For a range of reasons, women will sometimes either want or need to have breast implants from a previous breast augmentation replaced with newer implants. Additional work may also be done to improve breast appearance, or correct problems that developed over time as a complication of surgery. This is called breast implant revision.
Breast implant revision can be useful for women whose original implants were placed for either cosmetic or reconstructive reasons. For some women, having a breast lift or breast reduction at the same time as implant revision surgery might be the best option for rejuvenating the appearance of the breasts.
Breast implant revision is a specialized plastic surgery technique that must be customized for each woman’s situation. When breast implant revision surgery is requested, a good plastic surgeon will listen to your vision for your body and discuss which new implants and a combination of surgical techniques will give a result that suits your needs.
Dr. Ginger Xu uses her technical expertise and artistic sense to make sure each woman’s appearance will ultimately align with her own unique sense of self. Dr. Xu is a Board-certified plastic surgeon with specialty training in aesthetic plastic surgery at Harvard and is now based in the San Francisco Bay area.
Breast implant revisions can involve:
Breast implant revision is a perfectly valid choice women can make for either cosmetic or reconstructive reasons.
With time, the breasts and skin naturally change and the look and feel of breast implants can also change. Some women choose to have implant revision to improve the aesthetics of their breasts. Breast implants are also inserted for reconstruction after cancer or other medical conditions and so revision after breast reconstruction is also a possibility.
As time passes, some women feel the appearance of their breasts no longer matches their goals for their bodies. Women can choose implant revision for a range of cosmetic reasons including:
Dr. Xu can help you to choose the technique or combination of techniques (eg. a breast lift or reduction at the same time as the implant revision) that will give an appearance as close as possible to your vision for your body.
Women should consult a plastic surgeon if they feel any tightness or pain related to breast implants, if their breasts start to appear distorted or deformed over time, or if they experience any problems at all related to breast implants. Breast implant revision will address problems associated with an implant or previous implant surgery including:
It is very important for women to be properly counseled regarding implant size before surgery. Women often have breast implants placed that are too large for their bodies. This may initially look pleasing but over time, there can be long term consequences that are irreversible and difficult to correct.
A very large implant in a patient with a small chest will sometimes cause the skin to stretch too much and result in permanent stretch marks. It can also cause undesired areola enlargement. The pressure of the implant against the chest wall can also cause chest wall deformity and indentation of the rib cage, with a scooped-in appearance that is only seen if the implant is removed. The pressure from the implant can even result in a loss or atrophy of natural breast tissue. As a result, if the woman ever requires implant removal in the future, she may not be able to return to a normal appearance.
Dr. Xu is passionate about preventing these types of problems in women seeking breast augmentation or breast revision surgery. It is of paramount importance to her that all issues like this are reviewed and discussed, so each woman can make the best decision for her body.
Breast revision surgery is a complex procedure best performed by a surgeon with excellent skills. The technique or combination of techniques needed will depend on the reason for the revision.
Implant replacement involves removing old breast implants and replacing them with newer ones of your choice. This can result in cosmetic improvements or it can correct problems from previous surgeries. Dr. Xu will discuss any changes you would like in the size and shape of your breasts and the options available with newer models of implants. For women who have experienced a rupture or leakage, implant replacement can also maintain your breast size and shape.
Capsulectomy refers to the removal of internal scar tissue (breast capsule) that has formed around the implant. This is usually the solution to improving breast shapes that appear contracted and distorted due to the capsule. This can also relieve the source of implant hardening, tightness, deformity, and pain.
Acellular dermal matrix or surgical scaffold can help to support the breast to hold a new implant in position. The surgeon typically places this material on top of the implant but under the breast tissue to provide support. These are sterile medical products and help surgeons to decrease the risk of a number of problems such as:
Breast Skin Reshaping involves removing or re-shaping breast skin to improve the appearance and contours of the breasts. This can be a critical step in helping you to achieve your goals for your breasts. Examples are breast lift, breast reduction or nipple and areola surgery which might be performed in addition to implant revision surgery. This can help improve breast shape as well as symmetry.
All of these potential procedures must be customized to each woman’s individual body type and needs, and are best performed by a board-certified plastic surgeon like Dr. Xu who has specialty training in aesthetic surgery and experience in complex breast techniques.
Even before you arrive for your consultation, it is very important for you to think about your goals and be ready to discuss this. Dr. Xu will then perform a careful assessment and explain how your previous implant surgery, age, breast size, breast shape, and skin affect the choice of the new implant, the surgical techniques required, and the results you can achieve.
Dr. Xu understands how women’s preferences for their bodies can change with time. She will design a customized surgical plan and guide you on selecting new implants for the look you want.
Before you agree to a surgical approach, you should have a realistic understanding of:
The surgery will involve:
You may have new scars, or Dr. Xu may be able to use your existing scars. The degree of new scarring depends on:
Breast implants are medical devices and manufacturers and surgeons are constantly working to provide better results for people wanting their first breast augmentation or breast augmentation revision.
There have been dramatic improvements in the past few decades, and even in recent years, as newer generations of silicone are being developed and released on to the market. This has resulted in improved outcomes and improved device longevity. The gel is also more cohesive and less likely to migrate in scenarios of implant rupture or leak. Newer implants also have improved elasticity, shell strength, and a variety of other characteristics that make them feel more natural and life-like.
Even with the latest advancements to implant technology, it is important to understand that breast implants are not guaranteed to last a lifetime. While newer generations of implants are more robust than older models, future surgery may still be needed to replace an implant if a rupture or leaking develops. After the placement of breast implants, it is a good idea to have regular breast exams to check the condition of your implants.
Saline implant rupture would result in obvious deflation and a change in the size of the affected breast. But silicone breast implant rupture is often “silent” and undetectable by the woman or even by a physical exam. In this scenario, an MRI is a useful tool that can detect silent rupture. Currently, the Food and Drug Administration (FDA) recommends MRI screening for silent rupture three years after receiving a silicone implant and every two years afterward.
Breast implant manufacturers in the US have warranties. For the latest details, ask your surgeon or search the manufacturer’s website:
This a personal choice for each woman to make and Dr. Xu will help guide and support your decision. Modern silicone gel-filled implants are safer than ever before, and give a more natural shape and feel than saline-filled implants. It is important to remember that saline-filled implants are not silicone-free – they also have a silicone shell.
Women might have had a saline implant originally inserted because they:
A saline-filled implant is a viable option but, especially in thinner women, saline implants:
Yes, you can absolutely choose to change your implant size. In fact, breast implant revision surgery is a great opportunity for women to make these types of changes. Choosing the size of your new implants is one of the most important decisions you can make for breast revision surgery. Dr. Xu will help guide your decision, but ultimately supports women to make their own choices about their own bodies.
The condition of your skin and breasts before surgery will play a role in what implant size will give you optimal breast aesthetics. For example, if your skin is loose and stretched, a larger implant may help lift your breasts while a smaller implant might leave your breasts looking deflated. On the other hand, an implant too large for you may result in unsightly stretch marks and thinning of your natural breast tissue. If you prefer a smaller implant but have skin excess, Dr. Xu might then recommend a breast lift or other procedure to give you aesthetically pleasing results.
Dr. Xu will review these types of nuances with you at the time of consultation. She will also recommend a balanced surgical plan that helps achieve your goals in a safe way.
Breast implant removal is always an option. If that is your preference, it is important to understand that your breast skin will usually have stretched to accommodate your original implant. Once the implant is removed, your breasts will appear deflated. The level of deflation will depend on the size of the original implant, how much your skin stretched in response to the implant, and how well the skin is able to shrink back after the implant is removed. In addition, very large implants may have also placed pressure against your chest causing some rib cage indentation as well as loss or atrophy of natural breast tissue. Some women are very unhappy with their appearance after implant removal alone, and this can be a source of depression.
As with all breast surgery, the options available should be customized for your needs and anatomy. During a consultation for breast implant removal, Dr. Xu will discuss the potential of a breast lift. This can help restore a more shapely and youthful appearance to the breast which may otherwise sag due to skin excess. In some cases, a smaller implant will help camouflage emptiness and deflation in the upper breast after the removal of a larger implant.
In addition to breast revision surgery, some women will take this opportunity to enhance other areas of their bodies. This can be achieved with additional body contouring around the chest and torso, or perhaps even rejuvenation of the face. Liposuction is the most commonly requested addition to breast surgery. If this is of interest to you, Dr. Xu can examine your entire body with an artistic eye and let you know if liposuction or other procedures can enhance your results.
Areas that can be shaped and contoured with liposuction and other rejuvenating procedures during breast implant revision surgery include the:
Dr. Xu understands the responsibility of transforming a woman’s appearance to better reflect her identity and build self-esteem. Her top priority is understanding your vision and desires.
Once Dr. Xu has examined your body, implants, breasts, and chest, she will use her artistic sense and technical expertise to recommend an approach to your surgery that will best suit your goals.
During a consultation, Dr. Xu will explain:
Once you and Dr. Xu have agreed on an approach to your surgery, Dr. Xu will book your surgery time and give you instructions on what to do before and after your surgery.
Dr. Xu will also let you know which medications you should and should not take prior to your surgery and what to do on the day of your surgery. It is important to stop smoking at least 6 weeks prior to surgery.
You may need to get a blood test or undergo additional workup depending on your medical history. Dr. Xu may also correspond with your primary care doctor to ensure you are in an optimal state of health prior to surgery.
In the weeks before surgery, recommendations to help you prepare include:
It is essential that you feel comfortable about your upcoming procedure and fully understand the process. Dr. Xu encourages her patients to ask any questions about their surgery or recovery.
After your breast implant revision surgery, you will feel mild to moderate discomfort. The amount of pain you feel depends on a number of factors such as:
Prescription pain medications might be needed for the first few days. After this time, any pain should be relieved with over-the-counter or non-opioid medications.
Recovery typically takes approximately two weeks. During this time, you should avoid lifting any heavy weights. Once bruising and tenderness have gone, you can return to normal activities. Most women can return to work after a week, but strenuous exercise should be avoided for four to six weeks. Ask Dr. Xu when you can return to the full range of activities.
If you have had a combination of surgeries, Dr. Xu can advise you of any additional recovery needs.