Breast Implant Revisions
Breast augmentation surgery is one of the most popular cosmetic surgery procedures performed in the United States each year. The vast majority of women that undergo breast augmentation surgery are extremely happy with their results. However, even in the best of hands, unsatisfactory results can occur. In addition, breast implants are man made devices and do not last forever; implant deflation (implant rupture) may lead to a need to exchange the implant. Many women feel that once they have gotten implants, that's it, they will never require another operation the rest of their lives; this is often, but not always the case.
Breast implant exchanges for implant deflation are often a much less demanding procedure then the initial operation since the implant pocket has already been developed. A breast implant revision may be carried out for an unequal appearance to the breast, capsular contracture, synmastia (implants joined in the middle of the chest), or implant rippling. Patients have traveled from out of the state and out of the country to undergo breast implant revisions and exchanges at Dr. Spence's Orlando, Florida plastic surgery practice. Schedule your consultation today at 407-999-2585 with Dr. Kenrick Spence at Hillcrest Plastic Surgery. Also feel free to browse through our Breast Implant Revision Before & After Photos.
Who is a Candidate for Breast Implant Revision in Orlando, Florida
Examples of types of undesirable breast implant outcomes:
- Implant Deflation: Implants may deflate from simple wear and tear; they are man made objects and have a lifetime. Saline implants (the most common type of implants that are used today) will simply loose volume as the salt water in the implant gets re-absorbed by the body; the breasts then usually appear unequal. The exchange of the implant with a new one is a much less extensive procedure than the initial operation. Silicone gel implant ruptures are less difficult to detect particularly if the ruptured implant is confined to the surrounding capsule. Depending on the age of the implants, the patient may decide to exchange both implants to a smaller or larger size.
- Capsular Contracture: Capsular contracture is the hardening of the natural capsule, which forms around a breast implant. This may result in a hard asymmetric breast. There is often no clear reason why this happens, it may happen with one or both breasts; breasts may be painful.
- Implant Rippling: Breast implant rippling can become visible over time as breast tissue thins out with weight changes, hormonal changes, or pregnancy. Implants placed in front of the muscle, in patients with very little breast tissue, have a slightly higher chance of showing rippling over time, as the breast tissue thins out as there is no muscle to cover the upper portion of the implant.
- Synmastia: This occurs when implants are too close together in the middle of the chest, creating a loss of cleavage and joining of the breast
- Implant Displacement: When the implants sit too lateral on the chest wall under the armpit.
Procedures for Correction of Breast Implant Complications, Breast Augmentation Revisions in Orlando, Florida
Implant Rupture: Treatment of a breast implant rupture includes a breast implant exchange. The previous implant incision can be used requiring no more scars on the breast. For patients that require a larger implant, a capsulotomy may be performed (expansion of the initial breast capsule to accommodate a larger implant).
Capsular Contracture: Surgical correction of capsular contracture involves removal (capsulectomy) or release (capsulotomy) of the existing capsule. Implants previously placed in front of the muscle may be moved to behind the muscle to try to reduce the risk of future capsular contracture. Smooth implants are sometimes changed to textured implants. Though all of these procedures may lessen the risk of future capsular contraction, there is still a chance that capsular contracture may reoccur.
Synmastia: Treatment for synmastia involves capsulorrhaphy - releasing the capsule and sewing it back together to separate the implant pockets. The implant may be replaced by an implant of the same volume but with a narrow base.
Implant Rippling: Implant rippling can be addressed by exchanging implants from in front of the muscle to behind the muscle, as this muscle provides better coverage for the implant in the upper aspect of the chest. Saline implants can also be changed out for silicone implants, as they tend to ripple less. Silicone implants are only available through investigative studies. You may ask Dr. Spence if you are a candidate for silicone gel implants.
Implant Displacement: When implants sit too far out on the chest wall underneath the armpit, this may be corrected by a capsulorrhaphy - releasing and re-suturing the capsule to better shape the implant pocket.
Recovery from a Breast Augmentation Revision
This depends greatly on the extent of the surgery. Implant exchange patients may be back to work in a day or 2, while patients with a more extensive procedure may require 7 to 10 days for recovery. No heavy lifting is advised for several weeks for the more extensive procedures. A support bra is worn around the clock for 1 to 6 weeks after surgery depending on the procedure.
Breast implant revisions or breast augmentation revisions are performed in Dr. Spence's fully accredited out patient surgical suite. Patients have traveled from California, Connecticut, North Carolina, New York, New Jersey, St. Lucia, Jamaica, and England to undergo breast augmentation revisions in Orlando, Florida. To schedule a breast implant correction consultation with Dr. Spence at the Hillcrest Plastic Surgery, call 407-999-2585 or request a consultation online.
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Breast Implant Revision Frequently Asked Questions (FAQ)
Breast Implant Revision
I feel that the crease of my breast sits too low on my chest after my breast augmentation. Can this be changed?
Yes, the fold of the breast can be raised. Talk with your surgeon to determine their experience with this operation.
I feel that my implants are too far apart in the middle of my chest and too much under my armpit. Can this be fixed?
Yes, this can be changed. The extent to which the implant can be brought together in the middle of the chest is sometimes dependent on your own anatomy. The implant capsules can sometimes be repaired to bring the implant more medial.
It seems that after I got breast implants the asymmetry between my breasts became even more pronounced.
This is possible. Remember it is natural to have some asymmetry of the breast. Once they are augmented this may be amplified. It is important to meticulously examine the breasts before surgery to determine if this asymmetry is worth addressing.
I feel as though my implants are too large and I am over them. Can I go to smaller implants?
Remember large implants have trade offs, as they equal added weight on the breast tissue. It is not uncommon to want very large breasts at a young age; however, as time goes on some patients wish they had been more conservative. This is an individual and personal issue; take the time to discuss your long-term outcomes with your surgeon.
I can feel my implants rippling but I cannot see it through the skin, is this common?
It is not uncommon to feel implant rippling by virtue of the nature of saline implants, to most patients this is not a bother.
I have breast implants beneath the breast tissue but would prefer to have them beneath the muscle. Can this be changed?
Yes, a change of implant plane can be performed. This is most commonly done in patients who have rippling on the upper aspect of the implants or who have developed capsular contracture.
I had breast implants and one breast is firmer than the other, sits higher on my chest, and is not as natural looking; what could cause this?
One breast may develop a firmer capsule then the other. This may cause one implant to fall naturally while the other stays higher on the chest. If this does not respond to massage, a capsulotomy (release of the capsule) may be needed to lower the higher implant.
After my breast augmentation, the fold of one breast seems higher than the other.
Asymmetry of the fold may have existed before your surgery or the weight of the implant may have caused the fold to descend. Recreating the fold in an operation called a capsulorrhaphy can repair this.
I have breast implants behind the muscle and when I flex my arms I see a line across my breasts.
This is sometimes called "window shading"; releasing the muscles attached to the breast capsule may repair this.
Other Breast Implant Revision Frequently Asked Questions
Why do Breast Implants Deflate or Rupture?
Implants may leak or rupture from simple wear and tear, they are man made devices and have a lifetime expectation. Both Saline and Silicone implants are popular today.
When a Saline implant leaks the sterile salt water is absorbed by the body and the breast deflates. In the case of gel implants it is not so easy to detect a rupture. Due to the highly cohesive gels the breast shape may not change. Silicone gel ruptures may often be picked up on a mammogram or MRI. All deflated or ruptured implants should be exchanged. This may involved less surgery and recovery than the initial operation if it involves exchange alone. Patients may decide to exchange one or both implants depending on their age.
What is Implant Displacement?
Implants may be displaced in any direction, upwards towards the collar bone down onto abdomen and out under the arm pit. Precision surgery in the creation of the implant pocket can help to avoid this. When implants are displaced, the cavity into which they are displaced must be completely closed off and a new pocket created for the implant to avoid future displacement. This procedure can be very successful in the hands of an experienced revisionary breast surgeon.
What is Breast Implant Rippling?
Breast implant rippling can become visible over time as patients lose weight. The skin thins with age or after pregnancy. Implants placed behind breast tissue as opposed to behind muscle have a high chance of rippling at the upper aspect of the breast. The textured implants also have a higher chance of rippling. (Dr. Spence does not use textured devices in his practice for multiple reasons). Rippling can now be fixed through the use of fat grafting and ADM (Acellular Dermal Matrix). Rippling at the upper portion of the breast can be fixed by placing the implant behind the muscle.
What is Capsular Contracture?
All Breast Implants have a capsule, this is a scaffold of scar tissue which forms around any foreign object placed in the human body. The capsule may be soft and pliable ( A Baker Grade 1) or it may be hard, painful and deforming the shape of the breast. A Baker grade 4. There are many theories proposed as to why Capsular Contracture occurs. There are also many modes of treatment suggested medication, aggressive manipulation (closed capsulotomy) ultrasound, surgery etc. Ultimately surgery is the most successful. Capsular contracture can occur at any point in the lifetime of a breast implant. The latest techniques in the surgeons armamentarium to decrease the risk of capsular contracture is NO TOUCH TECHNIQUE which is practiced by Dr. Spence.
What is SYMMASTIA?
Greek; Sym together, Mastia- Breast
Symmastia may occur at birth or develop after breast augmentation a joining of the breast. Being born with Symmastia is extremely rare. Where breast implants are placed too close together in an attempt to create cleavage that was not present before, Symmastia may occur. Fortunately this can be repaired with the use of repair of the capsule and changing the placement of the implant along with the selection of an implant with a more narrow base.
What is Bioengineered Breast?
This is a concept that strives to replace missing tissue after a mastectomy by utilizing a combination of fat cells and acellular dermal matrix. Dr. Spence has taken the concept of a Bioengineered breast and applied it to revision breast surgery. He uses this concept in patients that has had multiple breast operations with thin skin, rippling, bottoming out and matipoution among other breast implant complications. Many times the breast tissue is exhausted for the placement of multiple large breast implants. Fat is used to replenish the tissue and Acellular dermal matrix are used to re-enforce the position of the implant.
I have had recurrent Capsular Contracture with a very hard and deformed breast, what can be done?
Dr. Spence sees many of these patients in his Orlando Florida Breast Revision Practice. A complete removal of the implant and all capsule. Using NO TOUCH TECHNIQUE and a 14 point plan he has been very successful in achieving a soft natural appearing breast.
I had a breast lift after losing a lot of weight and my breast look as if they are falling off my implant?
This is called a snoop or waterfall deformity. (recurrent droop) where the nipple seems to sit below the implant, this may be made worst by a hard capsule which holds the implant up on the chest. Many times the patients are best served by staged procedure. Due to the loss of elasticity for the breast after massive weight loss. The implants are removed along with the capsule and the breast tissue is tightened with a lift once this is healed the implants are replaced due to less weight on the tissue we are able to perform a much more aggressive lift with much better scars.
Can I revise my breast reconstruction?
Dr. Spence revises breast reconstruction patients in his Orlando Breast Revision Practice frequently, he uses the concept of a Bioengineered breast with the use of fat graft and acellular dermal matrix.
Is there a way to avoid a lift if I remove my large breast implants?
By staging your breast revision, removing the implants and allowing the breast tissue to “SNAP” back a smaller implant can sometimes be placed without a lift.
The responses to Frequently Asked Questions listed here are not intended to be medical advice, but are the practice of Dr. Spence and will vary from surgeon to surgeon and patient to patient.
To schedule a consultation with Dr. Spence at the Hillcrest Plastic Surgery, call 407-999-2585 or request a consultation online.