Breast implant Revision Boston Plastic Surgeon Dr. Volpe
It is not unusual in my practice to have patients present having undergone breast implant surgery somewhere else in the past and are not happy with their results and are seeking help. Often, conditions can be greatly improved or totally corrected with breast implant revision surgery. Breast enhancement surgery in general has a very high satisfaction rate. Unfortunately, situations and complications can sometimes occur which can create conditions that are not optimal. Common conditions that patients present with include:
- size issues
- asymmetries and malpositions
- capsular contracture
- loosening of breast skin
The size of one’s breast depends on the size of the implant used and also the amount of pre-existing breast tissue. How one’s breast looks on one’s body is also dependent on one’s anatomy, height, weight, chest dimensions and a
host of other parameters. More common than not, the presenting issue is that the implants are not large enough. There could be a couple of reasons for this. It is possible that your anatomy did not allow for a larger implant to be placed at your first augmentation. Surgeons must take into account the available skin and breast tissue to cover the implant and also your underlying anatomy. There can be limits on volume. Sometimes, sizing issues arise from miscommunication with the original surgeon. Fortunately, in many cases changes can be made. Breast implant exchange can be performed with either placement of larger or smaller implants. This may also include creating a larger implant pocket to accommodate a larger implant or tightening up a pre-existing pocket if smaller implants are to be placed.
Breast asymmetries and malpositions
It is very unusual for a woman to have perfectly symmetrical breasts and placing implants behind the breast may not correct the asymmetries. It is also possible for implants to be asymmetric from either a technical issue at the time they were placed or implants that settled in slightly different locations. This can result in implants either being too far off to the side or one implant may be higher or lower in its position than the other side. Every individual’s situation is unique and careful consideration must be given to the correct course of action. As part of your evaluation, consideration will be given to see if capsular contracture (see below) exists. Often, asymmetries can be greatly improved with secondary breast implant surgery and usually involves repositioning the implant pocket. This may require closing part of the pocket in one place and opening the pocket in another to allow the implant to shift. Implants are often echanged and can be placed closer together or higher or lower. Sometimes, very small implant asymmetries can be improved with techniques such as fat injection. Special bras and extra care may be necessary during the postoperative time period to allow healing.
Capsular contracture is a condition that sometimes can occur following breast augmentation surgery. This is seen more commonly when implants are placed on top of the muscle. It occurs when the body creates excessive scar tissue above and beyond what is normal around the breast implant. This results in a tightening of scar tissue around the implant and can make your implant feel firmer and in more developed cases, can cause an implant malposition which is typically a higher position than the opposite side. At your consultation we would try to determine the reason it developed and possible treatment options. This may include replacement of your implant, removal of scar tissue, and repositioning the new implant. Sometimes this may involve placing the implant in a new pocket below the muscle. It can be a complicated problem to fully correct for some and there is a chance of recurrence. When performing breast augmentation for the first time, we take all steps to minimize the possibility of this condition.
Loosening of breast skin
Unfortunately, as time passes and we age, changes may be seen in the breasts. This can be a result of normal aging processes and one’s genetics, pregnancy, weight gain and weight loss. Whether or not a woman has breast implants, there may come a time when she requires a breast lift. The medical name for this is mastopexy and often can be performed if there are pre-existing breast implants. It involves removal of excess breast skin and often repositioning of the nipple. This does result in scars and there are also limits as to how high the breasts can be lifted but great improvements can be made. Again, every individual is unique and careful consideration will be given to your circumstances.
* Individual results may vary.
View before-and-after pictures of real patients of George Volpe, M.D., F.A.C.S.