Breast Implant Revision

The goal of breast implant revision surgery is to replace old breast implants with new implants.

Introduction

What is breast implant revision surgery?

The goal of breast implant revision surgery is to replace old breast implants with new implants. Often the goal is also to change or improve the appearance of the breasts while updating the implant material, which could include:
  • A concurrent breast lift or reduction
  • Reshaping the breast implant pocket to reposition the implant on the chest
  • Either increasing or decreasing the size, shape or style of the breast implant
Breast Implants: What Patients Need to Know Allergan Biocell Device Withdrawal Information The desire to have breast implant revision surgery can be because of any of the following reasons:
  • Desire to change the size of the breasts
  • Pain from capsular contracture
  • Concern about rupture or migration of implant
  • Change from saline to silicone or different style of implant
Over time, breast implants can change shape or size, and the overlying breast tissue can also change, creating an appearance or feel to the breast that is less desirable than the original result. Also, many breast implants have a lifetime warranty on the actual implant device, but after ten years the costs associated with having surgery to replace the implants are no longer covered. Because of this, many women will elect to replace or update their breast implants at or around the 10-year time frame. Breast implant revision surgery is not a standard or routine procedure and needs to be tailored specifically to the patient’s goals and desires. Therefore, this surgery should be performed by a board-certified plastic surgeon who is well-trained and experienced in all types of breast surgery and who will listen to the patient’s goals and desires and will develop a surgical plan specifically to address all of the issues at the time of surgery.
Candidates

Who is a good candidate for breast implant revision?

Breast implant revision surgery is intended for patients who have had a breast augmentation in the past and are now unhappy with their implants or concerned about the condition of their implants. This procedure can address those concerns by replacing the existing implants with new implants.

Who is a good candidate for breast implant revision surgery?

In general, you may be a good breast implant revision candidate if:
  • You are unhappy with size, shape or appearance of your breast implants
  • You are concerned about the integrity or condition of your implants
  • You are physically healthy and at a stable weight
  • You have realistic expectations
  • You are a nonsmoker
If you’re considering surgery, spend some time reviewing breast implant revision surgery photos and learning about what to expect during recovery. Preparation ahead of time helps patients have reasonable expectations and a smoother recovery.
Cost

How much does breast implant revision cost?

A plastic surgeon’s cost for breast implant revision surgery may vary based on his or her experience as well as geographic location. In some instances, health insurance may cover breast implant revision surgery. Also, in some instances, the implant warranty will cover some of the costs associated with this surgery. Many plastic surgeons offer patient financing plans for breast implant revision surgery in instances where health insurance does not cover it, so be sure to ask.

Breast implant revision costs may include:

  • Surgeon’s fee
  • Hospital or surgical facility costs
  • Implant costs
  • Anesthesia fees
  • Prescriptions for medication
  • Post-surgery garments
  • Medical tests and x-rays
When choosing a board-certified plastic surgeon for breast implant revision surgery, remember that the surgeon’s experience and your comfort with him or her are just as important as the final cost of the surgery.
Consultation

What should I expect during a consultation for breast implant revision?

During your breast implant revision consultation, be prepared to discuss:
  • Your surgical goals
  • Medical conditions, drug allergies and medical treatments
  • Current medications, vitamins, herbal supplements, alcohol, tobacco and drug use
  • Previous surgeries
Your plastic surgeon will also:
  • Evaluate your general health status and any pre-existing health conditions or risk factors
  • Examine your existing breast implants
  • Take photographs
  • Discuss your options and recommend a course of treatment
  • Discuss likely outcomes of breast implant revision surgery and any risks or potential complications
The success and safety of your breast implant revision procedure depends very much on your complete candidness during your consultation. You’ll be asked a number of questions about your health, desires and lifestyle. Be sure to ask your plastic surgeon questions. It’s very important to understand all aspects of your breast implant revision surgery. To help, we have prepared a checklist of questions to ask your plastic surgeon that you can take with you to your consultation. It’s natural to feel some anxiety, whether it’s excitement or a bit of preoperative stress. Don’t be shy about discussing these feelings with your plastic surgeon.
Questions to Ask

What questions should I ask my plastic surgeon about breast implant revision?

Use this checklist as a guide during your breast implant revision consultation:
  • Are you certified by the American Board of Plastic Surgery?
  • Were you trained specifically in the field of plastic surgery?
  • What specific training do you have in breast implant revision techniques?
  • How many years of plastic surgery training have you had?
  • Do you have hospital privileges to perform this procedure? If so, at which hospitals?
  • Is the office-based surgical facility accredited by a nationally- or state-recognized accrediting agency, or is it state-licensed or Medicare-certified?
  • Am I a good candidate for this procedure?
  • What will be expected of me to get the best results?
  • Where and how will you perform my procedure?
  • What surgical technique is recommended for me?
  • How long of a recovery period can I expect, and what kind of help will I need during my recovery?
  • What are the risks and complications associated with my procedure?
  • How are complications handled?
  • How can I expect my breast implant revision to look over time?
  • What are my options if I am dissatisfied with the outcome?
  • Do you have before-and-after photos I can look at for this procedure and what results are reasonable for me?
Risks and Safety

What are the risks of breast implant revision?

The decision to have breast implant revision surgery is extremely personal. You’ll have to decide if the benefits will achieve your goals and if the risks and potential complications of breast implant revision are acceptable. Breast Implants: What Patients Need to Know Allergan Biocell Device Withdrawal Information Your plastic surgeon and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedures you will undergo and any risks or potential complications. The possible risks of breast implant revision surgery include, but are not limited to:
  • Anesthesia risks
  • Asymmetry
  • Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL)
  • Bleeding
  • Deep vein thrombosis, cardiac and pulmonary complications
  • Fatty tissue found deep in the skin might die (fat necrosis)
  • Fluid accumulation (seroma)
  • Hematoma
  • Infection
  • Numbness or other changes in skin sensation
  • Persistent pain
  • Poor healing of incisions
  • Recurrent looseness of skin
  • Skin loss
  • Skin discoloration and/or prolonged swelling
  • Suboptimal aesthetic result
  • Unfavorable scarring
These risks and others will be fully discussed prior to your consent. It’s important that you address all your questions directly with your plastic surgeon.
Preparation

How should I prepare for breast implant revision?

In preparing for breast implant revision surgery, you may be asked to:
  • Get lab testing or a medical evaluation
  • Get breast or implant imaging, such as a mammogram, ultrasound or MRI
  • Take certain medications or adjust your current medications
  • Stop smoking
  • Avoid taking aspirin, anti-inflammatory drugs and herbal supplements as they can increase bleeding
Breast implant revision surgery is typically performed in a hospital or licensed ambulatory surgery setting, and will likely use general anesthesia. If your breast implant revision is performed on an outpatient basis, be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.
Procedure Steps

What are the steps of a breast implant revision procedure?

Step 1 – Anesthesia

Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.

Step 2 – The incision

The type of incision used in breast implant revision surgery will vary depending upon the type of procedures that will be performed. The incision can include, but is not limited to, any of the following:
  • Inframammary incision – in the crease under the breast
  • Breast lift incision – either vertical incision or Wise pattern incision
  • Peri-areolar incision – incision part way or all the way around a areola

Step 3 – Closing the incisions

Sutures, skin adhesives, tapes or clips close the skin incisions.

Step 4 – See the results

The final results of breast implant revision surgery will be initially obscured by swelling. Get more information about breast implant revision results.
Recovery

What should I expect during my breast implant revision recovery?

Following your breast implant revision, gauze dressings or bandages maybe applied to your incisions. Depending on the details of your surgery, you may or may not be placed in a support bra or other type of garment. In some cases, a small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid that may collect. You will be given specific instructions that may include:
  • How to care for your surgical site(s) following surgery
  • Medications to apply or take orally to aid healing and reduce the risk of infection
  • Specific concerns to look for at the surgical site or in your general health
  • When to follow up with your plastic surgeon
Be sure to ask your plastic surgeon specific questions about what you can expect during your individual recovery period.
  • Where will I be taken after my surgery is complete?
  • What medication will I be given or prescribed after surgery?
  • Will I have dressings/bandages after surgery? When will they be removed?
  • Will there be drains? For how long?
  • When can I bathe or shower?
  • When can I resume normal activity and exercise?
  • When do I return for follow-up care?
Healing will continue for several weeks as swelling decreases. Continue to follow your plastic surgeon’s instructions and attend follow-up visits as scheduled.
Results

What results should I expect after breast implant revision?

The final results of breast implant revision surgery will be initially obscured by swelling. It will take at least six weeks for the swelling to resolve and the breasts to feel softer and more natural. In some cases, it can take 6-12 months for the breasts to feel “normal.” Healing time is different for everyone and sometimes it can take longer for the breasts to soften, for normal sensation to return, for scars to fade and for the patient to get used to the feel of having an implant. Please discuss realistic expectations with your surgeon regarding healing. The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. In some situations, it may not be possible to achieve optimal results with a single surgical procedure and another surgery may be necessary. When you go home, if you experience shortness of breath, chest pains or unusual heart beats, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment. Following your physician’s instructions is key to the success of your surgery. It is important that the surgical incisions are not subjected to excessive force, abrasion or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself.
Glossary of Terms

What words should I know about breast implant revision?

Capsular contracture

The scar tissue that forms inside the body, around the implant, that can sometimes become thick or tight resulting in a hard-feeling or -looking breast implant.

General anesthesia

Drugs and/or gases used during an operation to relieve pain and alter consciousness.

Hematoma

Blood collecting beneath the skin.

Intravenous sedation

Sedatives administered by injection into a vein to help you relax.

Local anesthesia

A drug injected directly to the site of an incision during an operation to relieve pain.
Choosing a Surgeon

How do I choose a plastic surgeon for breast implant revision?

Breast implant revision involves many choices. The first and most important is selecting a board-certified plastic surgeon you can trust who is a member of the American Society of Plastic Surgeons (ASPS). ASPS member surgeons meet rigorous standards:
  • Board certification by the American Board of Plastic Surgery® (ABPS) or in Canada by the Royal College of Physicians and Surgeons of Canada®
  • Complete at least six years of surgical training following medical school with a minimum of three years of plastic surgery residency training
  • Pass comprehensive oral and written exams
  • Graduate from an accredited medical school
  • Complete continuing medical education, including patient safety, each year
  • Perform surgery in accredited, state-licensed or Medicare-certified surgical facilities
Do not be confused by other official-sounding boards and certifications. The ABPS is recognized by the American Board of Medical Specialties (ABMS), which has approved medical specialty boards since 1934. There is no ABMS recognized certifying board with “cosmetic surgery” in its name. By choosing a member of the American Society of Plastic Surgeons, you can be assured that you are choosing a qualified, highly trained plastic surgeon who is board certified by the ABPS or the Royal College of Physicians and Surgeons of Canada.
Before and After Photos
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