A minority of breast augmentations result in complications requiring surgical correction. Common problems include:
- Distortion or hardening of the implants from capsular contracture. (Contraction of the capsule of scar tissue around the implant, causes the implant to feel hard).
- Malposition (the implant moved, or was placed in the wrong position).
- Synmastia (the implants touch each other, creating a single breast mound).
- Rupture, leakage or deflation of the implant. Silicone leakage may cause lumps in the breasts or elsewhere.
- Thinning of the tissues over the implant, with visible bulges, ripples or wrinkling of the skin over the implant.
Some patients request revision of their breast implants because they want a size change or to correct changes in the breast from pregnancy.
Do I need my breast augmentation re-done?
If you have had breast augmentation (with or without a breast lift) and are unhappy with the size or appearance, or if you have problems with your implants such as hardening, pain or leakage, you probably need your breast augmentation revised.
There is no need to replace breast implants that are intact and otherwise satisfactory just because they are over 10 years old! However the FDA recommends that all women with silicone gel implants have an MRI to check that the implants are not leaking at 3 years post surgery, and every 2 years after that.
If there is an infection around the implant, or the implant has broken through the skin, it is generally safer to remove the implant(s), let the breast heal, and put a new implant in several months later.
What to expect
Usually a prior scar around the nipple, or under the breast can be re-used for a revision. Some limited revisions can be performed through an existing axillary (armpit) scar, but often a second incision is needed. Revision breast surgery is often longer and more complex than first time breast augmentation.
A general anesthetic is usually used, Revision breast augmentation is an outpatient procedure.
If the implant has moved too low or towards the side, there may be temporary dimples in the skin from stitches placed to hold the new implant in the correct position. The dimples usually disappear in four to six months. If you decide to reduce the size of your new implants you may need to choose whether to have your breasts lifted, or accept that the breast will sit a little lower on the chest wall.
After surgery you will have some discomfort. If the implant has been moved from above the muscles to beneath, or stitches have been placed to hold the implant in it’s new position, the pain may be worse and pain may occur upon moving the arms. I usually place On-Q™ or Accufuser™ catheters on each side, as well. These are very small tubes, about the size of an I.V. catheter, but longer, that pass a steady flow of local anesthetic into the area of surgery for the first three or four days. They significantly reduce the pain, and the amount of painkillers that you will need.
Typically there is not a great deal of bruising or swelling. You should be able to return to work in seven to ten days. However, you must avoid strenuous activity for four to six weeks.
If you are considering a revision or re-do of your breast augmentation in Orange County, please click here to contact Newport Beach Plastic Surgeon, Dr. Bailey, for a consultation.
Before and After Pictures
Click on the picture to see more breast revision photos.