Breast Revision Surgery (Implant Replacement or Removal) – Dallas, TX*

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About Breast Revision Surgery

Breast augmentation is one of the most common cosmetic surgeries in the U.S. and, in the majority of cases, offers outstanding outcomes. However, sometimes a woman can be unhappy with the results of her breasts and may need breast revision surgery. It is important to note not all breast revisions are due to surgeon error. While there are a few surgeries that do end with an undesirable outcome, there are women who want a different size implant, while others may have a defect and prefer to have the breast implant revised or taken out all together. In addition, there are some women who need revision surgery for a unique condition. Dallas, TX plastic surgeon Dr. Robert Schwartz at Robert Schwartz Plastic Surgery performs breast revision surgery, and gives a thorough evaluation so that a healthy and desired outcome is delivered.

Ideal Candidates

An important part of breast revision surgery is having realistic expectations. In addition, revision surgery may not necessarily be needed. For example, some women may dislike the size and shape of their breasts, and in some cases it helps to talk to a second surgeon before considering a revision treatment. During this visit, some patients may realize that the original fullness and shape chosen still matches their body size and frame. If you have scarring, breast drooping, rippling, or size variations between the breasts, revision surgery can help the condition and provide a more pleasing and healthy outcome.

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Common Reasons for Revision

This cosmetic surgery removes an implant that is not working or functioning correctly or is no longer wanted. Breast revision surgery may also be performed to replace an implant due to sizing or going from saline to silicone (or vice versa). Furthermore, there are a few other common cases for which a revision or secondary surgery is needed:

  • Implant Rupture
    While this is a rare occurrence, implant rupture can occur. If a saline implant ruptures, deflation will take place quickly. Therefore, a visible defect will occur. On the other hand, if a silicone implant ruptures, it is only detected through an MRI. Either way, if a rupture happens, an additional surgery will be necessary.
     
  • Capsular Contracture
    This is the term used for scar tissue, which occurs when the soft tissue around the implant becomes hard and thickens. While most augmentations do result in some internal scarring, most patients will never know. In some patients, the scarring could alter the implant placement, which may change the breast shape and result in an undesirable outcome. Scar tissue removal surgery to clean up and reduce scarring would be necessary.
     
  • Asymmetry
    Asymmetry occurs when the implants look uneven. This could be because the wrong size implant was used, or there's sagging or drooping on one side, or another condition that would cause asymmetry. A physical examination would need to be done to determine the cause of the asymmetry, then surgery would be performed to correct the issue, and finally, new implants would be placed to achieve a balanced look. 
     
  • Bottoming Out
    Bottoming out is a continuum that depends on the distance between the nipple, breast crease, and the patient’s perception of an ideal breast. It is a condition that can occur when one or both breasts drop or "bottom out" too low. In many cases, this is a placement issue from the first treatment. To correct this, a new placement positioning approach may be considered. In some cases, tissue grafting may be needed, as well as a surgically created pocket to encircle the new implant. For most women, moving to a silicone implant can solve this problem. Dr. Schwartz carefully evaluates the severity of bottoming out to understand how to correct it.
     
  • Symmastia
    Symmastia occurs when implants are placed too close together. This is because the implant chosen was the wrong width, shape, or size in most cases. Breast revision surgery will correct this visible deformity by picking an implant that works your body type and looks proportionate. 
     
  • Implant Rippling or Double Bubble
    Implant rippling occurs when there are visible wrinkles and ripples beneath the skin. This deformity generally forms near the edge of the implant. Rippling is more common in women who are very thin. Often, this condition can be corrected by simply changing out to a silicone implant.
     
  • Breast Size
    There are times breast revision surgery is as clear cut as receiving a different size implant. With the original surgery, you may have gone too big or too small. A new breast implant size can be chosen to achieve the desired goal. 
     
  • Implant Rotation
    A shift in the position of your breast implants can cause a change in the appearance of your breasts. Anatomical implants, also called teardrop or gummy bear implants, are the most problematic because they are shaped in a way that does not allow room for error.

What to Expect

Breast revision surgery is performed with general anesthesia. The recovery period varies based on the complexity required. For instance, a breast lift may be needed if smaller sized implants are used to help address loose skin. The goal following a new revision surgery is to attain a result that is functioning, healthy, and aesthetically appealing. Revisions to breast pocket size, the placement of implants under, fully, or partially under the muscle, and selecting the correct type of implant are all factors that Dr. Schwartz carefully considers to obtain results that you will love. Dr. Schwartz may use different techniques to correct specific issues: 

  • Capsular Contracture
    By selecting the optimal implants and placing the implant under the muscle using a submuscular approach, the risk of this procedure is very minimal with an experienced plastic surgeon like Dr. Schwartz.
     
  • Asymmetry
    Correction can include adjusting the size of the implant, tightening the breast pocket, repositioning the implant, or any combination of these techniques to achieve the results you want. While a consultation offers some insight into the surgery, the real story will emerge during the operation. Selecting a plastic surgeon that understands how to tailor the procedure to your breast anatomy and proportions should be the main consideration for your breast revision.
     
  • Bottoming Out
    A capsulorrhaphy is a revision technique to correct bottoming out by suturing the breast pocket incision. This secures the implant within the breast pocket, eliminating the descent. Most Dallas patients recover quickly from this procedure and may want to resume their normal activities too soon after surgery. Dr. Schwartz recommends limiting activities until he is convinced the surgical site has healed and can support the implant. This type of revision requires a lot of experience, and may be done by switching implant position or using various artificial support materials to strengthen the pocket itself. Dr. Schwartz prefers to create support materials using your own scar tissue, which results in a lower cost with no artificial materials and works extremely well. Sometimes a mini breast lift is performed under the breast to remove excess skin. However, no two cases are alike and a careful diagnosis is required to find the best technique (or combination of techniques) to most reliably fix the problem.
     
  • Symmastia
    During your operation, Dr. Schwartz may use a number of techniques that include internal sutures to close the extended breast pockets and keep each implant in place. In other instances, symmastia can be corrected by creating brand new pockets for the implants. Symmastia patients will sometimes benefit by changing their implant size or shape to better match their physique.
     
  • Implant Rippling or Double Bubble
    During revision surgery to correct a double bubble, there are a few different options for correction. The first is to adjust the size of the breast pocket so that the implant sits correctly without shifting out of place. Another common correction is to reduce the implant size so that the breast tissue supporting it is not overstrained. 
     
  • Implant Rotation
    The key to correcting and preventing a future incident of this type is careful control in creating the breast pocket. Manufacturers have created textured anatomical implants that settle into place approximately 2 – 3 weeks after your breast augmentation. 

Call Today To Learn More

This surgery is a custom treatment tailored for your specific needs. If you are not happy with your breast implants or wish a different outcome, we welcome you to call our office to schedule your appointment. There are numerous factors to think about and we will give you a full physical exam, create your revision options, and help set realistic expectations.

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*Individual results are not guaranteed and may vary from person to person. Images may contain models.