Breast Implant Revision

During the consultation, you and your surgeon will discuss the changes that you would like to make in your appearance. Because this is a highly personal decision, you?ll want to take time to discuss all of your concerns and desires, including the size and shape of the implants. You may want to have more than one consultation in order to have the necessary time to contemplate the options available to you.

Under FDA guidelines, certain patients are eligible for silicone implants, which tend to have a softer, more natural feel than saline implants. Some patients prefer them. However if they were to rupture, they can result in more extensive complications.

Patients who are eligible for silicone include breast cancer patients, patients with birth defects, patients who have suffered trauma to the breast area, or have significant drooping. Patients who have had previous silicone implants are also allowed to choose silicone implants. If you choose silicone implants, you will be included in a national study, and your doctor will be required to follow your progress for at least five years.

Be sure to discuss the relative risks and benefits and the rational with your doctor. Your surgeon should also explain the anesthesia he/she will be using during your procedure. You should tell him/her about any medications you currently are taking, and any health conditions you have.

Be sure to ask all the questions you have about the surgery, and ask to see photos of the doctor?s recent patients, before and after surgery. Also ask for, and follow up on, patient references. Learning everything you can about your options, risks and benefits is the key to making an informed decision. See ?Questions to Ask Your Doctor? below.

During the procedure, your surgeon will make an incision to remove the existing implants and place new implants in the same area.

An incision may be made in any one of the following places: the crease below the breast, around the areola, under the armpit, or, in rare cases, through navel. The silicone implants are usually taken out through the same incisions used to put them in.

The new implants can be placed either under the chest muscle or directly under the breasts. Placement considerations include the anatomy of your breasts, toleration of soreness after surgery, and possible interference with mammograms. In addition, if you have some hardening or contracture in one location, your surgeon may choose to move the new implant to another site.

A general anesthetic will be typically used; this will allow you to be completely asleep during the procedure. Rarely, the surgery is done under intravenous sedation. The choice of anesthesia should be discussed with your doctor during the initial consultation.

Breast augmentation stretches the tissues, and can be painful. This may be true for breast surgery revision as well, especially when the implants are placed under the muscle or the pocket location is different. The pain is greatest within the first 48 hours, but improves with each day and is somewhat relieved by pain medications.

When you wake up you will feel tired, sore, and stiff. It is important to take the medication prescribed to you by your doctor. Someone will need to drive you home, and you may need assistance at home over the next couple of days.

Your surgeon may prescribe an antibiotic and an anti-inflammatory medication to be taken after the surgery. It is a good idea to have these prescriptions filled beforehand.

Your breasts will be wrapped with gauze bandage as well as a tighter bandage for protection and support. You also may have drainage tubes coming out of the incision for several days, to help drain some of the excess fluid. (This decision is based on your surgeon?s experience and the particular findings during your surgery.)

It is important to take the medication prescribed to you by your doctor. Someone will need to drive you home, and you may need assistance at home over the next couple of days as well.

Your scars will be pink for several weeks. After several months they will begin to fade. It is critical that you review post-procedure care with your doctor. Following his/her instructions carefully will help promote a speedy, healthy recovery. Also keep in mind that:

• Rest is important to the healing process, so get as much as possible following your procedure! Drink plenty of fluids, and be sure to take the doctor's prescribed medications.
• For at least 3-5 days, you should try to keep arm extension to a minimum. Elbows should not be raised higher than the armpit. The tissues will heal more quickly if you avoid stretching and separating the muscle / tissue surrounding the breast implants.
• After several days, the gauze dressing will be removed. You may be required to wear a support bra to help your breasts form and maintain a pleasing, balanced shape. You may or may not be able to shower, depending on where your stitches are.
• The stitches will come out within a week to ten days, but swelling may continue, gradually subsiding over several weeks. With the swelling, your breasts may seem hard and unnatural, but eventually they should soften to a more natural feel.
• Because revision surgery can range from minor surgery performed on soft breasts to a major procedure on hardened breasts, you should check with your surgeon to find out when you?ll be able to return to your normal activities. Recovery varies from patient to patient and depends upon the technique, type of implant, and site of placement that the doctor uses, as well as the level of activities in your daily routine.

The long-term outcome for breast surgery revision is good. This procedure allows women to continue their daily lives without the worry of silicone leakage and complications. Mentor and McGhan, the two makers of saline implants, guarantee their saline filled implant products for life.

An overwhelming percentage of women express high satisfaction with the results of their surgery and feel that it has a positive impact on their lives. Following FDA instruction, these two companies have published information pamphlets about such topics as wrinkling, leakage, contracture and asymmetry. When you have your surgery, you will be provided with information about one of these companies. Please discuss this with your doctor.

There is no one answer for how long implants last. It may be between 6-8 years or as long as 15 years, but predictions in individual cases are nearly impossible. Many doctors have patients that are pleased with their implants even as long as two decades later. You should periodically return to your surgeon to determine how well your implants are lasting.

Keep in mind that larger breasts sag faster than smaller breasts, and augmented breasts do this as well. Gravity, unfortunately has no exceptions. Ten or twenty years after surgery, successful augmentation patients will look far improved over those who haven?t had surgery.

• 18 years of age or older
• Not currently pregnant or nursing
• In good physical health
• Psychologically stable
• Wanting to improve their appearance
• Realistic in their expectations
• Having this surgery for the first time

There are several concerns regarding any breast surgery: the surgery itself, the implants, breast cancer, and the risk of anesthesia. All surgeries carry some risk and the possibility of complications can include (but are not limited to) infection, unsatisfactory results, excessive bleeding, adverse reaction to anesthesia, and the need for second or sometimes third procedures.

There is no known association of breast implants with breast cancer in human beings, and in fact several large studies have shown a lower incidence of breast cancer in women with breast implants. (Breast implants type devices have been shown to cause a rare form of cancer in rats that are prone to cancer, but this cancer has not been reported in humans with breast implants.)

Other side effects specific to breast surgery revision include:

• capsular contracture: occurs when the scar or area around the implant begins to tighten, causing the breast to feel hard.
• nipple sensitivity or loss in sensitivity: usually disappears after several weeks, but for some this is permanent.
• rippling: indentations on the breast, often caused when the implant moves. This tends to be more common with textured implants than smooth implants.
• rupture: when the breast implants tear and/or leak. If your implant ruptures, it will require a second operation to replace the implant. Rupture of a saline implant is generally not an urgent matter, and will almost certainly have fewer problems than rupture of a silicone implant. Silicone gel has the consistency of glue, and may irritate the body.
• symptoms of immune system disorders: some women have reported having symptoms such as joint pain swelling, fever, fatigue, or breast pain. Although research has not found conclusive evidence correlating breast implants with these symptoms, further studies have been requested by the FDA.

Use our payment calculator to see what your monthly payments might be if you financed this procedure.

1. How long has the surgeon been working with breast implants?
2. What is the total number of revision procedures that the doctor has performed?
3. Has the plastic surgeon ever had his/her malpractice insurance coverage denied, revoked, suspended? (No)
4. Does the FDA approve the implant the doctor will be using? (Yes)
5. What procedure is the doctor recommending and why? (Discuss different incision types, location of the implant, type of implant, and whether the doctor recommends a breast lift in addition to augmentation.)
6. Please explain the risks associated with the procedure, including: capsular contracture, infection, nipple sensitivity, rippling, rupture, symptoms of immune system disorders (see ?Risks? section for more information.)
7. Percent of patients who experienced any of the aforementioned risks?
8. In the event that a second procedure is needed, does the original cost cover the additional expense?
9. Is there a warranty on the implants?
10. Where will the procedure be performed?
11. Who will be assisting the doctor during the surgery? What are their qualifications? Does the plastic surgeon perform the entire surgery?
12. What type of anesthesia will be used, and who will administer it?
13. Will the doctor provide references of patients who have had the same procedure? (The doctor should have a list of references available.)
14. Will the doctor provide before/after photographs of breast augmentations he/she has performed?
15. What are the guidelines and recommendations for selecting the implant breast size?
16. Can you observe the exact procedure you are having before you decide to have the surgery? (Yes, either on videotape or ask to view one in real life.)
17. What should you expect post-operatively, in terms of soreness, what to watch for, medication, bathing, and level of activity?
18. Who will be assisting the doctor during the surgery? What are their qualifications? Does the plastic surgeon perform the entire surgery?
19. How will the breast implants affect the way your routine mammograms are performed?
20. Do you offer patient financing?

• Tell your doctor about any allergies you have (to foods, drugs, environmental elements)
• Tell your doctor about all medications you are taking (both prescription and non-prescription)
• Avoid aspirin and aspirin-containing medicines, as well as anti-inflammatory medicines such as Nuprin, Motrin, and Advil for two weeks prior to surgery. Also avoid herbal remedies such as St. John?s Wort, gingko biloba, some types of Chinese black mushrooms and other natural medicines and foods that may thin the blood.
• Try to schedule surgery at a time other than your menstrual period.