Even though the vast majority of women who get breast implants are happy with their results, breast augmentation revision surgery may be needed for a variety of reasons. Breast implants are not designed to last a lifetime and at some point, women either have them replaced or removed. Complications may also lead to a revision procedure. Elective breast augmentation revision surgery at my Chicago practice is also a choice some women make to change the size or type of implants they have.
Whatever the specific reason for undergoing breast augmentation revision surgery, there are actually some positive aspects of the procedure, including the opportunity to upgrade to the latest generation of breast implants. In this blog post, I’ll describe what happens during revision surgery and explain why it’s important to choose a plastic surgeon with extensive experience to perform this type of procedure.
The Revision Procedure
Secondary surgery is more challenging than a primary breast augmentation. Scar tissue that develops around the implant makes it more difficult to predict the results. Additionally, implants stretch tissues and can cause other anatomical changes. The specific techniques used during the procedure depend on the reason for undergoing revision surgery.
Reasons for Revision Surgery
Patients seek breast augmentation revision at our Chicago plastic surgery practice for a number of reasons.
- Elective revision: This includes women who choose to either replace or remove implants for cosmetic reasons. According to FDA statistics, switching to a larger size implant accounts for nearly 40% of all breast revision surgeries in the United States. Other women decide that they no longer want implants and undergo a procedure called explant surgery.
- Complications: Post-surgical complications may occur shortly after getting breast implants or more than 10 years after the procedure. The most common breast augmentation complication is capsular contracture, which occurs when the fibrous lining of scar tissue that develops around the implants—called a capsule—hardens and contracts around the implant. This can cause the breast to appear distorted and feel unnaturally firm.
- Breast asymmetry: In some cases, patients come to our practice after having breast augmentation performed by other plastic surgeons and are disappointed that their breasts now appear to be different sizes. While most breasts have some degree of asymmetry, revision surgery can correct more severe asymmetry.
- Visible wrinkling or rippling: When implants are placed above the chest muscle and the patient doesn’t have adequate breast tissue, the lack of coverage can reveal rippling or wrinkling of the implant. Revision surgery involves placing the implants behind the pectoral muscles for a smoother appearance.
- Upgrading to different implants: The newer cohesive gel implants have definite advantages of less silicone gel bleed and less migration of silicone in the event of a rupture. Many believe they have a lower capsular contracture rate than the older silicone gel implants.
Saline vs Silicone Implants
We continue to give patients a choice of implants. There are tradeoffs with each. Saline implants have salt water inside a silicone rubber shell, and therefore do not have issues with silicone gel bleed – small molecular weight silicone that passes through the silicone shell and causes chronic low-grade inflammation that results in a thicker capsule and can result in capsular contracture. The capsular contracture rate with saline is extremely low, but the tradeoff is that a small leak in the shell will result in total deflation, and in some patients with larger implants, the lack of capsule can result in lateralization of the implant (falling to the side when the patient lies down). In patients with some breast glandular tissue, and moderate size implants, saline implants continue to be a very good choice, and most of our patients still choose saline.
Because revision surgical procedures are more complicated than primary breast augmentation surgery, it’s important to choose a board-certified plastic surgeon who regularly performs this type of procedure. An experienced surgeon may also recommend combining the revision surgery with a breast lift to create optimal results.
You can see in our gallery of before-and-after photos the types of results that revision breast augmentation surgery can produce. If you’re considering replacing your breast implants and looking for a Chicago plastic surgeon who’s qualified to perform the surgery, contact us using the online form. You can also call our office at (312) 788-2560 to schedule a consultation.