The Surgeon Minute

With Breast Surgery, ‘Revision’ Isn’t a Dirty Word

With Breast Surgery, ‘Revision’ Isn’t a Dirty Word

You name the breast surgery patient and you’ll probably hear a different reason she wants her augmentation changed, or ‘revised.’ That being said, there are a few commonalities among women wanting to change.

The goal of breast implant revision surgery is to either replace old breast implants with new implants or correct problems that have arisen since the initial augmentation procedure. Often the goal is to change or improve the appearance of a woman’s breasts while updating the implant material, which could include:

  • A concurrent breast lift or reduction
  • Reshaping the implant pocket in order to position the implant on a different place on the chest
  • Either making them bigger or smaller, or changing the shape or style of the implant

The desire to have breast implant revision surgery can be because of any of the following reasons:

  • Size change desire
  • Complications and/or pain from capsular contracture
  • Concern about rupture or migration of implant
  • Change from saline to silicone or different style of implant

Board certified plastic surgeon Dr. Theo Nyame of Charlotte Plastic Surgery breaks down why patients require revision procedures and their options when the time comes.

Modern Implants Can Last a Lifetime, but Perhaps Not Their Placement

Modern breast implants are the most studied medical device in history. Technological improvements have made them so durable that they can last for a patient’s entire life. The problem, however, is a patient’s body. How it reacts and changes to implants can, and almost certainly will, require a breast augmentation to be revised at some point in a patient’s life. Bodily changes can alter shape and size, and the overlying breast tissue can also change, creating an appearance or feel to the breast that is less desirable than the original result.

Also, many breast implants have a lifetime warranty on the actual implant device, but after ten years the costs associated with having surgery to replace the implants are no longer covered. Because of this, many women will elect to replace or update their breast implants at or around the 10-year time frame.

Breast implant revision surgery is not a standard or routine procedure and needs to be tailored specifically to the patient’s goals and desires. Therefore, this surgery should be performed by a board certified plastic surgeon who is well-trained and experienced in all types of breast surgery and who will listen to the patient’s goals and desires and will develop a surgical plan specifically to address all of the issues at the time of surgery.

“A lot of patients who have had implants for quite some time may notice changes over years and decades,” says Dr. Nyame. “As the different devices that we’ve had to use have evolved, we start to see some of the shortcomings of the older devices. For example, some of the older devices have a high rate of something we call capsular contracture, where the actual implant may develop a capsule that tightens around that implant. That can actually distort the shape of the breast into a very unnatural appearance.”

Capsular contracture causing breast revision.

With Time Comes Improvements and Needed Changes

“We see a number of different changes,” Dr. Nyame tells The Plastic Surgery Channel. “Capsular contracture is one. Capsular patients get something called rippling. For example, some of the earlier saline implants used to cause rippling where you can actually see the indentations. New, more cohesive gel implants have allowed us to address this and we can get remarkable results with the newer implants out there.”

Rippling from older implants.

“I think revision breast surgery is an exciting part of plastic surgery,” says Nyame. “One of the great things about plastic surgery is that no one problem only has one solution. And with revision breast surgery, you get a chance to assess where the changes are happening and design an operation that are very unique and most of them yield a very satisfying solution.”

Breast Revision Surgery is a Rewarding Challenge

“Revision breast surgery can be very challenging, but that’s one of the things I appreciate about it,” Dr. Nyame continues. “It gives you the opportunity to use your creativity and expertise as a plastic surgeon to develop the operative plan to address all the issues that you may see.”

Breast revision results - Dr. Nyame.

As with any other type of plastic surgery, it’s best to check ahead of time to find out how experienced a surgeon is. Specifically for procedures like breast revision, it’s important to identify and select a surgeon who routinely performs these types of procedures. It takes a talented and experienced hand to turn worsening augmentation symptoms and/or the need for implant replacement back into beautiful results.

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