Breast Augmentation Revision in Scottsdale

An overwhelming majority of women who have had elective breast surgery including breast augmentation, breast lift or breast reduction have been extremely happy with their results. The impact on their lives physically, mentally and emotionally has usually been extremely positive. Among the happiest and most satisfied plastic surgery patients that we have are those women who have undergone either a breast enlargement or a breast reduction. In fact, a very frequent comment that we hear from our breast reduction patients is “why did I wait so long to do this?”

Nevertheless, not all results live up to expectations for any of a number of reasons and they also shouldn’t be expected to last forever. Some suboptimal outcomes can be technique or skill related where there were deficiencies in the performance of the surgery. Patient based factors can include genetics, compliance, misconceptions, injury and health related issues. Implants do not necessarily last forever and may eventually have to be replaced or removed. Finally, results do change with time and are not static – skin stretches, implants deflate or rupture, we get older, our weight changes or our tastes change. For these and many other reasons, there may be a need for a secondary procedure, also known as breast revision surgery, in order to address one or more of these issues.

Common or Significant Reasons for Breast Revision Surgery:

Breast Size

For breast enlargement, it seems that the most common issues are … size, size and size! The dissatisfaction with size after a breast augmetantion can be for many reasons– the breasts either were not enlarged enough initially or that they are not big enough now. For older women, some feel that smaller implants would make them look more youthful.

Breast reduction patients are extremely happy that they are much smaller and rarely do they voice concerns about size. Women who have had substantial weight gains or losses or continued breast growth subsequent to their initial procedures may decide later on to make adjustments to their breast size, either larger or smaller.

Breast Asymmetry

Virtually all women have some asymmetries of their breasts prior to surgery though they may have not noticed them previously. These can include differences in size, shape, location on the chest wall, chest wall irregularities as well as differences of nipple size, shape and vertical height. Although it may be possible to partially compensate for some of the asymmetries, the breasts never will be identical following surgery. Sometimes, some of these differences can even be magnified afterwards. Breasts are more like cousins than twins!!

Changing from Saline to Silicone Implants (or vice versa)

Silicone implants provide a naturalness and consistency similar to the female breast which the saline implants don’t have. They are superior in many other ways including durability. Most who change types of implants will go from saline to silicone implants. It is extremely unusual for a patient elect to change from silicone to saline implants and when it is requested, the reasons are not aesthetic ones – usually related to cost.

Repositioning the Implants From Submammary (on top of the muscle) to Submuscular (under the muscle) or vice versa

There are several important advantages of having breast implants in a submuscular (behind the muscle) pocket. By repositioning the breast implants from in front of the muscle, the location which is most often associated with problems, to behind the muscle, many of these issues can be addressed. The reverse can be performed though there are far fewer indications to do it.

Malposition of the Implants

Implants may not be situated exactly where they should be on one or both sides. This can be the result of pre-existing anatomic asymmetries that weren’t taken into consideration or just a lack of precision in their placement. As a result, the implants may be too high or low or too close or far apart relative to their ideal position or even asymmetrically placed.

Implant Pocket Configuration Issues

In order to be able to insert a breast implant, a pocket (space) is surgically created either in front of or behind the chest wall muscle. When performed without precision, these spaces can be too large, too small, too close together or higher or lower than ideal. This can result in an abnormally wide space between the breasts or not enough resulting in a confluence of the breasts called symmastia (or a“uni-boob”). The implants can also be situated too low, not low enough or asymmetrically. When the pockets are over-enlarged, the implants can slide too far out to the side when a woman is lying down or even leaning to one side.

Capsular Contracture

Capsular contracture is the situation where the body forms firm, constricting scar tissue around the breast implants, deforming their shape and causing the breasts to feel hard and appearing distorted. Research has shown that a small amount of bacteria which is present around the implant (not enough to make a person sick) will stimulate the body to form heavy scar tissue. This can occur shortly after surgery or many years later.

Implant Rupture

Even though breast implants are quite durable, they should not be considered to be permanent, lifetime devices. Given a long enough time, they will ALL have to be replaced or removed. Silicone implants generally last notably longer than saline implants.

When a saline implant leaks, the saline (salt water) from the implant is absorbed by the body, causing the implant to decrease in size. This usually occurs over a day or too, giving a “flat tire”. Although not a medical emergency, it is stressful to the patient because of the asymmetry. Saline implants cannot be refilled, and must be surgically replaced with a new implants

When a silicone implant ruptures, generally nothing occurs that is noticeable to the patient. Since the human body is not made of silicone, it is not absorbed, and stays in the pocket that was initially created for it. A woman could have a ruptured silicone implant for many years and never be aware that it is broken. However, the FDA has recommend that if a woman is aware that the implant is ruptured, it should be removed. It is not a medical emergency, and can be scheduled at the patient’s convenience.

Schedule A Consultation Today For Your Breast Augmentation Revision

At the office of Deborah Bash MD, FACS, you can schedule a consulation to meet with Dr. Bash to discuss any issues you have regarding your current implants. To schedule a consulation with us, call the office at 602-792-5789!
Deborah Bash

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