Undergoing breast augmentation is a big decision, and one that sometimes feels unsettling.  As they gather information before the procedure, women are informed about the potential need for replacement of the implants at some point.  This may cause some anxiety.  Deciding to have one elective surgery is enough without having to consider future surgeries.  It’s no wonder that some women remain in a perpetual state of procrastination when it comes to choosing breast augmentation!  I thought it might be helpful to discuss breast augmentation revision.

What is Breast Augmentation Revision?

Breast augmentation revision is a procedure in which changes are made to the breasts of a woman who has previously undergone breast augmentation.   Some women decide they want to have larger breast implants.  Less frequently, a woman may decide her breast implants are too large and she wants to go down in size.  When doing these procedures, the surgeon may have to make other changes as well.  Sometimes the internal scar tissue surrounding the breast implants needs to be modified, for instance.  It is important to choose a board-certified plastic surgeon who does a lot of breast revision procedures because that type of surgeon understands how to contend with tissue changes, scar tissue, and other unique factors.

When Do You Need Breast Augmentation Revision?

If you are happy with the appearance and feel of your breasts after breast augmentation, you may not need to do anything at all.  On the other hand, there are several reasons a woman may consider revision of her breast augmentation.  Some of these include:

• Capsular contracture.  Scar tissue forms internally around all breast implants.  That is a normal component of healing.  Problems may arise if the scar tissue becomes thick and rigid. Thickening of the scar tissue is called capsular contracture.  Sometimes this happens in the first few months after breast augmentation.  More commonly it shows up years later.  Capsular contracture can make a breast look and feel hard. Severe capsular contracture may result in a deformed appearance of one or both breasts, and it may cause discomfort. This type of situation can be pretty complex.  Sometimes all that needs to happen is that the old breast implants and surrounding scar tissue are removed, and new implants placed.  It may work better to add some type of soft tissue support device.  These can help minimize the risk of capsular contracture occurring again.
• Rupture or leak. All breast implants eventually wear out.  Small folds in an implant may rub together for years and result in a small hole.  The implant material will leak out.  With saline-filled breast implants, the saline is absorbed by the body.  The breast implant loses all of its volume and goes flat.  It’s noticeable.  With silicone implants, however, it’s different.  Often a leak in a silicone implant goes undetected.  The implant does not deflate.  Sometimes an abnormality is noted on a mammogram.  When a breast implant leaks, breast revision surgery will be required.
• Implant malposition.   Sometimes there’s a mismatch between the breast implant and the breast tissue.  This can result in the implants settling too low (“bottoming out”), or maybe to close to each other (“symmastia”).  As with capsular contracture, sometimes these can require complex revisions.  It’s best that these procedures are done by plastic surgeons experienced with breast surgery.
• No longer want breast implants.  It’s pretty common that we will see a woman who no longer wants to have breast implants.  She may have had them placed 20 or 30 years before and decides she no longer wants them.  Some women are concerned that their breast implants may be contributing to health issues.  Usually in cases like these, the breast tissue covering the implants has changed.  It is thinner, and may be droopy.  Often a breast lift (mastopexy) may be beneficial to help reshape the breasts once the implants are removed.

We would love to meet you at our plastic surgery office in the Fort Worth Medical District. Contact us at 817.335.5200 to schedule a consultation for breast augmentation or breast implant revision.