Summary

Over time, breast implants can change shape or size, and the overlying breast tissue can also vary, creating an appearance or feel to the breast that is less desirable than the first result; therefore, many women will replace or update their breast implants at or around the 10-year time frame. Also, many breast implants have a lifetime warranty on the implant device. Still, after ten years, the costs associated with having surgery to replace the implants are no longer covered.

The goal of breast implant revision surgery is to replace old breast implants with new implants. Often the goal is also to change or improve the appearance of the breasts while updating the implant material, which could include:

• A concurrent breast lift or  breast reduction
• Reshaping the breast implant pocket to reposition the implant on the chest
• Either increasing or decreasing the size, shape, or style of the breast implant

The desire to have breast implant revision surgery can be because of any of the following reasons:

• Willingness to change the size of the breasts
• Pain from capsular contracture
• Concern about rupture or migration of the implant
• Change from saline to silicone or a different style of implant

Over time, breast implants can change shape or size, and the overlying breast tissue can also vary, creating an appearance or feel to the breast that is less desirable than the first result. Also, many breast implants have a lifetime warranty on the actual implant device. Still, after ten years, the costs associated with having surgery to replace the implants are no longer covered. Because of this, many women will elect to replace or update their breast implants at or around the 10-year time frame. Breast implant revision surgery is not a standard or routine procedure and needs to be explicitly tailored to the patient’s goals and desires.

Who is the Right Candidate for Breast Implant Revision?

Breast implant revision surgery is intended for patients who have had a breast augmentation in the past and are now unhappy with their implants or concerned about the condition of their implants. This procedure can address those concerns by replacing the existing implants with new implants.

In general, you may be a right breast implant revision candidate if:

• You are unhappy with the size, shape, or appearance of your breast implants
• You are concerned about the integrity or condition of your implants
• You are physically healthy and at a stable weight
• You have realistic expectations
• You are a nonsmoker

If you’re considering surgery, spend some time reviewing breast implant revision surgery photos and learning what to expect during recovery. Preparation ahead of time helps patients have reasonable expectations and a smoother recovery.

What Should I Expect During a Consultation for Breast Implant Revision?

During your breast implant revision consultation, be prepared to discuss:

• Your surgical goals
• Medical conditions, drug allergies, and medical treatments
• Current medications, vitamins, herbal supplements, alcohol, tobacco, and drug use
• Previous surgeries

Prof. Moawad will also:

• Evaluate your general health status and any pre-existing health conditions or risk factors
• Examine your existing breast implants
• Take photographs
• Discuss your options and recommend a course of treatment
• Discuss likely outcomes of breast implant revision surgery and any risks or potential complications

The success and safety of your breast implant revision procedure depend very much on your complete candidness during your consultation. You’ll be asked several questions about your health, desires, and lifestyle. It’s natural to feel some anxiety, whether it’s excitement or a bit of preoperative stress. Don’t be shy about discussing these feelings with Prof. Moawad.

What are the Risks of Breast Implant Revision?

The decision to have breast implant revision surgery is highly personal. You’ll have to decide if the benefits will achieve your goals and if breast implant revision risks and potential complications are acceptable. Prof. Moawad and/or staff will explain in detail the risks associated with surgery. You will be asked to sign consent forms to ensure that you fully understand the procedures you will undergo and any risks or potential complications.

• The possible risks of breast implant revision surgery include, but are not limited to:
• Bleeding
• Infection
• Poor healing of incisions
• Hematoma
• Anesthesia risks
• Fluid accumulation (seroma)
• Skin loss
• Numbness or other changes in skin sensation
• Skin discoloration and/or prolonged swelling
• Unfavorable scarring
• Recurrent looseness of skin
• Fatty tissue found deep in the skin might die (fat necrosis)
• Deep vein thrombosis, cardiac and pulmonary complications
• Asymmetry
• Suboptimal aesthetic result
• The possible need for revision surgery
• Persistent pain

I will thoroughly discuss these risks and others before your consent. It would be best if you addressed all your questions directly with Prof. Moawad.

How Should I Prepare for Breast Implant Revision?

In preparing for breast implant revision surgery, you may be asked to:

• Get lab testing or a medical evaluation
• Get breast or implant imaging, such as a mammogram, ultrasound, or MRI
• Take certain medications or adjust your current medications
• Stop smoking
• Avoid taking aspirin, anti-inflammatory drugs, and herbal supplements as they can increase bleeding.

Breast implant revision surgery is typically performed in a hospital or licensed ambulatory surgery setting and will likely use general anesthesia. If your breast implant revision is performed on an outpatient basis, be sure to arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.

What Are the Steps of a Breast Implant Revision Procedure?

Step 1 – Anesthesia medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best option for you.

Step 2 – The incision type used in breast implant revision surgery will vary depending upon the type of procedures that I will perform. The incision can include, but is not limited to, any of the following:

• Infra-mammary incision – in the crease under the breast
• Breast lift incision – either the vertical incision or Wise pattern incision
• Peri-areolar incision – incision partway or around an areola

Step 3 – Closing the incisions sutures, skin adhesives, tapes, or clips close the skin incisions.

Step 4 – See if the final results of breast implant revision surgery will be initially obscured by swelling. Get more information about breast implant revision results.

What Should I Expect During My Breast Implant Revision Recovery?

Following your breast implant revision, gauze dressings or bandages may be applied to your incisions. Depending on the details of your surgery, you may or may not be placed in a support bra or other type of garment. In some cases, a small, thin tube may be temporarily placed under the skin to drain any excess blood or fluid that may collect.

You will be given specific instructions that may include:

• How to care for your surgical site(s) following surgery
• Medications to apply or take orally to aid healing and reduce the risk of infection
• Specific concerns to look for at the surgical site or in your general health
• When to follow up with Prof. Moawad
• Be sure to ask Prof. Moawad questions about what you can expect during your recovery period.
• Where will I be taken after my surgery is complete?
• What medication will I be given or prescribed after surgery?
• Will I have dressings/bandages after surgery? When will they be removed?
• Will there be drains? For how long?
• When can I bathe or shower?
• When can I resume regular activity and exercise?
• When do I return for follow-up care?

Healing will continue for several weeks as swelling decreases. Continue to follow Prof. Moawad’s instructions and attend follow-up visits as scheduled.

What Results Should I Expect after Breast Implant Revision?

The final results of breast implant revision surgery will be initially obscured by swelling. It will take at least six weeks for the swelling to resolve and the breasts to feel softer and more natural. In some cases, it can take 6-12 months for the breasts to feel “normal.” Healing time is different for everyone, and sometimes it can take longer for the breasts to soften, for normal sensation to return, for scars to fade and for the patient to get used to the feel of having an implant. Would you mind discussing realistic expectations with your surgeon regarding healing? The practice of medicine and surgery is not an exact science. Although good results are expected, there is no guarantee. It may not be possible to achieve optimal results with a single surgical procedure, and another surgery may be necessary for some situations. If you experience shortness of breath, chest pains, or unusual heartbeats when you go home, seek medical attention immediately. Should any of these complications occur, you may require hospitalization and additional treatment. Following your physician’s instructions is key to the success of your surgery. It is essential that surgical incisions are not subjected to excessive force, abrasion, or motion during the time of healing. Your doctor will give you specific instructions on how to care for yourself.