Breast Augmentation Correction and Breast Revision
Breast augmentation surgery is more popular than ever, with the vast majority of patients thrilled with their new proportions. There are however many patients that require additional surgery to correct problems with breast implants, to exchange outdated silicone gel implants, or simply to change to different size breast implants.
First, it is important to understand that every plastic surgeon will have, from time to time, a patient who has a complication or a result that is less than satisfactory which requires a 'touch up' or revisional surgery. Don’t be too quick to blame the plastic surgeon. There are many factors and variables in plastic surgery and in healing. It is important to realize that there is always some degree of unpredictability in the final outcome of the healing process.
It is usually beneficial and appropriate to follow-up and continue care with the plastic surgeon who performed the original breast augmentation and work through any problems or breast implant complications. Obviously, anyone who experiences a complication or poor result wishes to have the problem resolved immediately. However, working through these problems may take extended periods and will require time and patience. Lack of confidence, obvious poor judgment, or failure after two or more procedures may encourage one to seek a second opinion or an alternate plastic surgeon.
Breast Implant Problems
Unsatisfactory results may be from one or more of several breast implant problems associated with breast augmentation including: capsular contracture (thickening, firmness and contraction of the layer of tissue around the implant), malpositioned or displaced breasts implants, poor or unnatural shape, asymmetry, obvious rippling or wrinkling, deflation, inappropriate size, poor scars or firmness from excessive overfilling of the breast implants.
Understanding that a large number of women have significantly asymmetric breasts, it is important to take into account the original shape and symmetry prior to any surgery. Many women do not realize their asymmetries until after breast augmentation surgery, when their inspections become more intense. Conscientious and meticulous plastic surgeons will make every effort to make the breasts as symmetrical as possible; however, original asymmetries will prevent perfect symmetry. At times, asymmetry can even become more noticeable/obvious following breast augmentation. If pre-operative asymmetry is significant, two different size breast implants may be used to accommodate two different size breasts, thereby improving the asymmetry. When asymmetry involves differences in shape or position of the nipple, it may be wise to choose smaller size breast implants, with a more conservative change in size so as not to accentuate the asymmetry. In those patients who have one nipple significantly lower than the other, or one breast hanging or drooping more than the other, some type of lift for that particular side may be considered along with the breast augmentation. Careful planning before the initial surgery best helps to produce optimal results.
It is also important to understand that complete healing and the final result after breast augmentation surgery truly takes several months – approaching one year – and what may be unsatisfactory to a patient after surgery may be something that will improve or resolve over time. Do not be too quick to insist that the surgeon correct a problem or concern when more time is recommended. For example, a patient happy with the left breast noted the right breast implant placement appeared too high and requested it to be corrected. However, at just under one year the high riding right implant ended up in perfect position and the left implant ended up a little too low! In reality, it was the left implant that needed to be raised rather than the right implant lowered. Patience in the healing process is very important.
Correcting breast implant problems may be relatively uncomplicated or they may require one or more surgical procedures. For some, it is possible that no satisfactory result can be obtained requiring living with and accepting the "best" that can be done or removing the breast implants altogether. If removed altogether, one should wait six months to one year allowing breast tissue recoil/contraction before deciding if any type of breast lift or any other procedure is desirable.
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Content provided by Board Certified Plastic Surgeon Sam Gershenbaum. Dr. Gershenbaum is a plastic surgeon in Miami Florida