Almost every plastic surgeon’s goal is to achieve amazing results for their patients. No one goes into an enhancement surgery planning a second one. However, life isn’t always on our side. While complications associated with breast augmentation are low, they can occur. When they do, breast revision surgery is performed to restore the look and feel of the breasts.
Deciding on an implant size before your surgery can be tricky. It is a fine balancing act to find the right implant size for your body’s proportions and for achieving an attractive, larger bust. Sometimes that equation can be off, and your breasts don’t end up the size you envisioned. If you have allowed for adequate healing time (six months to a year) and you are still unsatisfied with the size of your breasts, revision surgery can replace your implants with larger ones.
In most cases, the original incision site is used to remove the old implants and insert new ones, which prevents further scarring. Not only can implant size be changed, but implant type can be switched as well. Some patients decide that they would prefer a different implant material to better simulate natural breast tissue.
Capsular contracture is a complication that, if it develops, usually occurs after the recovery period. During recovery, a natural scar capsule forms around the implant, keeping it in place. In cases of capsular contracture, this capsule begins to constrict the implant, causing it to appear distorted and feel tight and hard. In severe cases, capsular contracture can be painful.
For less severe cases of capsular contracture, the scar tissue shell is cut to relieve the pressure. In other cases, the scar tissue must be completely excised and new implants must be inserted.
Weakened implant folds or trauma to the implant can cause a rupture or slow leak. This is most common in older implants that have begun to wear out, but it can occur in newer implants as well. A saline implant rupture can be ascertained by the deflated look of the affected breast. Silicone implants have slower leaks and require an MRI to officially diagnose. The silicone leaking from the implant stays primarily in the implant pocket. Any silicone that may leak into the body isn’t extremely harmful to your health. However, it is important to get treated for an implant rupture or leak as soon as possible.
Correcting an implant rupture or leak involves removing the damaged implant. The implant pocket is then cleaned of any excess saline or silicone. The new implant is inserted through the original incision site, if possible.
Malposition of Implant(s)
When your implants move out of the breast pocket, they can cause your breasts to look distorted or fake and noticeably augmented. The implants may sit too high on the chest, they may drop below the breast tissue, or they might move laterally on your chest. The most common implant malpositions include:
- Double bubble deformity: when the implant drops below the lower breast tissue, creating the appearance of two bubbles in the breast.
- Malposition of an anatomical implant: when a tear-drop shaped implant rotates in the breast pocket, causing the breast to look oblong or misshapen.
- Symmastia: when one or both implants are positioned too close to the midline of the chest. The breasts fuse together at the cleavage.
- Lateral shifting of an implant: when an implant slips from the created breast pocket and moves towards the outer edge of the chest. The implant may slip into the armpit when the patient is laying on her back.
Common corrections for poorly positioned implants include the use of sutures to hold the implant in its correct place. In severe cases, the implant is removed and a new, more secure breast pocket is created to hold the implant.
Allen Doezie, M.D., is a board certified plastic surgeon with over 10 years of experience. His office is located in Orange County, California. To schedule a complimentary consultation, please call 949-481-9850.