Breast Revision Surgery/ Breast Redo Surgery: Part Two

Breast Revision Surgery or Breast Redo Surgery are operations done to fix, improve, and enhance the results after cosmetic breast surgery has already been done. Dr. Saunders specializes in cosmetic breast surgery, breast revision surgery, and breast redo surgery. Patients travel from many states to see Dr. Saunders. These include Delaware, Pennsylvania, New York, Maryland, and other states even much farther away. These educational writings on this topic are divided into three parts, described as follows. Part One describes general concepts. Part Two describes breast augmentation revision or breast redo augmentation. Part Three- A describes breast lift revision or mastopexy revision. Part Three-B describes breast augmentation and lift when both have been done.

Breast augmentation or breast enlargement is an operation with incredibly high satisfaction and results for many. Most recommend the operation without reservation because of the very high success rates. However, not everyone gets so lucky. Unfortunately, breast augmentation doesn’t always go as planned. Results can be less than expected and sometimes very disappointing.

It can take time to heal after breast augmentation. Breast augmentation settling or breast enlargement dropping takes time. Occasionally women just need patience to allow healing. See Dr. Saunders writing on breast augmentation settling. If healing has happened, and the breasts are still high, than breast augmentation revision or breast redo augmentation is needed. This means surgery to fix, improve, and enhance the results of the prior surgery.

Different things can go wrong after breast augmentation surgery, and this writing is going to cover three different things that can lead to the need for breast revision surgery. The first is excessive rippling or visibility of the breast implants, the second is “hardening of the implants” or capsular contracture, and finally the third is implants that have dropped too low and need raising.

1: Excessive rippling, feeling, or palpability of the breast implants

Rippling is seeing the breast implant more than is normal. Excessive palpability is feeling the implant more than is normal. Most women do not get these problems after breast augmentation surgery. However, it can occur from being placed on top of the muscle or from having very poor “soft tissue coverage.”

“Soft tissue coverage” is an important concept with breast surgery, breast augmentation revision, and breast redo augmentation. The tissue that hides the breast implants is called the soft tissue. It provides the coverage that covers the implant and makes it harder to see or feel. Poor coverage leads to a greater chance of seeing and feeling the implant. Good coverage hides it better. Placing the implant beneath the muscle is the greatest way to get the best “soft tissue coverage.”

Sometimes the rippling and feeling the implant comes from being on top of the muscle. This is a condition that can require placing the implants behind the muscle. The muscle will dramatically help with the situation. The space left behind on top of the muscle must be addressed. This can require a breast lift, staged operations, or other procedures to completely repair. The added cover of the muscle usually dramatically helps with a more normal feel and appearance to the breast.

Some women are surprised to find that rippling and feeling the implant to a “minor” degree is normal. In these situations nothing needs to be done. However, silicone implants can really help this problem, and this is an option.

Please see the educational writing on saline vs. silicone implants.

2: Hardening of the implants

“Hardening of the implants” is called capsular contracture. It really is not the implant hardening but the scar tissue around the breast implant. This scar tissue is also called the capsular, and hence the medical term is called capsular contracture.

The cause of capsular contracture is not know although subclinical infection is a possibility. Also, the location of implants above the muscle is another factor leading to the problem. Small degrees of hardening does not always require treatment but more hardening does.

Treatment is usually surgery. Complete capsulectomy gives the best results over lesser procedures like partial removal. Dr. Saunders strives to give the most thorough and most complete scar tissue removal possible to allow for the best results and the lowest chance of it’s recurrence. Most of the time the implants can be replaced after the scar removal. This allows for a single operation and recovery.

Recurrence of the scar tissue can occur and in this situation it is recommended that a staged procedure is done. Recurrence of capsular contracture can be a problem and can be concerning to patients with this condition. Stage one is complete removal of scar tissue and the breast implants. The second stage is replacement of the breast implants at a later operation. The staged procedure is believed to address possible subclinical infection that might be the cause of the recurrent scar tissue or capsular contracture. Dr. Saunders believes this is a key to better results with this condition.

3: Breast implants too low

When breast implants drop too low, the breast can get a very unnatural appearance. The nipples can look too high, and there is no fullness in the upper parts of the breast. Women might feel like they need a lift or that the implants have deflated. There are different terms for this problem- such as the implants have “come out of the pocket” or “bottoming out.”

Treatment is almost always surgery. Larger sizes can be an easy solution because it fills up the upper aspects of the breast, as the implant gets bigger. However, the added weight can sometimes lead to the problem worsening. Other surgery is directed at suturing the pocket up higher (capsulorrhaphy) and giving the breast a more natural appearance.

Breast redo augmentation or breast augmentation revision is surgery directed at fixing problems that can occur after cosmetic breast augmentation. Breast augmentation revision surgery can be complicated and require more than one stage or operation. Breast revision surgery cost varies depending on the exact operation required and treatment needed.

Dr. Saunders is a board certified plastic surgeon who practices exclusively cosmetic surgery. He is also specializes in breast revision surgery, breast redo surgery, breast augmentation revision, and breast redo augmentation. Please check out the breast revision surgery before and after photos on our web site. Also, please come in for a complimentary consultation to learn about your choices and options!