The last thing you are thinking about after getting a breast augmentation, is doing it again—or what we call a breast augmentation revision. Sometimes it is necessary to treat a complication like bleeding or capsular contracture, or maybe it is just time to upgrade to a newer type of implant or to change sizes. But whenever a revision is planned, it can be scary. However apprehensive you feel, there is nothing to be afraid of. As I reassure my breast augmentation revision patients in Columbus, Ohio, the surgery is a natural part of the breast augmentation life cycle and there can be real advantages to it as well.
From Fine to Fabulous.
Over the last 15 years, there has been a huge improvement in implant technology. The first generation of the silicone gel implants were fine, but now on generation 5, the implants are fabulous. This is the reason I only use this newer type of implant. These have a couple names you might have heard of—they are termed the highly cohesive, gummy bear, or form stable implants. In other words, when the outer silicone envelope is removed, the shape remains the same—thus form stable. This means they do not rupture and get gooey, sticky gel all throughout the capsule. This is a major step forward. I want all of my patients to have the peace of mind that this knowledge brings. And as time goes by, I am sure we will have even better technology. So if your first set of implants was saline and now you are ready to replace them, it will be quite an upgrade. And you just jumped over all the intervening technology from the past 15 years to the very best on the market. (I talk more about this type of revision in my related blog post, All About Breast Implant Revision.)
It Is a Woman’s Prerogative To Change Her Mind.
Besides the scheduled implant revision for patients that have had their set for over 10 years, there are other reasons for revisions. One of the most common revisions is to tweak the size and symmetry of the implants. For some patients, their body may have changed due to weight fluctuations, or pregnancy, but for whatever reason, the patient is not satisfied with the size. For these patients, changing the implant to a new size can alleviate their concerns. To make a noticeable change in size, either up or down, requires about at least 100cc change. But when the patient wants just a little larger, it is about 50cc. This type of simple change can be done in my state-of-the-art office OR with a twilight anesthesia. We usually do this type of revision on a Thursday, and the patient can go back to work on Monday—for most jobs!
Wondering what breast augmentation revision results look like? Take a look at my patients’ before and after pictures in our photo gallery.
There is a rare but real condition when the implants that are placed beneath the muscle can move or have what we term animation with pectoral muscle movement. If animation deformity is bothering the patient, the implants that are placed behind the muscle can be switched and placed on top of the muscle, if the patient has enough subcutaneous fat on their chest wall. For patients that do competitive bodybuilding, putting the implants on top can be the best answer and really is a compromise of the animation and the visibility of the implant. During competition, when the patient is at her leanest with a low body fat composition, the implant ripples can be more readily seen, but there would not be any animation deformity.
Even for a very good long-term result, there are minor tuneups that can be done to the capsule at the time of the revision. We have all seen ladies lying out in the sun at the pool or beach who have implants that are too far over to the side of the body, and the gully between the breasts along the sternum is very wide. This is because even in the best case, over a long period of time, gravity pulls the implant over this way, and the pocket gets looser or more stretched out along the side. To correct this during a revision entails tightening the capsule along the outer pole of the breast so that when the patient is lying on her back, the implants do not shift as much to the side body. This type of “down and out” migration of the implants is more common for saline or larger silicone implants. As we all know, gravity is our enemy!
Thicker Capsules May Need Removal.
For many patients that have had implants for an extended period of time, the capsules can be tighter than desired. While not a real capsular contracture, the thicker capsule can limit the softness of the implant. For these patients, a complete or partial capsule removal can be done at the time of the revision, resulting in a much softer, natural-feeling breast. This is a larger operation that does require a general anesthesia. Often this case also necessitates the use of drains that can stay in up to a week. In this scenario, sometimes the implant is moved to a new pocket as well. And of course, all of this depends on the particular case. In your consultation with a board-certified plastic surgeon, she will cover all of this.
Previous Implant Records
If you have them, the record of your previous, and current breast implants can be a huge help when it comes to planning for surgery. You should have received an implant record card and hopefully tucked it away safely so that you could find it now! The style and size of the implants helps direct the next operation. If you want to be the same size or smaller or larger, it’s a snap when you know what the original size is. But if you do not have the records, it is not a deal breaker, it just means that multiple sizes will be considered—what we call the tower of tits. In the OR, when the old implants are removed and the actual size noted, the decision is made then.
Breast augmentation revision is part of the natural process with implants, and at the minimum, you will have the operation to place the implants and the one to take them out. But I would bet you a nickel that once you have a new enhanced shape, you will not want them removed and begin to understand that revisions are a natural part of having implants and nothing to be afraid of. Instead, we like to view this as an opportunity to improve on an already good thing. We will guide you through this journey, so that you will continue to enjoy your enhanced shape.
To learn more about your breast implant revision options at our Columbus plastic surgery practice, use our online form to request a consultation. Or call us at (614) 569-2649 to schedule an appointment.