Breast Implant Revision
After breast surgery, whether cosmetic or reconstructive in nature, time does not stand still. Studies have shown that the majority of women who have had breast augmentation will undergo one or more additional surgeries on their breasts over the course of 30 or 40 years. It is expected that there will be changes in your breast shape due to pregnancy, weight fluctuations, gravity, and implant integrity.
There are many reasons to seek breast revision surgery. Women who have had breast augmentation are common candidates for revision breast surgery. Some reasons for revision breast surgery in women who have had breast augmentation include issues with capsular contracture, where a robust scar capsule has grown to encase the implant; rupture or deflation of the breast implant; laxity of the skin and changes in breast shape, as part of the normal aging process or natural stretching of the skin caused by pregnancy and breastfeeding.
A variety of techniques are available to assist with addressing concerns that may result from such changes. Such techniques include fat grafting to correct contour irregularities, implant exchange, adjustments to the shape of the implant pocket, breast lifting to improve the relationship of the breast with the underlying implant, site changes where the implant is moved from below the muscle to above the muscle, and scar revision.
Breast revision surgery is a highly individualized procedure that may be a good option for women who wish to sustain the appearance of their breasts as they change over time, who are able to cope with ongoing treatment, women that do not have significant medical conditions or illnesses that may impair natural healing, and those who have a positive outlook and realistic goals for revision surgery.
Each breast revision surgery requires careful study of the patient’s reasons for revision, needs and desired outcomes. Dr. Cohn will discuss the options and outcomes with you during your initial consultation, so that a personalized plan can be created to achieve the best outcome possible.
The Initial Consultation
The success of your breast revision surgery depends on your complete candidness during the initial consultation. You will need to be prepared to discuss why you are interested in surgery, your personal medical history, drug allergies, use of medications, vitamins, herbal supplements, alcohol, tobacco and drugs, and any family history of breast cancer, as well as the results of any mammograms or previous biopsies.
Dr. Cohn will perform a physical examination and take detailed measurements of your individual physical attributes, as well as note breast asymmetry that may need to be addressed at the time of your procedure. Photographs will be taken for your medical record. At that point, Dr. Cohn will be prepared to discuss your surgical options, recommend a course of treatment, and discuss the use of anesthesia during your breast revision. The consultation consists of a thorough discussion to get a sense of what an anticipated final appearance might look like. Dr. Cohn is happy to assist with recommendations while using your personal goals to guide final decision making.
Preparing for Breast Revision Surgery
Prior to surgery, you may be asked to participate in lab testing or a medical evaluation, receive a prescription for certain medications or adjust your current medications, stop smoking well in advance of your surgery, avoid taking any anti-inflammatory drugs or herbal supplements. Some special instructions you receive will cover what to do on the day of surgery, the use of anesthesia during your breast revision, documentation for breast implant registry (when necessary), as well as post-operative care and follow-up.
Breast revision surgery may be performed in an accredited office-based surgical center, outpatient/ambulatory surgical center, or a hospital. If your breast revision procedure is performed on an outpatient basis, you will need to arrange for a ride to and from surgery and someone to stay with you for at least the first night following your revision surgery.
Breast Revision Procedure
Note: There have been continual advancements and improvements in every aspect of breast revision plastic surgery. New surgery and post-operative techniques offer more enhanced results today than in years past. With these improvements, breast revision surgery has become an increasingly popular and successful option for women facing a revision surgery procedure.
The technique used to reconstruct your breast(s) will be determined by your individual condition, your personal preferences and Dr. Cohn’s advice and guidance.
- I. The breast revision surgery begins with anesthesia, where intravenous sedation or general anesthesia will be provided. Dr. Cohn will recommend the best choice for your surgery.
- II. After the anesthesia has taken effect, incisions are made in inconspicuous areas to minimize visible scarring. You and Dr. Cohn will discuss which incision options are appropriate for your desired outcome. Incisions vary based on the type of implant, degree of enlargement desired, your particular anatomy, and patient-surgeon preference.
- III. Capsular contracture correction & implant Replacement Procedure: this breast implant replacement procedure is performed to both address scar tissue that has formed around an existing breast implant, as well as replace the implant. After the initial incision is made, the capsule and breast implant may be removed from the pocket and a new breast implant is inserted. In other cases, a fresh pocket/position for the implant is created while leaving the prior capsule behind. Options and recommendations will be made by Dr. Cohn during the consultation.
- IV. The Deflated or Ruptured Breast Implant & Replacement Procedure: in cases where an existing breast implant has ruptured or lost shape, the breast implant is removed and replaced. In cases where a silicone breast implant has ruptured, the remaining silicone material is meticulously removed from the pocket. Once the pocket is thoroughly cleaned and sterilized, a new breast implant will be inserted
- V. The Procedure to Correct Laxity of the Skin and Changes in Breast Shape: in cases where the skin of the breast is loose, due to normal aging processes or stretching of the skin caused by pregnancy, breastfeeding or changes in weight, the revision goal is to reconstruct a youthful breast shape. If the skin is loose due to pregnancy or aging, a breast lift or mastopexy is required (the Breast Lift page will explain the various lift procedures). In cases where a significant amount of time has elapsed since the initial breast augmentation surgery, breast implants may require replacement.
- VI. Following your revision surgery, gauze or bandages will be applied to your incisions. The use of an elastic bandage or support bra will help minimize swelling and support the newly-revised breast. A thin tube may be temporarily placed under the skin to drain any excess blood or fluids.
Potential Risks and Complications
The decision to have breast revision surgery is extremely personal and not without risk. Dr. Cohn will fully review and explain the risks associated with your surgery. After you fully understand the procedure, you will be asked to sign consent forms.
Recovery for Breast Revision Surgery
Although many factors are involved in your recovery time, you will likely experience an initial post-surgical recovery period of several weeks. During the healing process, swelling will decrease and your breast shape and breast position will improve You may also require a reduced-activity period of a few days. During recovery, you will likely experience soreness and swelling for a few weeks. Exercise and normal activity can resume at Dr. Cohn’s direction.
Following all of Dr. Cohn’s post-surgery instructions is crucial to the success of your surgery. Surgical incisions should not be subjected to excessive force, abrasion, or motion during healing. Dr. Cohn will give you specific instructions on how to care for your incisions following your surgery, which medications to take, how to reduce the risk of infection, and when to make a follow-up appointment.
Birmingham Breast Revision Costs
Breast revision surgery is often considered a reconstructive surgical procedure that is covered by some health insurance plans. This is largely based on the initial reason for your original breast procedure. Coverage of your breast revision surgery may require that you make a co-payment of some amount. Dr. Cohn’s office will assist all revision breast surgery patients in determining your specific insurance coverage for your procedure. Typical costs include a surgeon’s fee, hospital or surgical facility costs, anesthesia fees, prescriptions for medications, post-surgery garments, and any associated medical tests.
Cohn Plastic Surgery proudly offers patient financing plans, so be sure to ask if such a plan is of interest to you.
For more information about breast revision surgery, we invite you to call us at (205) 930-1600 – Monday through Friday from 8:00 am to 5:00 pm – to schedule an appointment. You may also use the Contact Form page to send us a message.