Breast Revision is any secondary breast procedure. It may involve correcting complications from a previous breast surgery or improving changes that have occurred over time. A breast revision may include removing and/or replacing the breast implant, removing excess scar tissue (capsulectomy), pocket exchange and/or breast lift (mastopexy).
There are many reasons why a woman may want to have additional surgery, or breast revision. Breast revision surgery may be an option when the outcome from breast cosmetic or reconstructive surgery does not meet patient expectations. Such outcomes can occur due to a complication or when surgical goals fail to achieve the desired result. These conditions range from something as straightforward as a ruptured implant to a complicated situation such as a healing problem or breast position asymmetry.
Breast implants may eventually fail (deflate or rupture) and patients may require one or more additionally procedures in their lifetime. Given that a Breast Revision is more difficult than a first time Breast Augmentation, it is very important to locate a Board-Certified Plastic Surgeon of the Face and Body, such as Dr. Juan Pablo Cervantes, who not only has significant experience but who specializes in this area.
Indications for Breast Revision
Breast revision surgery can be offered for problems that result from previous surgery. More than one of these problems may be present in any given patient. The following is not an exhaustive list but serves as a broad sampling of the types of breast problems that may result from previous surgery and respond to a corrective procedure.
- Ruptured implant
- Mal-positioned implant
- Visible implant wrinkles
- Wrong implant size
- “Bottoming out” (breast slides below nipple and nipple appears to high)
- Severe scarring
- Depressions and contour deformities
- Loss of tissue in a flap reconstruction
- Mal-position of a flap reconstruction
- Asymmetry due to radiation post-cancer treatment
Options and Techniques
Ruptured implant is treated by implant exchange.
Mal-positioned implant requires a modification of the capsule, or internal scar tissue, that surrounds the implant. If the implant is too tight and firm this may be accomplished by opening the capsule to relax it or removal of the entire capsule to permit the formation of a more relaxed one. If the implant is too low then a tightening of the capsule called a capsulorrhaphy can reposition the implant in a more elevated, pleasing position.
Visible implant wrinkles may be improved by a variety of maneuvers. These include conversion of implant type from saline to silicone, conversion of position from on top of the muscle to under the muscle, or implantation of material inside the space that will help conceal the wrinkles.
Wrong implant size can be improved by changing to a larger or smaller size provided the patient’s chest dimensions accommodate this change.
“Bottoming out” correction consists of the removal of excess skin from the breast crease and tightening the capsule if an implant is present.
Infection can cause any number of problems including loss of the implant or loss of the breast reconstruction. This situation calls for great care when a secondary attempt is made. Sometimes a salvage procedure can be performed that saves the augmentation or reconstruction and avoids another procedure at a much later time.
Severe scarring is treated using steroid injections, scar revision, or a type of scar release called z-plasty. Sometimes a combination of these modalities is used.
Depressions and contour deformities can be improved by fat grafting.
Loss of tissue after flap reconstruction can often be corrected by another flap reconstruction as a salvage procedure.
Mal-position of a flap reconstruction can be corrected by mobilization or freeing of the tissue and proper repositioning.
Asymmetry due to radiation may require any number of procedures. Among these are placement of breast implant for decreased size; z-plasty scar release for a tight, tethered lumpectomy scar, and symmetry procedures for the opposite breast such as breast reduction, breast lift, and breast augmentation.
Before you decide to have a breast revision surgery, think carefully about your expectations and make sure you discuss them with Dr. Juan Pablo Cervantes in your complimentary consultation at Plástica Tijuana Surgery.