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Breast Revision

Thousands of women undergo breast augmentation every year and achieve successful outcomes that last very long periods of time. However, some patients who have had breast implants placed eventually may need a breast augmentation revision procedure due to either medical or personal reasons. If you are considering breast augmentation revision to upgrade your breast implants or to address other concerns that have resulted from a previous breast augmentation, Dr. Thomas Crabtree will be happy to meet with you and discuss your goals. 

Breast Revision at a Glance

  • This procedure is usually performed on an outpatient basis in a surgical facility 
  • Treatment time for most patients is approximately 2 to 3 hours 
  • A board-certified anesthesiologist will administer general anesthesia 
  • Recovery time is typically about one week before normal daily routines can be resumed; strenuous exercise/activities should be avoided for a minimum of three weeks 
  • A special bra may be prescribed to be worn for up to two weeks to manage swelling and help with healing; temporary side effects including swelling, bruising, and soreness are normal 
  • Results should be immediately apparent and continue to improve over the ensuing months 

What Is Breast Revision Surgery?

A breast augmentation revision is a surgical procedure primarily performed to either replace or permanently remove breast implants. This treatment is typically ideal for women who would like to exchange their current breast implants for a different model or size, as well as for those who would like to remove or replace their implants due to complications, general dissatisfaction with the results, or other concerns. The section below describes the common reasons for breast revision surgery in greater detail. 

What Are the Most Common Reasons for Breast Revision Surgery? 

In general, the most common reasons for breast revision surgery include: 

One of the most important things to note about breast augmentation revision surgery is that our plastic surgeon will listen attentively to your concerns and take your best interests into account, regardless of the specific reason you are seeking this procedure. Whether you are interested in a breast implant exchange or if you would like to permanently remove the implants, Dr. Crabtree will create a customized treatment plan designed to help you achieve the results that you expect. 

Breast Implant Exchange/Removal

As noted above, there are a variety of reasons to have breast implants removed. These include failure of an implant (leakage), poor outcome (appearance), and/or firm internal scars, also known as capsular contracture. Many patients are also concerned about possible long-term health effects and simply wish to remove otherwise “normal” implants. Dr. Crabtree is very experienced with these types of procedures and is often sought after to address these various situations. 

Dr. Crabtree will work with you to decide on the right surgical procedure. If your breast implants are ruptured, or if you have capsular contracture or capsular calcifications, you may also need your implant capsule removed. This is a surgery called “capsulectomy” and is often performed with breast implant removal or replacement. Whether the removal of the capsule is necessary or not is determined by your physical exam, radiological studies, or both. 

Depending on the amount of loose skin that you have, you may also need a mastopexy, or breast lift. The scar for mastopexy varies from patient to patient, depending on the degree of excess skin. In all cases, however, the scar is kept to a minimum, and the skin is never used to hold or lift breast tissue. Many times, however, this is not required as the breast has a remarkable ability to lift itself after the weight of the implants is removed. Dr. Crabtree often suggests letting the breasts heal and recover between the explant surgery and the breast lift surgery. This allows for a more precise and predictable final result with less risk. 

Capsular Contracture Treatment

One of the most common complications from breast augmentation is capsular contracture (or capsular contraction), a condition that results in distorted and sometimes even painful, hard breasts. A capsule is the normal tissue that the body produces surrounding a breast implant. Usually, it is pretty thin, sometimes almost transparent. The capsule is larger than the implant, allowing them both to move around and feel soft. In capsular contracture, the capsule becomes thicker and tightens, which makes the space for the implant smaller and smaller. Some signs of capsular contracture can be the implant rising to a higher position on the chest or the breast looking oddly constricted and artificially round, like a baseball. The capsule can get so small that the implant feels firm (grade 3 capsular contracture) or can even feel hard and be painful (grade 4 capsular contracture). 

Treating Capsular Contracture

Dr. Crabtree typically uses the total capsulectomy technique to correct capsular contracture. This technique involves the removal of the entire capsule that surrounds the breast implant. The capsule may be removed in pieces following removal of the implant itself 

It is important to note that not all implants can be removed via capsulectomy technique. For Dr. Crabtree, capsulectomy is typically the preference, but there are some circumstances which make him change course. Occasionally, the hardened capsule will not be able to fit through the tiny incision intact. Rather than making a larger scar, Dr. Crabtree will open the capsule carefully with sterile towels nearby, remove the contents within the balloon of the capsule onto the towel, clamp the capsule closed again, and then get it out through the incision. 

The second reason has to do with capsule variability. Sometimes the capsule is thin and too tightly adhered to the nearby tissue. To remove the capsule would involve risk. The most common example of this is in a subpectoral implant where the posterior capsule is thin and adherent to the underlying ribcage. The lung lies just below this. Another example would be when your skin is very thin, and to remove the capsule would cause the overlying skin to be injured. Again, as with the example above, Dr. Crabtree dissects as much as possible, empties the contents within the balloon of the capsule, and then finishes the dissection of the capsule. 

Prevention of the recurrence of capsular contracture typically involves removing the implant and capsule, employing a “no-touch” surgical technique with new breast implants, and using evidence-based antibiotics. 

What Is the Breast Revision Procedure Like?

The breast revision procedure is most often performed as an outpatient under general anesthesia. As noted in the sections above, there are a variety of surgical techniques that can be utilized for breast revision surgery; the specific approach will be based on the unique needs and goals of each patient. For many individuals, the incision locations that were used in the original breast augmentation can be used for the revision procedure, as well. This makes it possible for Dr. Crabtree to perform this treatment without creating additional incisions that will produce new scars. 

Breast revision surgery usually takes about two to three hours to complete; however, this varies among patients depending on their unique needs and the overall complexity of the treatment. 

What Does Recovery from Breast Revision Entail?

The recovery process from breast revision surgery is often very similar to the process experienced after an initial breast augmentation. Swelling, soreness, and some bruising in the treatment areas can be expected; however, oral medication can help alleviate discomfort as the breasts heal. A special bra may also be prescribed, which will only need to be worn for a brief period of time in order to aid the healing process. Most patients are ready to return to their normal daily routines after about one week of rest. Patients should refrain from engaging in strenuous activities for at least one month, or as recommended by Dr. Crabtree. The results will be noticeable immediately; however, the final outcome won’t be apparent until the breasts have “settled” and swelling has completely dissipated. 

Breast revision surgery has helped many women successfully address their concerns with exceptional results that look both natural and beautiful. If you have questions about breast revision surgery, or if you would like to schedule a consultation to talk more about this procedure, please contact Crabtree Plastic Surgery today.