Breast Revision

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What is breast implant revision?

What is breast implant revision? Breast implant revision is a general term for a variety of procedures used to correct problems or issues that may develop in women with breast implants.

What types of problems are corrected by breast implant revision?

The most common breast implant revisions are:

  • Replacement of ruptured implants
  • Adjustment of poorly positioned implants
  • Treatment of capsular contractures
  • Correction of double-bubble deformities
  • Repair of synmastia
  • Implant size changes
  • Changes from saline to silicone gel implants or vice-versa
  • Changes from subglandular to submuscular positioning or vice versa

This list does not include all possible revisions or combinations of corrections.

Will insurance pay for breast implant revision?

Health insurance will sometimes cover breast implant revisions. Most of these procedures are considered cosmetic and are not covered.

Where will my breast implant revision be performed?

We perform most breast implant revisions on an outpatient basis at a JCAHO-certified ambulatory surgery center.

What type of anesthesia will be used for my breast implant revision?

Most breast implant revisions are performed under general anesthesia (i.e. you will be asleep). We use only board-certified physician anesthesiologists.

Where are the scars from breast implant revision?

If your implants were originally placed through an incision adjacent to your nipple (periareolar) or underneath your breast (inframammary), most revisions can be performed through the previous incision. Options for revision through an underarm or umbilical scar are limited and a new incision may be required.

When can I return to work after breast implant revision?

When can I return to work after breast implant revision? Most patients with desk jobs can return to work in 4-7 days. Patients with more physically demanding jobs will require a longer recuperation.

How painful is breast implant revision?

Most breast implants revisions are less painful than the initial implant placement.

How soon can I exercise after breast implant revision?

Exercise can be restarted 3-4 weeks after most breast implant revisions. Longer waits may be necessary after some implant repositioning operations. Performing physically strenuous activities earlier than this can impair healing or disrupt the repairs.

When can I drive after breast implant revision?

Most patients can resume driving seven days after breast implant revision.

What are the signs of a ruptured silicone implant?

Signs of a ruptured silicone gel implant may include:

  1. New pain or discomfort in the breast
  2. A change in the appearance of the breast
  3. Hardening of the breast
  4. A change in the way the breast feels

You should also consider the possibility of rupture after a strong blow to the chest (fall, car accident, etc.)

In most cases, breasts with ruptured implants look and feel the same as they did before the rupture; the history and physical exam are not reliable for detecting rupture.

The best test for rupture is a breast MRI. MRI's will detect 80-95% of ruptures.

Are there special precautions for breast implant patients when scuba diving?

Yes, but they are minor. Silicone gel implants are heavier than water and will subtly alter your buoyancy and trim in the water. This may require gear or technique adjustments. This does not apply to saline implants which are buoyancy-neutral. Divers are also advised to avoid buoyancy compensators with constrictive chest straps, which can put undue pressure on the implants.

Pressure changes themselves are unlikely to damage the implants. In a study performed by the Divers Alert Network (www.diversalertnetwork.org), implants experienced a very small increase in gas bubble size and overall volume. The effect was more prominent in silicone gel implants because nitrogen is more soluble in silicone. Regardless, the volume change was not sufficient to damage the implants and the gas bubbles disappeared with time.

What can be done for implants that fall to the side when I lie down?

The first thing to determine in these situations is why this is happening. In most cases, it is because the implant pocket is extending too far to the side. This can happen over time due to pectoralis muscle pressure on the implants. The treatment for this is a capsulorrhaphy - a procedure where the outer part of the pocket is tightened with sutures.

Sometimes, the pocket is not too wide and the implants lie to the side because the the breast skin has stretched. This can sometimes be improved with a breast lift but there is a significant chance of at least partial recurrence.

In all these situations, we should keep in mind that natural breasts fall to the side when a woman lies down so not all of these laterally displaced implants need treatment.

Is it normal to have a sore throat after surgery?

Sore throat can happen after surgery. It is usually caused by the endotracheal tube the anesthesiologist uses to help you breath. It is somewhat more common in women than in men. The soreness is usually mild and goes away within a few days. A severe sore throat or one that lasts for more than a few days should be reported to Dr. Schwartz.

Can I donate blood before surgery?

Donating blood causes a temporary anemia. This usually corrects within 1-2 weeks. Nonetheless, we recommend that patients do not donate blood for at least one month before cosmetic surgery.

Some patients have expressed interest in donating blood for their own use, if needed. Since most cosmetic procedures are designed to produce minimal to moderate blood loss, transfusion is almost never needed. While you are, of course, free to self-donate blood, this would almost always be unnecessary.

Should breast implant patients take antibiotics for teeth cleaning?

I do recommend that my breast implant patients take a dose of antibiotics before dental work.

The problem is that dental work introduces bacteria into the blood stream. If that bacteria gets to the breast implants, it can cause an infection or a capsular contracture. Either of these may require surgery to fix.

Now it's unlikely that a dental cleaning will lead to any problems with your implants but since the consequences can pretty significant, it's worth taking the antibiotics as a precaution. Ask your dentist to prescribe whatever antibiotics he or she uses for patients with heart valves or other implants.

One additional note: You should avoid any dental work for the first 2 months after your breast implant surgery.

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