implant pockets either too far away or too close together and the patient doesn’t like the look. In these cases, the scar tissue from the capsule can be used to reconstruct new pockets in better positions.
Implant rippling is usually a result of saline implants that have been placed atop the chest muscle. There isn’t enough skin and tissue to cover the implant, and rippling occurs. Sometimes the edge of the implant may even be able to be felt. To correct this problem, we enter through the original incisions and replace the implants with better muscle coverage. This may involve switching implant types and/or placing them in new breast pockets. Saline gel implants have less occurrence of rippling.
When a patient decides she no longer wants to have her implants, they are removed through the same incisions. We will also remove the capsule if it is calcified and thick. In most cases, we will recommend a breast lift at the same time to remove excess sagging skin and breast tissue that were created with the larger breasts when they had implants.
Breast augmentation is major surgery. It’s not something to trust to a low-ball estimate or an inexperienced practitioner. Dr. Low and Dr. Cheung are both board-certified plastic surgeons with extensive experience. Do your research beforehand and the odds are you’ll be happy with your results.