The Surgeon Minute

Breast Revision: Considering All Options

Breast Revision: Considering All Options

The need for revision after breast augmentation can be due to an implant failure, or it can come about as the result of time taking its toll on a body. As youthful skin loses elasticity, larger implants may begin to droop. As a result, many previously augmented women wish for a more youthful shape. If you had your breasts augmented fifteen or twenty years ago and are faced with the need for a revision, you have options.

New Jersey board certified plastic surgeon Dr. Caroline Glicksman begins the breast revision conversation with her patients by asking what they desire. “A lot of women may have gotten implants in their twenties or thirties, but the reasons and that same look that they once wanted then really isn’t there anymore,” says Dr. Glicksman.

by Anne Meyer
and Caroline Glicksman, MD

Revision of Saline Implants

Patients with saline implants have the option of deflating the implants during an office visit with their plastic surgeon before making further surgery planning decisions. “The ability to deflate a saline implant in the office, painlessly, allows the patient the chance to see what they really look like,” explains Glicksman. If a patient isn’t sure whether they want to have a lift done at the time the implant is removed, this deflation allows the patient to see how well the deflated tissues contract before the surgery is scheduled to remove the implant. If the skin does not shrink back to a pleasing shape before the time of explant surgery, the patient may opt to proceed with a breast lift or they may decide to have a smaller implant put in the place of the old implant.

Vectra 3D™ Imaging

After the saline implants have been deflated, Dr. Glicksman employs a useful in-office tool to aid the decision making process. The Vectra 3D Imaging system produces a three dimensional image of the patient’s breasts in the comfort of the consultation room. Simulations can then demonstrate their potential outcome with a breast lift (mastopexy), an augmentation, or a combination mastopexy augmentation procedure. Patients can compare side by side before and “after” results before going to the operating room. Dr. Glicksman believes that a better-educated patient will make better decisions about which procedure is right for them.

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Revision of Silicone Implants

Patients with silicone implants requiring a revision face a slightly different decision making process. “Sometimes we’ll do a staged process where we’ll do an explantation, allow the tissues to contract back, and again, bring them back if they want to do a smaller implant or a mastopexy,” says Glicksman. Vectra 3D is also useful for silicone revision patients, as it can also simulate what results would be if they choose to undergo a lift alone or a lift with a different sized implant.

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If you have your implants removed and decide you don’t want to proceed with a lift or a re-augmentation, you won’t be alone. Plastic surgeons from Los Angeles to New York are removing implants from the very same women they augmented fifteen or twenty years ago. Now, more than ever, there are options and tools to aid the decision making process for anyone who desires a revision to their breast, regardless of the reason why.

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