About Breast Revision Surgery
Breast augmentation is one of the most popular cosmetic surgeries in the United States and in most cases, allows for beautiful and natural outcomes.
However, sometimes a woman can be unhappy with the results of her breasts and may require breast revision surgery. In addition, when saline breast implants are used, it is known and expected that, at some point, the implant will leak, go flat, and need to be replaced.
Sometimes, a woman may be happy with her result, but want a change, such as a larger or smaller size. If there has been a pregnancy since the breast augmentation surgery, there may be changes to the breast that will benefit from additional surgery.
In addition, some women, after ten or twenty years following their breast implant surgery, will find themselves at a different stage of their lives. Some of those women may decide to reduce the size of their implants, and others will want to completely remove the implants.
For all of these woman, an additional breast surgery, or a "breast revision" surgery, may be appropriate.
Scottsdale, AZ plastic surgeon Dr. James Nachbar is an expert in breast revision surgery, and gives a thorough assessment at Scottsdale Plastic Surgery so that the desired outcome is achieved.
Although some surgeons refuse to help patients who have had trouble with surgery by other doctors, because they note (correctly) that it is more difficult than first-time surgery, Dr. Nachbar is happy to help all women who want to make changes in their breast surgery.
Breast Revision Reviews
"Dr. Nachbar is fantastic! I used him for my second breast augmentation in 2000, and they look as great now as they did then! He actually fixed a lot of the problems that I had from the previous surgery. I have referred countless friends to him, and I've had a handful of friends actually do procedures with him. Every single one of them is more than happy, and so am I! I highly recommend him! He is fantastic!"- D.S. / Yelp / Sep 06, 2017
"Breast Implant Exchange - Dr. Nachbar is AMAZING!!!!!!!! Extremely professional, knowledgeable, patient, friendly, and made himself available every step of the way. I am so thankful for him, Amber, his staff, and everyone at the surgery site. Everybody was simply amazing!!!!!!!"- C. / RealSelf / Sep 17, 2017
"Breast Implant Revision - Dr Nachbar and his Staff are awesome! They make you feel very welcome and never once made me feel bad for calling and asking questions or when seeking help following the procedure. I have recommended Dr Nachbar ti several friends who have also had procedures with him. Thank you!!"- Anonymous / RealPatientRatings / Jul 11, 2018
"Breast Lift - I much happier and more confident.I wish I would have had Dr Nachbar the first time. I went through several surgeries to correct the first surgery, Dr Nachbar corrected everything and there is very little to nothing left from the mistakes the other Dr made. Dr Nachbar is an exceptional surgeon I am very happy and highly satisfied. I will always recommend him over any other, he is awesome. I hardly have any scarring he did such a great job."- Anonymous / RealPatientRatings / Apr 06, 2018
"Breast Augmentation - This was a replacement of an earlier surgery that lasted 12 years. I was extremely satisfied then and now. Dr. Nachbal is the best!"- Anonymous / RealPatientRatings / May 29, 2018
If you have any concerns about your breast implants, whether cosmetic or medical, please schedule an appointment for a consultation with Dr. Nachbar to talk about your goals and to create your unique surgical plan.
Whether it is scarring, breast sag, rippling, uneven breasts, or a desire to change the increase or decrease the size, revision surgery can help fix the problem and create a more appealing and healthy outcome.
This procedure can also help if you would like to change size, implant styles, or address any other aspect of your breasts.
Common Reasons for Revision
Women have secondary breast surgery for a variety of reasons.
Sometimes, we remove an implant that is not working or functioning correctly or is no longer wanted. Sometimes the implant is replaced, and sometimes the woman does not want to replace the breast implant.
Breast revision surgery may also be performed to switch implant size or go from silicone to saline (or vice versa).
Also, the implant may have shifted and need to be repositioned. This is more common when the implant is larger and heavier than when a smaller breast implant is used. Often, when the implant is shifted, it may be necessary to use a supportive mesh to hold the implant back up into its correct position.
Both saline and silicone breast implant rupture may occur.
We know that, eventually, every saline implant will leak and go flat at some point. This occurs because, every time you move, the implant moves within its pocket. Like an aluminum can that is bent enough times, sooner or later a small opening will occur.
Even the tiniest hole in a saline breast implant will cause the saline to leak out, where it will be absorbed into the body, and the size of the breast will diminish. Most often, this occurs within hours, but occasionally may take weeks or even months. If you think your saline breast implant may be leaking slowly, we recommend that you come into the office; we can take photographs that can be compared with later photographs to determine if there is a slow leak.
Silicone breast implants may also rupture, but they are different than saline implants. Modern silicone breast implants are not liquid inside, but are more like a "gummy bear," in that they are semi-solid, like a piece of soft candy.
Also, the silicone is not absorbed by the body like saline is, so the breast typically does not reduce in size when there is a rupture. Indeed, there is usually no way, other than MRI scan, to detect whether a silicone breast implant is ruptured.
This is the term used for thickening, contraction, and tightening of the scar that always forms around any "foreign body," such as a breast implant.
Mild capsular contracture is often hard to detect, and may not need treatment unless it bothers the patient. However, if the tightening is enough to interfere with the appearance of the breast, or to interfere with your activity, surgery may be needed for the capsular contracture.
No two breasts are ever the same, either with or without surgery. They are "sisters" rather than "twins."
Often, asymmetry can be reduced by using a slightly different technique or implant size on each side. However, some women will have enough of a difference between the breasts that occurs or later develops after breast surgery. For them, an additional procedure may be appropriate to correct the problem by reducing the asymmetry.
Bottoming out is a condition that may happen when one or both breast implants drop below the level of the breast. This is often due to using larger and heavier breast implants.
There are several approaches to this problem, depending on the underlying cause. Sometimes, putting the breast implants into a different pocket, and sometimes with a concomitant breast lift, may be the right approach.
Other times, it may be necessary to use artificial or natural tissue supports to hold the breast implants back where they belong.
In every case, you should consider whether you would be willing to reduce the size of the breast implants, as larger breast implants have a higher risk of "bottoming out" again.
This condition is the "Uni-Boob," and occurs when there is not enough attachment of the skin between the breast to the underlying breast bone ("sternum"). It is more common when the breast implants were placed above the pectoralis major muscle, because the muscle helps hold the implants in place.
Other times, symmastia occurs because of ill-advised attempts to reduce the gap between the breasts by releasing the attachment of the pectoralis muscle to the sternum.
In any case, symmastia is a difficult problem to treat. The most reliable approach is probably to remove the breast implants, sew the tissue back together, often with a mesh support, and then replace the implants at a later surgery. It is also possible to do this procedure and immediately replace the implants, but that does increase the chance that the symmastia will recur, especially when the implants are of a larger size.
Rippling occurs when there are visible lines and ripples under the skin.
Rippling is more common in females who are relatively thin, and is much more common with saline breast implants than with silicone gel breast implants. Indeed, the substantially reduced rippling with silicone breast implants compared to saline is one of the main reasons women select silicone gel breast implants.
Most often, when rippling is seen with saline implants, it can best be treated by simply changing from a saline implant to a silicone implant.
There are times revision surgery is as simple as switching to a larger or smaller sized implant. This is sometimes done years after the first surgery, and other times it is done shortly after the first surgery.
In either case, a new breast implant size can be switched with the original to attain the desired aesthetic goal.
What to Expect
A secondary breast surgery is performed under general anesthesia. The expected course of healing varies significantly based on the type of surgery that was done.
Be sure to discuss the expected recovery process with Dr. Nachbar at your consultation.
Plan Your Procedure
Change Your Mind?
Breast implant revision surgery is a custom treatment tailored for your individual problem by plastic surgeon Dr. James Nachbar. If you're displeased with your breast implants or want a different outcome, we welcome you to contact our Scottsdale, AZ office to book your appointment at Scottsdale Plastic Surgery. Or, schedule your appointment online for a confirmed appointment time now!
There are many factors to think about, and Dr. Nachbar will help you create your revision plan, and help you understand the realistic goals and expectations.