Greensboro, NC

336-907-7980

Breast Revision Surgery

Breast revision surgery may be an option when the outcome from breast cosmetic or reconstructive surgery does not meet patient expectations. Such outcomes can occur due to a complication or when surgical goals fail to achieve the desired result. These conditions range from something as straightforward as a ruptured implant to a complicated situation such as a healing problem or breast position asymmetry. Hopefully, the original surgeon can perform the corrective surgery. Sometimes a second opinion is helpful. When it is needed, a second opinion should be sought from a plastic surgeon certified by the American Board of Plastic Surgery who has a special interest in all types of breast surgery.

Best Candidates

A good candidate for breast revision surgery will have the following:

Good physical and mental health
Normal mammogram performed within the past year if over 40 years old
An undesirable result from a previous breast surgery
A dissatisfaction with the undesirable result
Realistic expectations

Indications for Breast Revision Surgery

Breast revision surgery can be offered for problems that result from previous surgery. More than one of these problems may be present in any given patient. The following is not an exhaustive list but serves as a broad sampling of the types of breast problems that may result from previous surgery and respond to a corrective procedure.

Ruptured implant
Mal-positioned implant
Visible implant wrinkles
Wrong implant size
“Bottoming out” (breast slides below nipple and nipple appears to high)
Infection
Severe scarring
Depressions and contour deformities
Loss of tissue in a flap reconstruction
Mal-position of a flap reconstruction
Asymmetry due to radiation post-cancer treatment

Options and Techniques

Ruptured implant is treated by implant exchange.

Mal-positioned implant requires a modification of the capsule, or internal scar tissue, that surrounds the implant. If the implant is too tight and firm this may be accomplished by opening the capsule to relax it or removal of the entire capsule to permit the formation of a more relaxed one. If the implant is too low then a tightening of the capsule called a capsulorrhaphy can reposition the implant in a more elevated, pleasing position.

Visible implant wrinkles may be improved by a variety of maneuvers. These include conversion of implant type from saline to silicone, conversion of position from on top of the muscle to under the muscle, or implantation of material inside the space that will help conceal the wrinkles.

Wrong implant size can be improved by changing to a larger or smaller size provided the patient’s chest dimensions accommodate this change.

“Bottoming out” correction consists of the removal of excess skin from the breast crease and tightening the capsule if an implant is present.

Infection can cause any number of problems including loss of the implant or loss of the breast reconstruction. This situation calls for great care when a secondary attempt is made. Sometimes a salvage procedure can be performed that saves the augmentation or reconstruction and avoids another procedure at a much later time.

Severe scarring is treated using steroid injections, scar revision, or a type of scar release called z-plasty. Sometimes a combination of these modalities is used.

Depressions and contour deformities can be improved by fat grafting.

Loss of tissue after flap reconstruction can often be corrected by another flap reconstruction as a salvage procedure.

Mal-position of a flap reconstruction can be corrected by mobilization or freeing of the tissue and proper repositioning.

Asymmetry due to radiation may require any number of procedures. Among these are placement of breast implant for decreased size; z-plasty scar release for a tight, tethered lumpectomy scar, and symmetry procedures for the opposite breast such as breast reduction, breast lift, and breast augmentation.

Surgery

Breast revision surgery is usually performed in an outpatient setting under general anesthesia. These procedures require varying amounts of time depending upon the type of problem. Every effort is made to utilize existing scars to address the problem. Occasionally a new approach is required.

These procedures are highly individualized. There are a variety of problems that may be addressed and each patient presents a unique set of circumstances. It is imperative that patient and doctor have a candid discussion about the specific problem from the patient’s viewpoint. An individualized operative plan is formulated based upon this candid discussion.

The procedures vary depending upon the nature of the problem. They vary from exchanging implants, to internal suturing in order to add support, to either a repositioning of tissue or an additional tissue transfer. These corrections are challenging precisely because they are unique for each patient. A successful correction is enormously rewarding for patient and surgeon.

Recovery

It is normal to experience bruising, swelling, and discomfort for approximately one to two weeks after surgery. Most procedures require activity restrictions for 4 to 6 weeks. It may be necessary to use a supportive bra night and day for several months after surgery.

Risks

Breast revision surgery involves risks that are similar to other breast surgeries. These include bleeding, infection, healing problems, scarring, loss of sensation, anesthesia related complications and asymmetry. Dr. Bowers will discuss risks with you and make certain your questions are answered.

Results

The results of breast revision surgery are generally extremely satisfying. They are usually apparent almost immediately following surgery. These procedures provide a profound improvement of self-image.

Please call 336-907-7980 or Contact Us to schedule a consultation with Dr. Bowers. He will be happy to discuss breast revision surgery with you and identify options that may prove beneficial in your particular case.

Get in Touch

Phone: 336-907-7980

1002 North Church Street, Suite 203

Greensboro, NC 27401

Schedule your consultation today.