Even after proper planning and execution of breast surgery, limitations based on healing, the patient’s pre-operative anatomy, or placement changes can lead patients to consider breast revision surgery. These changes can be implant-related or from natural changes in the breast tissue from pregnancy and breastfeeding. The most common reasons for seeking revisionary breast surgery are implant deflation, a desire to change implant (size or type or position), or capsular contracture. Dr. Charles Hsu, a Beverly Hills plastic surgeon, has performed many successful breast revision surgeries that have improved his patients’ satisfaction with their breast surgery.
Best Candidate for Breast Revision
Differences in nipple position between the two sides
Wanting their implant size either bigger or smaller
Switching their implants from saline to silicone
Implants that have dropped or risen over time
Concerns about capsular contracture
Unhappy with another facility’s breast augmentation results
During the consultation, Dr. Hsu will talk to the patient about their current concerns about their breasts and what they are expecting after breast revision surgery. Each patient is given a thorough physical examination. This includes taking current breast measurements, as well as discussing the patient’s full medical history. This is so Dr. Hsu can determine the best treatment plan for the patient.
Breast revision surgery varies depending on each patient’s problem. The majority of revisions revolve around symmetry. In general, the most common reason for breast revision is when patients would like to improve their symmetry in terms of the position of the implant or the position of the nipples. Dr. Hsu will make a small revision to the pocket where the implants were placed and improve the symmetry of the implant position. Dr. Hsu uses a special technique to close the incisions with dissolvable stitches that will leave a minimal, barely visible scar.
Recovery and Post-Op
After the surgery, Dr. Hsu will wrap dressings around the breasts for support during the first week. Patients will also be given a surgical bra to wear for about a week to aid the healing process. Patients are advised to walk as soon after surgery as they feel comfortable and continue to walk while recovering to help healing and prevent clots. It is important to keep the breast area dry until the patient gets approval from Dr. Hsu. Patients will see the most swelling and bruising within 48 hours after the surgery, but it should resolve itself by the second week. Patients will be given pain medication to take, which will mean they cannot drive. Most patients return to work 1-2 weeks after the surgery and more strenuous activity can be resumed after 4-6 weeks. Patients must schedule their follow-up appointment before they are dismissed.
From Dr. Hsu
“Breast revision surgery is a highly individualized procedure, and it depends very much on exactly what needs to be revised. Often, there may be a variety of reasons why a revisional procedure needs to be performed. In my experience, the most common reasons patients come see me for revisional surgery is for breast asymmetry after they have healed from prior surgery.
Revisional surgery is challenging and requires experience with these types of procedures. I’ve found that my experience taking care of challenging breast reconstruction cases comes in very handy in making decisions on how to best revise the results from a prior operation. This is particularly true when the original operation was performed elsewhere, and the patient does not have all the information available about their prior operation. Small differences in choice of procedure and technique utilized can make a significant difference in aesthetic outcome.
The good news is that in many cases, prior breast surgery can be revised and changes can be made to improve the outcome. The cases are very individualized and the surgical plan needs to be carefully tailored on a patient-by-patient basis.”
Frequently Asked Questions
What is the solution to asymmetry in my breast?
Most patients come to Dr. Hsu for breast revision surgery after their initial breast surgery created asymmetrical or lop-sided breasts. This is very common because it can be difficult for the surgeon to account for differences inside the body when choosing and placing implants.
When is capsulectomy necessary?
Dr. Hsu may also perform a capsulectomy procedure during breast revision surgery to remove any thickened capsule (scar tissue) that is surrounding the implant. This may be what is responsible for the implant malposition.
Why people are moving to silicone implants?
Due to the advancement in the quality and safety of silicone implants in recent years, many patients decide to have their saline implants removed and replaced with silicone. Many patients find that they are happier with the natural shape and appearance of silicone implants.