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Revisions in Breast Implant Surgery

How Do We Rescue Your Breast?

As promised in previous blogs, we’ll review this challenging topic.

I would say revision breast implant surgery involves far more planning, better skill, and more of an artistic eye than even initial breast surgery. Patients often come to see me from around the world to tackle complicated cases which have caused them to have had in some instances multiple pervious surgeries. In effect, the initial issues and the anticipated management are too often underestimated and or taken for granted leading to additional failures.

First and foremost lets be clear on one thing- problems and problematic outcomes occur from many sources. First their is poorly planned surgery. If you don’t pick the right implant your going to end up with issues. An example of this would be to put too narrow of implants in a wider torso and then wonder why the breasts appear far apart? Next is poorly executed  surgery. An example of this would be to under or incompletely separate the pectoralis muscle leaving the implants pushed outward or upward. Also there is the poorly compliant patient who underestimates the subtle healing issues inside the tissues which require a period of time to settle predictably and injudiciously does not follow early post op instructions. Then there is human variability of healing and despite the best efforts of patient and surgeon, things just don’t heal ideally. Remember we are dealing with a unique area- implants placed bilaterally in a body in constant motion and asking it to heal predictably well in a bilateral setting essentially all the time- things are going to happen. It’s how you rescue these misguided events that I believe separate  plastic surgeons.

My evaluation looks at implant position, size and shape. I ask patients for their desired goals and map out a strategy. Sometimes the problem includes failure to recognize that a breast lift was really needed initially with the first surgery. Sometimes it was because the implant was placed over the muscle and has caused accelerated breast aging. Sometimes it is due to hard scar formation called capsular contracture . Sometimes it’s because these healing processes don’t happen symmetrically. Sometimes it’s because previous attempts at correction were ill conceived or incompletely addressed the problem. Read the next blog on dealing with capsular contracture, see the section on the web site with before and after photos, and read the patient testimonials.

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