Breast augmentation is one of the most popular cosmetic procedures and growing annually. While most women have many years without any complications, some women will inevitably want to replace their implants due to changes in their breasts, or complications with the implant itself. Whatever the reason, breast revision surgery is a procedure aimed at restoring a patient’s augmentation. William P. Adams Jr., MD, of Dallas performs many revision cases in his practice and finds the procedure to be rewarding to both a patient’s look and self-esteem.
By William P. Adams Jr., MD
and Adam McMillon
The Plastic Surgery Channel
Leading Causes of Implant Complications
“There are many more patients that come in for breast revision than for a first breast augmentation,” says Dr. Adams. “The typical patient is someone who has a problem. The most difficult thing about revision surgery is the tissues are not the same as they were when the patient had her original surgery. She could have problems with the breast tissue sagging or the patient can see the implant rippling under the skin and therefore the patient is no longer happy.”
Although rare, another complication that can happen in some patients is capsular contracture. This happens when there is an abnormal response of the immune system to the breast implant. The body’s immune system responds to the presence of the implant by forming capsules of tightly woven collagen fibers that can tighten and squeeze the implant, often causing discomfort and a distorted appearance.
Dr. Adams’ capsular contracture rate of 2% or less, is far below the national average because of his particular techniques in surgery. The national contracture rate falls between 5 and 10%.
Who is a candidate for revision?
“The best patient for revision is someone who initially had a good surgery and the tissues are still in good shape,” says Adams. “Sometimes women want to change their implants from saline to the newer silicone gel. Other times, a woman’s breast tissue has become stretched because of pregnancy, breast feeding, weight gain and loss, or just the natural aging process. When the skin is stretched out it, Adams says many patients will need a breast lift in addition to a new implant.
“On the other end of the spectrum, some patients have a lot of problems and need additional support to their breasts,” says Adams. There are two new materials that act as an ‘internal bra’ called, GalaFLEX® mesh and SERI® Surgical Scaffold . These scaffolding meshes are absorbed into the body eventually becoming your own tissue. These natural meshes, says Adams are a way that we can really help achieve the goals of the patient who wants fullness and volume to their breasts but no longer have enough support in their natural breast tissue.
Recovery
Following surgery, your breasts will be wrapped in gauze dressings and an elastic bandage or support bra to minimize swelling and support the breasts as they heal. You can go home after a few hours and may need to wear a support bra around the clock for the first week or two. After a post-surgical recovery period of 24 to 48 hours and an additional reduced-activity period of a few days, you will likely experience some soreness and swelling for a few weeks. Exercise and normal activity can resume at the direction of your plastic surgeon.
Modern Technology means Less Downtime
A good majority of patients coming in for breast revision had their initial augmentation performed upwards of 15-20 years ago, a very different time in medicine than now. Modern medicine and technology have improved nearly every corner of surgery, including, recovery. “Patients can get back to work quickly now,” says Adams. “The recovery is pretty acceptable; it doesn’t last very long at all. It’s refreshing and comforting for them to realize they’re not going to go through a lot of pain and discomfort.”
Overall, breast revision can quickly get a woman back to where she wants to be physically, which will also translate to where she would like to be mentally. “We see our patients have a boost in their quality of life through this procedure,” says Adams. “We’re able to take something that is no longer right and make it right. No matter what the problem is, we have some great tools and techniques to get you back to where you want to be with your breast and breast shape.”