Also known as breast implant replacement
Breast implant revision surgery, which commonly involves removal and/or replacement of saline or silicone breast implants, is performed to change the size or type of your implants and to correct any complications from your primary breast augmentation. The overall goal is to restore a youthful breast contour and appearance.
These are the top three pros and cons to weigh when considering breast revision. If you wish to focus on what is unique to you, please consult with your aesthetic plastic surgeon.
Are you a good candidate for breast revision?
Even if your breast implant surgery was perfectly planned and beautifully executed, changes can occur over time.
The following are some common reasons why you may want to consider breast revision:
If you are in good general health, have a positive attitude and realistic expectations, you are most likely a good candidate for this procedure.
The exact procedure your surgeon will use for breast implant removal and replacement varies depending on the reason for your breast revision.
Change in implant size: If you decide to change your implant size, your surgeon will frequently use your original incision for implant removal and replacement. If you want a larger implant, your doctor will surgically enlarge the "pocket," or space in the breast, surrounding your implant to accommodate a larger implant. If you want smaller implants, you doctor may surgically reduce the size of the pocket with sutures to properly fit smaller sized implants. A breast lift may be done at the same time.
Capsular contracture (hardening of the capsule and implant): Your doctor will probably use the same incision used to insert the original implants to remove the hardened capsule and implant. He or she will then insert a new implant.
Implant rippling: When the edges of saline breast implants are visible and palpable (able to be felt), your surgeon may use the same incision to remove or reposition the implants as was used to originally insert them. Other options include using a different type of implant or placing the new implant into a different breast pocket that either has thicker muscle coverage or uses other tissues to cover the implant edge.
Implant malposition: Sometimes implant pockets are created too far apart or too close together, resulting in poorly positioned breasts. To correct this, using the prior incision, your surgeon will manipulate the scar tissue from the capsule surrounding the implant and reconstruct the pocket in the appropriate position using suturing techniques. Your surgeon may need to utilize other tissues to reinforce this new implant pocket and may recommend using an acellular dermal matrix product to add additional support.
Implant removal: If your implants are large and your skin has stretched, your surgeon may recommend a breast lift in addition to implant removal, but implant removal alone may suffice. The original incision created to insert the implant will almost always be the same one used to remove it. The lining around the implant, or "capsule," is often surgically removed at the same time to facilitate rapid healing.
Elevation of nipple and areola position: If it is necessary to elevate the position of your nipples and areolas (pigmented skin surrounding the nipples), you will need additional incisions. Incisions around the upper portion of the areola will be adequate in cases where not much elevation is needed. When more lifting and tightening is necessary, an incision all the way around the areola, including a vertical scar extending down from the areola to the crease under the breast, may be necessary. For cases where significant excess skin needs to be removed (such as in women who have had massive weight loss), a third incision may be necessary that will extend horizontally beneath the breast, following the natural curve of the breast crease. If your nipples need lifting, the nipples and areolas remain attached to underlying mounds of tissue and this usually allows for the preservation of sensation and the ability to breast-feed.
The goal of your aesthetic plastic surgeon and the entire staff is to help you achieve the most beautiful and natural-looking results, as well as making your surgical experience as easy and comfortable as possible.
Good communication with your plastic surgeon is the key to achieving the results you want. It is your job to clearly state your aesthetic goals so your surgeon can suggest the right options. During your consultation, you and your surgeon will resolve these issues:
The original incision used to insert the implant is almost always the same one used to remove it; however, if you undergo a breast lift, elevating the position of your nipple and areola will result in breast lift scars (see How is breast revision performed?).
It's important to choose your surgeon based on:
Members of the American Society for Aesthetic Plastic Surgery are experienced and qualified to perform your aesthetic procedure. Learn how to select a surgeon.
After finding a board-certified plastic surgeon in your area that is experienced in performing breast revision, you will need to make an office appointment to set up your consultation. Generally, because of the in-depth nature of the consultation, there is a cost associated with the initial visit.
During your initial consultation, you will have the opportunity to discuss your cosmetic goals. Your surgeon will evaluate you as a candidate for breast revision and clarify what a breast revision can do for you. Once your surgeon understands your goals and medical condition, both alternative and additional treatments may be considered (see related procedures).
Your plastic surgeon will examine, measure and photograph your breasts for your medical record. Your surgeon will consider:
If your breasts are sagging, a breast lift may be recommended in conjunction with breast revision.
You should come to the consultation prepared to discuss your complete medical history. This will include information about:
If you are planning to lose a significant amount of weight, be sure to tell your plastic surgeon. The surgeon may recommend that you stabilize your weight before undergoing surgery.
If you think that you may want to become pregnant in the future, discuss this with your surgeon. Pregnancy can alter breast size in an unpredictable way and could affect the long-term results of your breast revision.
Based on your goals, physical characteristics, and the surgeon's training and experience, your surgeon will share recommendations and information with you, including:
For a general list of questions to ask your surgeon about his or her background, to find out about plastic surgery safety and to plan your procedure, visit the Planning Toolkit.
We developed these questions to help you:
It is important for you to take an active role in your surgery, so please use this list of questions as a starting point for your initial consultation.
Your surgeon will provide thorough preoperative instructions, answer any questions you may have, take a detailed medical history and perform a physical exam to determine your fitness for surgery. In some instances, you may need to have a mammogram before revision surgery.
In advance of your procedure, your surgeon will ask you to:
Breast revision is usually performed on an outpatient basis. Be sure to arrange for someone to drive you home after surgery and to stay with you at least the first night following surgery.
Your breast revision surgery may be performed in an accredited hospital, free-standing ambulatory facility or office-based surgical suite. Your surgeon will give you an estimate of how long your surgery will last based on the details of your surgical plan.
You will probably be permitted to go home after a short observation period unless you and your plastic surgeon have made other plans for your immediate postoperative recovery.
Your surgeon will discuss how long it will be before you can return to your normal level of activity and work. After surgery, you and your caregiver will receive detailed instructions about your postsurgical care, including information about:
See options for short-term recovery in Aftercare and Recovery (Planning Toolkit).
Immediately after your breast revision surgery
Your postoperative discomfort and recovery time will be similar to that of your primary breast augmentation. You should be up and walking on the day of surgery. It will take several days to return to more normal activities after your breast revision surgery, but it is important to your recovery that you get up and move around. The extent and duration of discomfort depends largely on the size and placement of the implants, and may include pain, stiffness, swelling, bruising and itching.
When the anesthesia wears off, you may have some pain. If the pain is extreme or long-lasting, contact your physician. You will also have some redness and swelling after the surgery. Contact your surgeon to find out if your pain, redness and swelling are normal or are signs of a problem.
Recovery time frame after breast revision
It is vitally important that you follow all patient care instructions provided by your surgeon. This will include information about wearing compression garments, care of your drains, taking an antibiotic, if prescribed, and the level and type of activity that is safe. Your surgeon will also provide detailed instructions about the normal symptoms you will experience and any potential signs of complications. It is important to realize that the amount of time it takes for recovery varies greatly among individuals.
Undergoing a breast lift in conjunction with implant removal will lengthen your recovery time. If your breast implants are removed entirely, your recovery will likely be brief, with minimal discomfort. Avoid heavy physical activity for at least the first two weeks following surgery. After that, be gentle with your breasts for at least the next month. Your plastic surgeon will give you specific instructions and restrictions about physical activity.
The first week
Two to six weeks
Most residual swelling will resolve within a month.
After breast revision surgery, it is often possible to return to work within seven to ten days, depending on the type of activities you perform.
If you selected large implants, the skin around the breasts may feel tight as your body adjusts to accommodate the size increase.
It may take several weeks or months for new implants to "settle" into their final position. Altered sensation, such as numbness or tingling, may be present around the incision site, but this should decrease over the following weeks or months.
Unless you gain or lose a significant amount of weight or become pregnant, your new breast shape should remain fairly stable. However, gravity and the effects of aging eventually alter breast size. The weight of the implant used will also affect how your breasts appear as time goes on. Breast implant revision results are long-lasting; however, you may want to periodically visit your doctor to make sure that your implants are not posing health risks, and to help prevent any further complications.
Maintain a relationship with your aesthetic plastic surgeon
For safety, as well as the most beautiful and healthy outcome, it's important to return to your plastic surgeon's office for follow-up evaluation at prescribed times and whenever you notice any changes. Do not hesitate to contact your surgeon when you have any questions or concerns.
The cost of a breast revision varies from doctor to doctor, from one geographic area to another.
These numbers only reflect the physician/surgeon fees last year and do not include fees for the surgical facility, anesthesia, medical tests, prescriptions, surgical garments or other miscellaneous costs related to breast revision.
Because a breast revision is elective surgery, insurance does not cover these costs. Many surgeons offer patient financing plans to make the procedure more affordable.
Choose your surgeon based on quality, training and experience—not cost.
See why ASAPS members are widely recognized for upholding the highest standards in the area of aesthetic plastic surgery by viewing their basic credentials, training, and certifications.
Fortunately, significant complications from breast revision surgery are infrequent. Every year thousands of women undergo successful breast revision surgery and are pleased with the results. This surgery is usually performed without any major problems. Your specific risks for breast revision will be discussed during your consultation.
All surgical procedures have some degree of risk. Some of the potential complications of all surgeries are:
You can help minimize certain risks by following the advice and instructions of your board-certified plastic surgeon, both before and after your breast revision surgery.
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