The Surgeon Minute

Life Happens and So Does Revision Breast Surgery

Life Happens and So Does Revision Breast Surgery

Breast augmentation surgery has come along way from the days of simply being a “boob job”. Surgeons and medical scientists have coupled engineering, science, and experience-based knowledge to make breast surgery the best it has ever been, yet revision rates in breast surgery are still high.

Dr. Michael Edwards, a plastic surgeon from Las Vegas and current president of the American Society for Aesthetic Plastic Surgeons, is no stranger to utilizing modern surgical tools and breast implant devices. Even so, he acknowledges that despite intense planning and great initial results, variables change during the course of a patient’s life that can cause them to become unhappy with their results. “We always hope that someone having had a breast surgery is happy with their results and that they last a long time,” he says. “Unfortunately, that doesn’t always occur in spite of our best planning.”

By Michael Edwards, MD, FACS
and Adam McMillon
The Plastic Surgery Channel

What can go wrong?

Life goes on after breast surgery and so does all that life brings with it! As patients live through life changing events like multiple pregnancies, weight gain and loss or just general aging, they may experience changes to their breasts that require surgical revision. Breast revision surgery can be very complicated, after all, the first surgery always presents the most optimal surgical landscape for the surgeon to work with. However, new breast implant devices and materials give surgeons options and tools they never had before, making the repair and rejuvenation of a breast easier and improved outcomes more predictable.

“There can be some implant malposition, or maybe the patient isn’t happy with their size, any number of reasons [why a patient might need revisional surgery],” explains Edwards. “And, once you’ve had breast surgery, your body goes through changes. Whether it’s multiple pregnancies, weight loss/gain. Implants aren’t made to be a life-long device, so there are many reasons why someone might have revisional surgery.”


New techniques and technologies

When revising a breast, finding a surgeon who is familiar and experienced with the new tools available in the market is critical to receiving the best care and end result. One of the most talked about tools is an “internal bra“. Having internal support of an implant in a patient with thin and stretchy tissue is a huge advantage in revision surgery.

In the past couple of years, there have been advances that have given us more tools to work with,” explains Edwards. “SERI Scaffold is a silk scaffold that can be placed in the breast pocket after the repair is done to support the implant. More and more surgeons are getting more creative and looking at these techniques to support the breast, especially in somebody like a massive weight loss patient whose tissues have really been damaged by being so stretched.”


In addition to these engineered materials, more implant options are providing even more refinement when it comes to breast augmentation planning. “New implant lines are coming out as they are FDA are approved,” says Edwards. “Inspira by Allergan is a new implant that is overfilled, which I think will be a great tool for someone with thin coverage.”

Patient education is always paramount

The best breast revision surgery will never be as good as the first surgery even with today’s advances. Dr. Edwards emphasizes the need for both patients and surgeons to do their homework and communicate clearly as they make the initial operative plan and decisions that will shape their first breast augmentation result. Engaging in this process will lower the chances for disappointment and dramatically increase the satisfaction rate and number of happy patients!

“We try to educate patients – especially when we see them for their primary surgery – to do their homework,” says Edwards. “Patients need to go where they feel comfortable and feel like someone is going to take good care of them. As I say, “You get one chance to have your first breast surgery.” Picking the right sized implant, the position of the implant, where the incision should be… The patient should be involved in the decision.”

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