Secondary breast surgery can be complex and needs to be done by an experienced plastic surgeon. The specific procedure to be performed will depend on the complications and the condition of the implants. Dr. Newen will advise you on the best course of action based on your individual circumstances.
If you are considering breast revision surgery, we want you to be thoroughly informed about the procedure. Below is some helpful information. A personal consultation with Dr. Newen is the best way to obtain the additional information you will need.
Am I a good candidate for breast revision surgery?
Candidates for breast implant exchange are women with existing breast implants who are experiencing complications such as:
- Hardening of the breast implants (due to capsular contracture)
- Feeling of tightness or pulling
- Distorted look to the breast (an unnatural round appearance or asymmetry)
- Rupture or deflation of an implant
- Rippling or Wrinkling
Your personal consultation
During the consultation with Dr. Newen, you will be asked about the results you expect to achieve from breast revision surgery. This will help him to understand your expectations and determine whether they can be realistically achieved.
How will Dr. Newen evaluate me for breast revision surgery?
Dr. Newen will examine your breasts and assess their size, shape, quality of the skin, and possible causes for the complication you are experiencing. Measurements and photos may be taken for your medical record. You should be prepared to discuss your medical history. This will include information about any medical conditions, drug allergies, medical treatments you have received, pregnancies, previous surgeries, and medications that you currently take. It is important for you to provide complete information.
The following is a brief description of the possible causes of common breast implant complications:
Capsular Contraction: The scar tissue that forms around the implant is a natural response to a foreign object implanted in the body. The capsule can tighten and squeeze the implant making it firm. This is referred to as capsular contracture. This firmness (breast capsule) can range from slight to very hard. The firmest ones can cause varying degrees of discomfort or pain. Capsular contracture can occur in one breast or both.
If the patient is experiencing firm capsular contracture, there are generally two ways to make the breasts soft. Capsulotomy refers to incisions within the scar tissue that release the capsule allowing more room for the implant. Capsulectomy is a more involved operation that removes all or most of the scar tissue creating a “new, fresh pocket” for the breast implant.
The technique of “closed compression” or “closed capsulotomy” is currently not used by Dr. Newen because of the possibility of rupturing the implant. This method requires the doctor or patient to squeeze (compress) the breast until the capsule tears open allowing more space for the implant.
Dr. Newen is currently the principal investigator in a study that incorporates acellular dermis tissue into the breast pocket after capsulectomy is performed. His success rate of achieving favorable outcomes, as evidenced by soft natural breasts and absence of recurring capsular contracture, has been over 95% in all cases utilizing the acelluar dermis.
Deflated or Ruptured Implant: A rupture or deflation of the implant may be experienced at any point after the initial augmentation. The cause of the rupture is often unknown, sometimes it can be attributed to under-filling or overfilling of saline solution into the implant, excessive compression, or trauma. When a saline implant ruptures, the patient will be able to self diagnose because the breast will shrink to its preoperative size. A silicone implant that has a rupture is usually noted on a routine mammogram or MRI scan. In either case, although the situation needs to be corrected on a timely basis, it is not dangerous to your health from our current knowledge base.
Wrinkling of the Implant: The implant shell may ripple beneath the skin creating the appearance of visible wrinkles. This most often occurs in females with thin breast tissue covering the implant, or with textured implants placed above the breast muscle. Saline implants are generally at greater risk to develop rippling than silicone.
Displacement of Implants: Over time, the implants may shift in any direction causing the need for a revision. In rare cases, a “bottoming out” effect occurs, in which the implant sinks too low in the chest wall causing the nipple to appear to point upward or be positioned too high.
Symmastia: This is a condition in which the tissues in the cleavage area have been over dissected allowing for the implants to touch each other under the skin. This appearance is casually referred to as “kissing implants”, uniboob”, or “breadloafing”. Symmastia is very uncommon and may involve a complicated correction. Extremely large implants make this condition more common.
How is breast revision surgery performed?
Individual factors and will determine the specific technique selected for your breast revision surgery, depending on what complications you are experiencing. Dr. Newen will discuss with you the appropriate technique that he feels will suit you best.
How do I prepare for my breast revision surgery?
You will be provided with complete information about what to do before your breast revision surgery, and our staff will check up on you and make sure you are ready for your procedure. If you are a smoker, you will be asked to stop smoking well ahead of the surgery date. You will also be asked not to take certain medications which increase the risk of bleeding. Your breast revision surgery will be performed on an outpatient basis, please be sure you have someone to drive you home and take care of you for at least the next 24 hours.
Breast Revision Recovery – How will I look and feel initially?
It is important to realize that each individual’s recovery time will be different. You will be asked to restrict your activities and relax for at least a week. Generally, the greatest amount of swelling occurs 24 to 48 hours after surgery, but it may take several weeks before all swelling is resolved. You will be required to wear a compression garment over your breasts for 6-8 weeks. After surgery, there may be a temporary feeling of numbness, pain, swelling, and bruising.
The types of symptoms experienced and the duration of the symptoms vary in patients. Most patients return to work within a week.
Significant complications from breast implant exchange are very rare. Anyone considering surgery, however, should be aware of both the benefits and risks. The subject of risks and potential complications of surgery is best discussed on a personal basis during your consultation with Dr. Newen.
Your surgical experience
Our goal is to make your surgical experience as easy and comfortable for you as possible. If you’re a smoker, you will be asked to stop smoking well in advance of surgery. Aspirin and certain anti-inflammatory drugs can cause increased bleeding, so you should avoid taking these medications for a period of time before surgery. You will be provided with complete preoperative and postoperative instructions.
Breast revision surgery is performed at Huntington Surgery Center, our outpatient surgery facility located within The Image Center. Please be sure to arrange for someone to drive you home after your procedure and stay with you for at least 24 hours.
For more information
For more information on breast revision or to schedule a consultation, please call our office at (714) 230-2430.