Breast revision surgery is a cosmetic procedure intended to correct for breast irregularities or imperfections that negatively impact the self-esteem of a woman after breast augmentation surgery. Unfortunately, for some women, breast augmentation outcomes may be less than optimal, leaving their breasts with unnatural rippling, soft tissue restrictions, or breast asymmetry. For women who are unhappy with their breast surgery outcomes, the surgeons at Ennis Plastic Surgery  can offer hope for a more beautiful breast shape even after unexpected outcomes.

Breast augmentation surgery is a complex procedure that requires excellent attention to detail, taking into consideration the anatomical presentation and desired outcomes of each client. Too often, inexperienced surgeons lack attention to detail when it comes to surgical technique and patient expectations, leaving some patients dissatisfied with their breast surgery. Fortunately, breast revision procedures are offered that may help with patient dissatisfaction. The first and most important step to optimal correction is understanding the problem and why the problem exists. At Ennis Plastic Surgery, our cosmetic surgeon has years of advanced training and experience to properly identify and correct for surgical issues.

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To learn about breast revision, please read the guide below or contact Ennis Plastic Surgery at 561-405-9020 to book a consultation or ask us a question. We are here to help you get the look you desire.

Capsular contracture

Capsular contraction is a condition in which thickened scar tissue forms around the implant, making the implant feel hard and round. The implant itself does not change, but the scar tissue around the implant forms in such a way that it contracts and squeezes the implant. The squeezed implant can be seen visually and lacks natural movement and feel hard. There is a much lower rate of capsular contracture when the implant is placed below the chest muscle, as opposed to over the chest muscle. For this reason, breast revision due to capsular contracture is performed with a submuscular (beneath the chest muscle) positioning. Typically, the implants are much more natural in appearance and mammograms are much better when the implant is behind the muscle.

Rippling

Rippling happens when the shell of the implant can be easily seen and felt under the skin. This commonly occurs in patients who have a small amount of natural breast tissue and when the saline implant is placed in a subglandular manner (above the chest muscle and under the breast tissue). Revision typically involves removing the existing implant and replacing it with a silicone implant, oftentimes positioning it beneath the chest muscle.

Bottoming Out

Bottoming out (also termed “double bubble”) is a condition in which the implant drops too low in the breast. The implant can drop behind the natural breast fold, rather than sitting forward in the breast. In this situation, women complain that their nipple is too high, because the distance between the nipple and bottom of the breast is too long. Surgical correction is performed with a small incision under the breast. Sutures are placed along the bottom fold to tighten the lower aspect of the breast and reposition the implant, re-centering the nipple over the implant. In more complex cases, soft tissue slings may be needed to help support the implant.

Asymmetry

Asymmetry may be related to size or orientation of the breast implant. In some cases, the implants may have been positioned improperly or settled into unequal positions. The natural breasts of most women differ in size, and if this is not accounted for, the breasts may present with different sizes after breast augmentation surgery. Depending on the type of asymmetry, the surgeon will address positioning or may change the implant for a different size.

Ruptured Implants

Deflation with saline implants is typically very obvious as the volume is lost rapidly over 1-2 days. The saline is harmlessly absorbed by the body, but the implant should be replaced within a couple of weeks to prevent the implant pocket from shrinking. When a silicone implant ruptures, it is much harder to detect. Imaging with an MRI may be required to determine if in fact it has ruptured. In either case, replacement of the ruptured implant is necessary.

Implant Exchange

Another common complaint is dissatisfaction with the size of an implant. Most women wish to exchange their implants for a larger implant size, though not always. For this reason, it is important to spend a considerable amount of time analyzing and discussing your desired outcomes and your expectations. This way, you can properly choose the appropriate implant size.

Breast Revision? Q&A with Dr. Ennis

Breast Revision Surgical Procedure

What to Expect During Breast Revision

Depending on the extent of revision to be performed, the length of the breast surgery can vary greatly. The patient is usually placed under anesthesia to ensure comfort and safety. Most breast revision procedures take 1-2 hours for completion. After the surgeon completes the breast revision, the surgical incisions are closed and the incision covered in a surgical bandage for healing. Depending on the procedure that was performed, different types of garments will be used post-operatively.  Patients can expect to have some swelling in the area, which decreases rapidly over the following weeks. There will be some surgical pain, which can be controlled with medications.

After breast revision, heaving lifting should be avoided for 4-6 weeks. Patients are allowed to return to most of their normal daily tasks within one week. The recovery is much the same as after having the initial breast augmentation procedure.

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