Breast Revision Surgery

What is Revision Breast Surgery?

While surgeons and patients alike all want excellent results from a single breast augmentation procedure, at times a breast revision procedure is necessary to optimize or revise the appearance of the breasts. A breast implant revision procedure involves replacing existing breast implants with new ones. In some cases, patients choose to have implants removed and do not replace them. In our office we regularly see patients who have had breast implant surgery performed elsewhere and have results that are disappointing but that we feel can be improved. After a clear discussion and examination, we put together a plan for procedures to help better achieve our patients’ goals.
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Why Do Most Patients Seek a Breast Revision Procedure?

The most common reasons patients are interested in breast augmentation revision surgery or procedure include:

  • Dissatisfaction with the breast implants size (either too small or too large) or feel
  • Desire to change to a different style of breast implant (Breast implants come in a wide range of sizes, shapes and materials. Some patients may decide over time that they want to try a different style of implant for aesthetic reasons.)
  • Implant malposition, migration or rupture (the implant has moved out or down from where it was placed, or in some cases, injury or trauma can cause an existing implant to rupture)
  • Capsular contracture (unusually thick or dense scar tissue has formed around the breast implant which can alter the shape or feel of the breast and may even hurt or cause discomfort)
  • Asymmetry (the two breasts look very different from one another)

What Are the Goals of Breast Augmentation Revision?

Very simply, breast implant revision surgery typically strives to:

Replace old implants

Most often, the goal of breast revision surgery is to simply replace old implants with new ones. No implant is meant to last forever, so this is a normal part of the breast augmentation experience. Your plastic surgeon will tell you how long you can expect your initial set of implants to last, but most last at least 10 years.

Change or improve breast appearance

Sometimes, a patient’s body composition may change over time. Other times, patients simply decide they wish to have a different figure. In both instances, breast revision can help them achieve the desired breast appearance by altering the size or shape of their implants.

Update the implant material

Since breast implants are generally expected to last at least a decade or more, this means that there is always a chance that a newer implant material may come out that interests a patient. Additionally, some patients may decide over time that they would prefer saline breast implants over silicone gel or vice versa. In these cases, breast revision surgery is performed to provide implants with a new material.

Our goal is to listen carefully to your concerns and after a careful exam have a very open and honest discussion of options and realistic expectations for the results.

What Are My Breast Revision Options?

There are several options depending on the patient, their anatomy and their goals.  These are the most common options to choose when getting breast revision.

Changing the breast size, breast shape or style of the breast implant

Sometimes patients simply want to change their implant size, exchanging for smaller or larger implants, or they would like to switch up their desired style of implant.  Or perhaps they are reconsidering the type of implant and will opt to have their saline implants removed and replaced with silicone implants to achieve a softer look and feel.  There are several different types of silicone implants available today, including textured implants and anatomic implants (tear drop in shape).

We also can utilize different materials (often called “ADMs” or “Acellular dermal matrices”) to help internally reposition the implants or create an “internal bra”.

Repositioning the implant

During breast revision plastic surgery, patients may have their surgeon reposition the breast implant and place the new or existing implant in a different location to improve the shape of their figure.

Combining Breast Surgeries

It is also common for patients to have complementary and more extensive surgeries performed alongside a breast revision to minimize the number of times they must go under anesthesia. For example, some patients may opt to have a breast lift (add hyperlink) or breast reduction (add hyperlink) performed concurrently with their breast revision surgery.

A breast lift involves tightening and lifting the existing breast tissue to give a perkier, more flattering appearance to the breasts. This pairs well with breast revision or augmentation because it can boost the look and feel of the breasts post-procedure.

Some women choose to have a breast reduction and also get implants. Often, this is because their natural breast tissue is uncomfortably heavy or sagging. Once some of the natural breast tissue has been removed, many women opt for implants to help restore fullness and improve the overall shape and appearance of their breasts.

Working together we will discuss the advantages and disadvantages of each approach so that you can pick the procedure that is right for you.

How Long Should I Wait Before Pursuing a Revision Procedure?

In general, we ask patients to at least wait a few months from their initial breast augmentation procedure before you decide to undergo breast revision. This ensures your body has had enough time to completely heal from your initial surgery.  In addition, it can take weeks or months for the swelling to settle completely, which means that you will not be able to see your final results right away. Sometimes, patients are unhappy with their post-surgery bodies simply because they have not given themselves enough time to heal. Waiting several months will allow both of us to have a good sense of the final results.

In addition, we encourage patients who had their initial surgery at another facility to contact their surgeon about their concerns if at all possible, as most surgeons really do want to know if their patients are unhappy and would love the opportunity to help them. There are plenty of reasons that a patient may feel dissatisfied with the outcome of their breast augmentation, so it is important to talk candidly with your plastic surgeon before and after the procedure so they can help you make the right choice for your goals.

What to Expect During the Procedure

Generally speaking, a breast implant revision surgery will follow much the same course as a breast augmentation surgery.

First, you will receive some form of anesthesia. Your plastic surgeon will discuss options beforehand and make recommendations about which is the best choice for you.

Second, the plastic surgeon will make a breast augmentation incision either around the areola, under the breast crease or both (sometimes called a “lollipop incision”). Once the incisions are made, the surgeon will perform any tissue tightening or reshaping and place the implant in the desired location.

Third, the surgeon will close the incisions once the surgery is complete. Some use sutures; others use adhesives, tapes or clips. Your surgeon will tell you beforehand how they plan to close your incisions and what the potential scarring will look like.

In most cases, this is an outpatient procedure. This means that you will be kept under observation for a period of time while the anesthesia wears off. Still, you will not stay overnight in the hospital. As with all surgical procedures, it is recommended to have someone you would entrust with your care to drive you home after the surgery.

What is the Recovery Like?

The recovery varies depending on the patient– some patients report less discomfort compared to their original procedure, others more, and this also depends on the type of revision procedure that we would perform.

Generally speaking, recovery from breast revision surgery is similar to the recovery process for a breast augmentation. Patients will often find that the steps required are nearly identical to the ones they were given initially following their first breast implant surgery.

Your incisions will typically be covered with gauze or bandages, and you may be required to wear a support garment for some or all of this process.

In addition, your plastic surgeon may install a small drainage tube in the incision site to keep fluid buildup at a minimum, which reduces discomfort from swelling.

After your procedure, the surgical staff will give you post-operative instructions that may include how to care for the incisions, when to take medications and when to follow up with your plastic surgeon. The more closely you can follow these directions, the better and smoother your recovery will be.

Many people also find it helpful to have a trusted friend or family member stay with them in the early phases of this process. Most patients are not permitted to lift more than a few pounds or perform strenuous activities that may aggravate the incisions, so having someone to help with everyday tasks can be helpful for the first week or two following a breast revision surgery.

How Long is the Recovery for a Breast Implant Revision?

Every patient’s timeline will be different, but a patient’s recovery schedule will generally entail:

  • 1-3 days on average of post-surgery pain medication
  • 1 week to return to work, provided it is low-impact and doesn’t require routine use of affected areas.
  • 2 weeks for visible bruising to typically subside
  • 3 weeks for swelling to begin to subside
  • 6 weeks average time to return to normal activities without restriction

What Kinds of Results Can I Expect from a Breast Revision?

It is important to remember that you will not be able to see the final results of your breast revision for a minimum of two months following your procedure. This is because there will be some bruising and swelling that must resolve. In addition, revision breast surgery is usually a more challenging procedure and the results can be less predictable.

There will also be a period of time when your breasts feel “hard” or lack normal sensation. For some patients, this can last 6-12 months. Recovery is different for everyone because no two bodies are exactly alike. In the months following your revision, patience and realistic expectations are essential for a good recovery.

In almost all cases, your breasts will soften to give a more natural look and feel. The keys are to follow your surgeon’s instructions closely, be gentle with your body while it heals and give yourself time to settle into your new body.

During your surgical consultation, be sure to discuss all of your concerns and expectations with your provider in order to get a more complete picture of what to expect for yourself.

Am I a Good Candidate for Breast Implant Revision?

As with all plastic surgeries, you should make sure that you are a good candidate for the procedure before giving it serious consideration. It’s important that Breast Revision surgery patients:

  • Maintain a stable weight
  • Are generally healthy
  • Do not smoke
  • Discuss realistic goals with their plastic surgeon and have reasonable expectations about the outcome
  • Have a normal mammogram or breast ultrasound if they are over 40 years of age
  • Obtain information about their previous surgeries, including operative reports, from their previous surgeon if at all possible

In addition, it is very important to abstain from smoking, heavy drinking and certain drugs to ensure safety and a healthy recovery. If you are unsure about whether or not a breast revision is the right step for you, consult with your physician and board-certified plastic surgeon to discuss your concerns.

What Are the Risks of the Breast Revision Procedure?

All surgical procedures carry some inherent risks. Because surgery can be invasive, there is always a small chance that you will experience complications. Possible complications of a breast revision include:

• Bleeding
• Infection
• Temporary or permanent numbness in the nipple or areola
• Asymmetry or Uneven positioning or shape of breasts or nipples
• Widening of scars
• Poor incision healing
• Fluid buildup
• Breast hardening
• Damage or necrosis of breast tissues
• Skin discoloration
• Persistent pain or swelling
• Need for further revision surgery

Your surgeon will discuss all of the possible risks and side effects during your consultation.

How to Choose a Breast Implant Revision Surgeon

Finding the right surgeon for your cosmetic procedure is ultimately a personal choice. However, there are a few factors to consider when you are looking at your options.

1. Before and After Breast Revision Photos

Cosmetic surgery includes a certain amount of artistry in addition to experience. Most surgeons develop a signature style or tend to excel in creating a specific body shape. When researching potential providers, be sure to look at their photo galleries. Look for people who are similar to you in the “before” photos to get a better idea of what your “after” results are likely to be.

2. ABPS Board Certification

Any surgeons you shortlist should be verifiably board-certified by a reputable organization like The American Board of Plastic Surgery (ABPS), the only plastic surgery board recognized by The American Board of Medical Specialties. When you choose an ABPS-certified provider, it gives you extra peace of mind and the assurance that a highly skilled individual will perform your surgery.

Board-certified plastic surgeons must meet a rigorous standard of requirements and display a deep knowledge of cosmetic surgery procedures. In addition, they are licensed and insured and only operate in accredited medical facilities. This means that you should be provided the highest levels of care and safety.

3. Personal Preference

Remember that you will be building a relatively long-term relationship with your plastic surgeon. When you are choosing a surgeon, it is extremely important that you feel safe, comfortable and valued as a patient. Look for a provider who puts you at ease and can comfortably address all of your questions and concerns.

Questions to Ask

Are you Board Certified by the ABPS (The American Board of Plastic Surgery)?

Because any surgical procedure demands the appropriate skill, expertise and experience to perform safely and competently, entrusting your care to a surgeon Board Certified by The American Board of Plastic Surgery (ABPS), is a critical factor when choosing to undergo Breast Revision surgery. Patients can confirm a plastic surgeon’s certification status and history at The American Board of Plastic Surgery website.

Where and how will you perform my procedure?

At a minimum, Patients will want to ensure their surgeon of choice has hospital privileges and can ensure a private and safe environment. Some surgeons can perform cosmetic surgical procedures in their own office surgical suites. For example, Dr. Salemy has his own surgical center and operating room in Seattle, WA that is fully accredited and licensed by the Washington State Department of Health and AAAASF, the national ambulatory surgery center accrediting body. Here he is able to perform surgery with the confidence that he has met their rigorous standards and offer the highest level of safety, privacy, comfort and care.

When providing breast revision surgery, Dr. Salemy & his staff perform it in his accredited operating room. Upon completion of the procedure, Dr. Salemy will have his patients spend the appropriate amount of time in the recovery room with a recovery nurse where they can be kept under observation and assessed until they are ready to be released with detailed after-care instructions.

Do I have to wait a full six months before breast implant revision?

In most cases, six months is the minimum wait time. It is extremely important to be fully recovered from your initial surgery before going under anesthesia again to ensure your health and safety.

Some surgeons may perform breast revision around the three-month mark for medical concerns, but this is done at your provider’s discretion.

Breast Revision Can Reveal the Real You

Sometimes, breast augmentation simply does not give the results you were envisioning. Whether you have changed your mind, or you are experiencing unexpected or uncomfortable side effects, a breast revision can be the right choice for your body.

Finding a board-certified plastic surgeon to perform a breast revision could be the ideal solution for your situation. The right surgeon can help you determine the size, shape, style and position for your implants that help you meet your aesthetic goals and help you feel confident in your body.


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Dr. Shahram Salemy Provides:

  • Customized Treatments
  • Natural-Looking Results
  • Compassionate patient Care in Safety-
    Rated AAAASF-Accredited Medical Clinic

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