These days my patients are quite informed about the procedures they are requesting from me. They’re reliant on my professional advice on the details and implementation of their goals, but most Breast Augmentation patients have an idea about what the procedure entails. The lesser known sister of Breast Augmentation is Breast Revision surgery. There are a variety of reasons someone might need this “surgery after the surgery,” and I’ll cover those here.

Breast Revision surgery is for someone who’s already had a Breast Augmentation and needs a change that requires another surgery to the breast area at any point in time near or distant from the original Breast Augmentation. The majority of women love their new breasts with no complications and often experience satisfaction for many years.

However, a Breast Revision surgery is a great option for a variety of reasons, such as:

1. Address the natural effects of aging and gravity on the breasts. The breasts with the implant still will sag over time and so a Breast Lift could help restore perkiness and placement.
2. Breasts change as a result of pregnancy, weight loss or gain. If the Breast Augmentation occurred before these events, a Revision can be intended to restore your breasts to their former stature.
3. Change the implant size with a Breast Implant Exchange to go smaller or larger. Fortunately, the Breast Implant Exchange is less intense of a surgery than the original augmentation. The space or pocket for the implant has already been created so there’s not the stretching discomfort experienced during the initial surgery. Also, the recovery time is usually shorter.
4. Repair breast implant malposition. The implant didn’t settle where it should be and has caused the breasts to look unnatural.
5. Correct capsular contracture where the tissue surrounding the implant contracts and squeezes the implant into an awkward and uncomfortable position. In this case, the constricting tissue would be removed and the implant replaced.
6. Change the implant type. Some women who got saline implants and experience rippling or wrinkling, prefer to exchange them for the consistency of a silicone gel. This is particularly common for women who got a Breast Augmentation when the silicone option was off the market from 1993 to 2006.
7. Breast Implant Exchange for prevention or in the case of leakage. Implants do not have a lifetime guarantee to not leak. It is recommended to exchange for a new implant every 10 years. If a saline implant is leaking, it’s easy to detect because the breast will appear deflated. However, in most cases, a silicone implant leak would require an MRI to detect leakage, so regular checks are recommended.
8. Breast cancer treatments may require the implant to be removed. This is a decision that should be made along with your medical support team.

In conjunction with considering the need for a Breast Revision surgery, I can’t emphasize enough the importance of choosing an experienced plastic surgeon to perform it. Maintaining aesthetics of the breasts while navigating prior surgery effects is an art that requires much technical skill and expertise. To discuss the possibility of putting yourself in the hands of a triple board certified surgeon, such as myself, you can schedule a consultation at www.davinciplastic.com.

Steven Davison M.D.

Board Certified Plastic Surgeon

One of the hardest situations in the plastic surgery industry is to have a patient’s results not go as expected. This may or may not be the fault of the physician, but the best results are directly correlated to the most credentialed, experienced surgeon. This is why it is crucial to only trust your face and body to an experienced, Board Certified Plastic Surgeon…someone like myself.
In my area, I’m the only triple Board certified plastic surgeon, a member of multiple prestigious medical societies, and a published professor at Georgetown University. Along with my many years of experience, compassion and patient care, these credentials have led to my ability to provide a very high level of patient satisfaction. As a result, I’m often called upon to correct the concerns that arise from unsatisfactory surgeries, at the hands of other physicians, and the unforeseen side effects that happen from improper healing.

For example, an occasional unwelcome side effect after beast augmentation surgery is Capsular Contracture. This occurs when the scar tissue that has formed around breast implants tightens and hardens around the implants to create an imbalanced external appearance. This means that the affected breast will look a different shape or be at a different height on the chest. While meticulous surgical precision can help prevent capsular contracture, as with any surgical procedure there will be scar tissue and there are factors outside of the physician’s control.
Here are some tips that can contribute to avoiding Capsular Contracture:

…Avoid smoking is one of the most predictable ways to reduce your chances, as you’re twice as likely to have Capsular contracture if you smoke.
…Two weeks prior to surgery, start taking Vitamin E and possibly Prednisone, a prescription corticosteroid drug.
…Breast implants in a submuscular position, or under the pectoral muscles, may be less likely to develop capsular contracture than when breast implants are placed in a subglandular position, or over the pectoral muscles.
…There’s a slightly higher percent of Capsular Contracture with silicone implants over saline.
…Upon the instruction of surgeon, massaging and compression of the breast implants can help keep the capsule flexible and loose.

Capsular contracture may develop at any time, but can occur as early as 4 to 6 weeks after surgery, and usually not later than 6 months. It can affect just one or both breasts. Fortunately, it can be corrected with Revision Breast Surgery.  There is a special art and skill to correct Capsular Contracture… because of the difficulty of working with scar tissue. It’s a puzzle figuring out what possibly went wrong and then to skillfully correct it.

Revision Breast Surgery to correct Capsular Contracture can involve a variety of ways for releasing the interior scar tissue. These ways may include capsulotomies, capsulectomies, implant exchange or placement behind the pectoral muscle. A Capsulotomy is a surgical procedure that releases scar tissue without removing it from the pocket. This gives room for the breast pocket to expand, relieving the scar tissue contraction that is squeezing the breast implant. A Capsulectomy is a more aggressive approach, as it completely removes the scar tissue surrounding a breast implant. This procedure is more often used when the scar tissue is very thick and calcified or when a silicone breast implant has ruptured.

If you’ve experienced the disappointment of your breast augmentation not going right and want to trust your body to one of the leading plastic surgeons to correct it, please set up a consultation at www.davinciplastic.com.

Steven Davison M.D.

Board Certified Plastic/Reconstructive Surgeon