Many patients come to me with problems from breast augmentation surgery they had done in the past. An original operation aimed to give patients confidence may have had the opposite result. Embarrassment & guilt about having had a “vanity” operation can make the process of returning for further surgery difficult. But getting a patient to a result she is thrilled with can be a triumph.
More than half of all surgery I do involves the use of implants, either alone or along with a breast lift. As an experienced surgeon, many of my cases are secondary procedures, where after previous surgery, patients have issues needing “revision”.
Resolving long standing issues from old surgery can be an extraordinary, liberating experience, finally giving have the soft, natural result you always wanted.
Introduction to Revision Breast Augmentation
When the outcome from breast augmentation leaves you disappointed or there are aspects of your breasts that despite prior surgery you would like altered.
Secondary breast augmentation may involve:
- General (complete anesthesia)
- Occasionally minor revisions can be done under local (freezing)
- Exchange of implants
- Removal of or alteration of the “capsule” (capsulectomy, capsulotomy)
- Breast lift
- Change of implant size or type
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Breast augmentation can help women feel more feminine and more confident. However, as with any surgery, complications can occur. These are discussed extensively in our breast augmentation page.
If you have had previous breast augmentation and the results have been disappointing or have resulted in problems in one or both breasts, we may be able to offer you a surgical solution.
Dissatisfaction with the results from original (“primary”) breast augmentation surgery may stem from complications of surgery or from a variety of other reasons.
We always encourage patients to try to return to their original surgeon to resolve residual concerns. Sometimes, however, this is not possible.
Secondary, or “revision,” surgery is always more complex than primary surgery. There are psychological and physical reasons. Your expectations of the original surgery may not have been met, and disappointment makes it hard to achieve the absolute satisfaction you may have expected from the original surgery. If we can get much closer to your desired cosmetic outcome, most likely you will be happy. The physical or technical reasons will depend on your individual case.
The most common reasons for re-operative surgery are to switch to larger or smaller implants, developing capsular contracture (hardness around the implant) and to treat drooping of the breasts that was not present or was not treated at the time of the previous surgery.
When patients request a change of implant size, there are many factors that need to be considered. Going larger is more common than going smaller. However, when a patient feels her implants are too large, this can be very upsetting.
Capsular contracture used to be more common than it is now. With contracture, women are afraid of even being hugged, because their breasts often feel like foreign objects in their bodies. Better implants have played a role, as have gentler surgical techniques. But the most significant improvement was the more widespread technique of placing implants under the muscle (called the partial sub-pectoral approach).
When we do see contracture with implants above the muscle (as in the case titled “Nopali 10639”), the treatment is usually complete capsule removal (a procedure called capsulectomy) and replacement with new implants under the muscle. While this procedure is not guaranteed to be successful, the results usually offer an improvement in the breast shape and feeling. This is preferable to hard, immobile, round breasts — not to mention the embarrassment and self-consciousness that often accompany capsular contracture.