Seventy to eighty percent of breast cosmetic surgery proceeds without complication or problem. There are certain cases however where breast revision, or addressing a problem comes up. Whenever you place a foreign object, for example, a breast implant into the human body certain circumstances may occur.
The first set of circumstances is the fact that the foreign object or breast implant is not recognized by the body as its own. Therefore to a degree, a foreign body reaction occurs. This may include scar tissue that forms around the implant. It may cause contracture or firmness of the breast implant area. This is not to say it is a defect in the implant. It is a response to the presence of a foreign object. This capsular contracture can be treated with breast revision surgery. One way is by open capsulotomy with partial or full removal.
Occasionally it creates pockets in such a fashion that they fuse in the midline. This is referred to as symmastia. In my experience, the best way to treat this is to remove the implants for a period of time and then re-create the pockets new. Occasionally the pocket housing the implant violates the infra memory crease. And, when this occurs we have what is termed a double bubble. This means essentially that the implant is moved below the formation where a crease causing a double indentation and double fullness at and below the intra-memory crease.
Attempts to create this crease without removing the implant usually fail. So there are three types of revision surgery that may be required after breast augmentation. Capsular contracture, symmastia, and double bubble. With patience and skill, they can be corrected.
THOMAS TREVISANI, MD
BOARD CERTIFIED PLASTIC SURGEON
MEMBER AMERICAN SOCIETY OF AESTHETIC PLASTIC SURGERY