Breast Implant Revision
Conveniently located to serve San Diego, Oceanside, CA and Carlsbad, CA
Breast implants, like other medical devices, may not last forever. If revision surgery is required, Dr. Gregory Park can help you to determine your best options. Surgery may involve simple removal or complex revision that requires removal of scar tissue, modifications to your implant pockets, and implant exchange in a one stage or multi-stage approach. The revision surgery may be indicated for medical reasons or it may be a personal choice.
Breast Augmentation Revision in Carlsbad & San Diego
Breast augmentation results may not be permanent. Over the course of time, changes may occur to your breasts from aging, weight changes, hormonal fluctuations, and gravity. At some point in your life, it may be necessary to remove or replace your implants. In order to restore your breasts to a more youthful appearance, you may decide to undergo a mastopexy/breast lift or implant exchange. During a revision breast augmentation, older breast implants are removed and replaced with new implants for medical indications or personal reasons. Often times a different size or type of implant (silicone or saline) is chosen or a breast lift is performed during or after the implant exchange to optimize your aesthetic results.
To view Before & After Revision Breast Augmentation photos, click photos above. Individual results may vary.
Perhaps you have undergone one or even several breast augmentations in the past. There may be a number of reasons why an implant exchange may be an important concern for you at this time. During your consultation with Dr. Park you will be able to discuss your goals with revision breast implant surgery.
Maybe your thoughts about breast implants have changed, or you feel that it is time for a change in size or type of implant. The following reasons may apply to you. You may want:
- Smaller or larger implants
- Saline or silicone implants
- Round or anatomically shaped implants
- Removal of your implants because of rupture
In some cases, infection, acute or chronic surgical complications, chronic pain, or trauma are medical indications for removing your breast implants. Some of these complications are as follows:
This condition may occur when breast implants are placed under the pectorals muscle. Sometimes, when a dual plane technique releases the pectorals muscle fibers along the lower chest, these fibers can adhere to the overlying breast tissue. When the chest muscles are flexed, the implants and breasts can move and become distorted. Animation deformities can also occur in patients who have really strong pectoralis muscles from working out. The active distortion of the breast can be improved by changing the location of the implant to a pocket above the muscle, by using an acellular dermal matrix, or by creating a split-muscle pocket.
This malposition issue occurs when the breast implant drops below the normal breast fold (inframammary fold). Excessive release of the fold during surgery, time, gravity, and the use of very large implants, are common factors that contribute to this deformity. The breasts will appear bottom heavy and the nipples may be in a “stargazing” position or pointing up. In order to improve this deformity, the pocket must be repaired with multilayered suture capsulorrhaphy, and sometimes with the use of acellular dermal matrix, such as Strattice. The implant is often switched out for a smaller one, as well.
When any medical device (pacemakers, artificial joints, steel plates and screws, etc.) is placed in the body, scar tissue forms around the object. This is also the case for breast implants. In the best situations the scar remains soft and pain free. In some cases, the scar capsule around a breast implant becomes hard, resulting in distortion of the breast and possible pain. It is theorized that bacteria gets on the implant and creates a biofilm and inflammation, which in turn causes the scar capsule to become hard: capsular contracture. Definitive treatment involves the removal of the breast implant and scar capsule (capsulectomy). Reuse of the old implant is not recommended. A new implant can be placed at the time of the explantation and capsulectomy, or placed after a period of healing.
There are several reasons for the development of a double bubble deformity. Placement of an implant too high on the chest with the breast positioned at the lower part of the implant will result in a snoopy or waterfall deformity. Treatment may involve the release of more pectoralis muscle fibers along the lower aspect of the breast implant pocket, and or a breast lift to reposition the nipple and areolae in a higher position on the breast mound. A high inframammary fold as seen in constricted breasts or tuberous breast deformities can also create a double bubble deformity. Radial incisions along the inframammary fold defect may alleviate this problem.
This malposition deformity can occur if a pocket is over-dissected along the outer chest. Time, gravity and large smooth implants can contribute to this condition, as well. Suture repair or capsulorrhaphy along the outer implant pocket will help to improve the position of the implants within the pockets. Sometimes the use of a smaller implant is recommended at the time of the pocket repair.
This deformity occurs from over-release of the pectorals muscles along the sternum with a sub-muscular pocket or over-release of subcutaneous tissue with a sub-glandular pocket. With symmastia (bread loafing or uni-boob deformity), there is distortion of the cleavage and the implants appear to touch each other in the middle of the chest. Treatment for this deformity may include a site change to a sub-muscular pocket if the implants are above the muscle, or pocket repair along the middle chest (sternum) using a suture capsulorrhaphy technique if the implants are under the muscle.
This deformity occurs when the breast tissue overlying the breast implant is very thin. Visible wrinkling or rippling in the breast tends to occur more often when implants are placed above the muscle (sub-glandular). In this situation, a site change to a sub-muscular pocket may potentially improve the deformity by providing more soft tissue coverage over the implant. Saline implants that are under-filled are also a common cause of visible rippling. Overfilling the implant can help with smoothing out the ripples. Soft tissue coverage can also be accomplished with the use of acellular dermal matrix in the area of the wrinkles.
Whatever your reason for revision surgery, Dr Park will perform a comprehensive exam, listen to your goals and expectations, and provide a detailed explanation of the best options for surgery to help ensure that you are well informed and confident when making your decision to schedule surgery with us.
Preparing For Your Surgery
Before your surgery, Dr. Park and his nurses will see you at your preoperative appointment. During this appointment you will get another opportunity to ask any additional questions you may have with regard to surgery and review all the details of surgery again. We will also ensure that you have chosen the right implant to achieve your goals, if you have decided to exchange your implants.
In some cases, a preoperative mammogram may be recommended if there is strong family history of breast cancer, a clinical concern, or for patients 40 years of age or more.
You will be provided with prescriptions for medications required after surgery. You will also be provided with instructions to prepare for surgery, including guidelines on drinking, eating, smoking, and avoiding certain medications or supplements.
While preparing for surgery, make sure to make arrangements to have a family member or friend drive you home after surgery. You may also want to have someone help you for a couple of days while you recover
The removal of breast implants is a fairly straightforward surgery. In most cases your preexisting scars are opened to remove the older implants and place new ones. A simple breast implant exchange surgery can sometimes be performed in less than one hour. But, when there are other issues to address, surgery may be more involved and time for surgery could be a bit longer.
After Breast Implant Removal
If you decide to remove your breast implants without replacing them with new ones, there is the potential for a suboptimal cosmetic result. Over time the skin around the breasts can lose elasticity, especially when implants have been in place for many years. When the implants are removed, the breast skin may have enough flexibility to shrink back its original shape. However, in many cases the skin around your breasts remains stretched and saggy. In cases where the breasts become loose and ptotic, patients may want to consider undergoing a breast lift to tighten the breast tissue and skin.
The Next Step
To find out if you are a good candidate for revision breast augmentation surgery, call us at 760.655.1414 to schedule your consultation with Dr. Gregory Park. We look forward to helping you in achieving your goals.