Breast revision refers to one or more procedures of the breast after the initial procedure has been performed. Often times following a past augmentation a patient will desire new implants. A breast revision involving larger or smaller implants. Or, a breast revision removing implants.
Also, patients with implants may develop capsular contracture. This is a situation where the pocket, over time shrinks. The initial pocket should be 20%
greater than the base diameter of the implant. If this relationship is maintained the breast will always be soft and natural appearing and natural-looking. If capsular contracture forms it can be treated with a revision of the pocket with or without larger or smaller implants.
To my knowledge, there is not a difference between over the muscle or under the muscle implant placement as it relates to capsular contracture. Capsular contracture is a function of the body and how it forms scar tissue around a foreign object. It is not the fault of the surgeon. In all of my years of experience, I have found that massage does help. Furthermore, infrared light treatments that we offer at our office also help.
BREAST LIFT REDO
Another breast revision option is a breast lift or mastopexy. Sagging breasts do not do well with implants. They can form the so-called “rock in a sock” look. The breast lift or mastopexy restructures, realigns, and removes excess skin. This is done so the shape is restored to its more youthful and perky appearance. Often times in conjunction with the breast lift an implant can be placed.
I caution my patients to not exceed a certain volume of the implant when a lift is indicated and performed at the same time. The breast lift is a removal of skin. The breast implant is the addition of volume. This requires more skin. The two operations conflict with each other.
In my opinion, when the breast requires a lift due to sagging, a large implant should be placed at a second stage. Attempting to place excessively large implants during a breast lift may result in the separation of the wound. It can also cause extrusion of the implant. At worst, and at best there is a possible widening of the scar. A breast revision may be needed.
Finally, breast surgery is an integral part of our life and society. Care and caution must be taken at all steps in order to ensure the best possible result. Please browse our before and after gallery. Contact us at (407) 629-4100 to schedule a consultation.
THOMAS TREVISANI, MD
BOARD CERTIFIED PLASTIC SURGEON
MEMBER AMERICAN SOCIETY OF AESTHETIC PLASTIC SURGERY
