About Breast Revision Surgery
Breast surgery of any type, like any other surgical procedure, can result in less than a perfect outcome. Cosmetic surgery would not be as popular as it is unless most outcomes are excellent. While most patients are very happy with their results, many factors are involved in producing a satisfying outcome for a patient. First and foremost, a frank discussion of cosmetic expectations must be made. These expectations are set based on your surgeon's experience, your anatomy, your mental health, and outside forces such as infections or mechanical issues with your implant.
What are some factors influencing the potential for breast revision surgery:
- Breasts with a lot of pre-existing droop with pre-existing asymmetry will have a higher chance of revision as the surgery will require a balance of removing breast tissue AND potentially adding volume using a breast implant. Determining size is not even close to an exact science. During your operation, adding a breast implant might provide extra volume, fullness, and cleavage; but depending on the discrepancy in size AND shape, some breast tissue may be removed from one or both breasts to get them to be more equal. Revision after a breast lift with or without implants is up to 20%
- Patients will have anatomic differences internally such as the contour of the ribs or the insertion point of their muscles. This leads to differences in how we can place implants.
- Infections are unfortunate and unpredictable. We take precautions in surgery such as surgical scrub soap and IV antibiotics but infections are still possible. The results of infection are unpredictable and may require revisions
While few breast augmentations do end with an unpleasing outcome, there are individuals who wish to have a larger or smaller implant, while some may have a visible irregularity and would like to have the implant corrected or removed all together. Furthermore, some women must have revision treatment for a particular condition. Leesburg, VA plastic surgeon Dr. Phillip Chang offers breast revision surgery after giving an in-depth exam at Aesthetica Cosmetic Surgery & Laser Center in Loudoun County, so that a healthy and desired outcome is attained.
"It's been over a year and a half since I've been going to Dr. Chang's office, I drive an hour just to get here (although I know some drive three hours or more to see him!). I did a lot of research to find a board certified plastic surgeon in the area with a solid and reputable background.Throughout my visits, he's been incredibly kind and taken the time to listen to my never ending list of questions. There are a lot of doctors that push services that you don't need just for money but he'll be transparent to tell you exactly what he feels you'll need in order to gain improvement and will work with you to see what could be the best outcome. You can also text or email him directly after any invasive procedures if you have any questions/concerns instead of waiting for a follow up. I also don't want to forget the rest of the staff - everyone from the receptionists and nurses have been very gracious, patient and accommodating to my needs but I also want to mention Melanie whose an RN at Dr. Chang's office. She has superb bed side skills and truly makes you feel at ease when you're speaking with her. I've probably annoyed her with a million questions and emails but she's still been stellar. I highly recommend her for any non-surgical procedures. They have a few videos on their website and youtube as well so you have an idea of who they are and the procedures they perform if you want to get a better idea yourself but I definitely recommend them, they're awesome."- M. / Google / Jul 24, 2018
"Aesthetica is indeed one of the best cosmetic surgery and laser centers in Loudoun. Dr. Chang is a born artist. Highly recommended!"- S.G. / Facebook / Aug 07, 2019
"I highly recommend Dr. Chang and the staff at Aesthetica. The positive, caring staff, including nurse Katy, were outstanding every step of the way, as are the results Dr. Chang delivered. I am 100 percent satisfied with my procedure and will return. Choosing Aesthetica was a wonderful decision. Don’t waste your time going anywhere else!"- L. / Google / Aug 02, 2019
"This past Tuesday I had a Botox treatment with Melanie. I can’t say enough about how knowledgeable and caring she was throughout the procedure. The way she communicated put me at ease and gave me comfort. She has a natural ability to make patients feel safe and confident. This experience surpassed my expectations and I fully plan on recommending her to all of my friends. Aesthetica is a top notch Cosmetic Surgery & Laser Center run by Dr. Chang who is always friendly, caring and knows how to help a woman achieve her cosmetic goals."- T.R. / Facebook / Jul 18, 2019
"My name is Carmen, and I live in Lucketts, Virginia. Back in May of 2016 I had an accident with our dog, a feisty Jack Russell Terrier. The dog leaped up and bit me on the center of my upper lip, causing the skin to rip open. I was very upset and scared, and I was also concerned that my face would be permanently disfigured for the rest of my life.My husband John took me that Sunday afternoon to the Emergency room of Loudoun Hospital. After waiting one hour, the nurse cleaned my lip and gave me a tetanus injection. Then they told me there was no surgeon that evening, so a nurse practitioner would do the stitches on my lip. I was very worried, so I asked for a plastic surgeon, and they said that was impossible, because the only one available was out of the office that day. However, they said they would try to reach him. They did call him, and Dr. PHILLIP CHANG came to treat me after an hour. I am grateful for life to him, not only because he really is a magician the way that he stitched me, also the fact that he offered to come to the hospital on Sunday on his weekend evening without even knowing me.He treated me with kindness and great professionalism and care. He calmed my nerves and was all about optimism from the start. He assured me that, by using a proper method, nearly all of my injury would not be visible because of his experience in treating similar cases. He sewed the wound carefully, and then treated me so well that there is almost no evidence of the injury.I highly recommend DR. PHILLIP CHANG for such an injury. There are not enough words I can find to express my gratitude to him. That’s the reason I am writing my story. HE IS THE BEST.-Carmen Lucketts, VirginiaSent from my iPad"- C.D. / Google / Jun 19, 2019
Should you have any trouble (either medical or aesthetic) after breast augmentation surgery, please make a consultative appointment with Dr. Chang to go over your wants and needs and to develop your personalized plan for breast revision surgery. Whether it's scar tissue, drooping or sagging, ripples under the skin, or size variations between the breasts, revision surgery can help correct the condition and result in a more normal and properly functioning outcome. This operation may also be appropriate if you are wanting to alter the implant style, size, or address another aspect of your breasts.
Common Reasons for Revision
Breast revision surgery either removes an implant that is defective or not functioning or is no longer desired. Breast revision surgery may also be performed to change implant size or go from an implant to a fat transfer (or vice versa). There are other common situations where a revision or secondary surgery is desired or required:
Even though this is a rare occurrence, breast implant rupture can possibly occur. When a saline implant type ruptures, the implant will deflate almost immediately. Due to this issue, a visible defect will be noticeable. Meanwhile, if the implant is silicone based and ruptures, it is only seen via an MRI. Whether silicone or saline, when a rupture occurs, an additional procedure will be required.
This is known as scar tissue hardening, occurring when the delicate tissue that surrounds the saline or silicone implant becomes thick and hard. Although many implant surgeries do create some internal scar tissue, most women will never see or feel it. In some patients, the hardening tissue could interfere with implant placement, which can change the breast shape and implant functionality and deliver an undesirable outcome. Capsular contracture surgery to clean up and remove scarring would be recommended.
This condition occurs when the implant sizes look disproportionate. This may be due to an incorrect size implant, or sagging or drooping on one side, or a different condition that may cause asymmetry. A physical examination would need to take place to determine what is leading to the asymmetry, then a revision surgery would be needed to resolve the problem, and finally, a new set of breast implants would be positioned to create a symmetrical result.
This is a problem that happens if one or both implants "bottom out" or drop too low. Sometimes this is a case of a positioning error from the original treatment. To modify this, a different placement positioning approach may be needed. For some patients, tissue grafting most likely will be needed, in addition to a surgically formed pocket to encircle the new implant. For many patients, going to a silicone breast implant usually will solve this issue.
Symmastia is a condition that takes place when breast implants are inserted and placed too closely together. Most often, this is because the breast implant used was the incorrect shape and width. A revision treatment will repair this problem by picking an implant that fits your frame and looks pleasing to the eye.
This condition occurs when you see obvious rippling and wrinkles under the skin. This irregularity typically forms just along the edging of the implant. Rippling is generally found in patients who are of low body weight. Many times, this issue can be fixed by simply switching to a silicone breast implant.
Sometimes a secondary breast surgery is as straightforward as getting a smaller or larger sized breast implant. During the first surgery, you may have opted to go too conservative or gone a bit too large. A different implant size can be chosen to reach the desired goal.
What to Expect
Expectations depend obviously on the type of revision that is required. Minor revisions can be performed under local anesthesia in the office. Many revision procedures will require a return to the operating room. The most common revisions are simply for scar conditions or the removal and tailoring of skin folds.
Most revisions will require you to wait 6 months to a year. This is because most issues will resolve on their own; but the more important reason that is that there is extra scar tissue and inflammation in the first year that makes any form of surgery extremely difficult and risky.
Recovery from a revision surgery varies depending on the revision type. For example, if a different size is being placed, a breast lift may work if less volumes are used to help remove wrinkled or loose skin. Revision surgery that warrants complex revision techniques will need a longer recovery that could possibly last up to 6 – 8 weeks.
Patients will slowly start to see their newly revised outcomes once the bruising and swelling starts to disappear. The most important aspect following a new, revision surgery is to reach a result that is both functioning well and aesthetically appealing.
Frequently Asked Questions
How much does breast revision surgery cost?
Your cost for breast revision surgery will vary based on the complexity of your procedure. In your consultation, Dr. Chang will listen carefully to your needs and goals before completing a physical examination of your implants. After this, he will talk about your choices before creating your treatment plan. The total cost of revision surgery will be based on the complexity of the procedure, plus your new implants. It's better to concentrate on getting great results by finding a skilled plastic surgeon, like Dr. Chang, instead of the cheapest surgeon. As a way to help make your surgery affordable, Aesthetica Cosmetic Surgery & Laser Center accepts many different payments and we will give you information on low-interest financing.
What if Dr. Chang wasn't my original surgeon?
Dr. Chang can perform your revision surgery even if he was not the surgeon who did your original breast augmentation. Revision surgery is sometimes more difficult compared to augmentation surgery especially if you want significant changes or have problems, which is why it is best to find a plastic surgeon like Dr. Chang who has advanced training and experience in breast surgery. Dr. Chang also welcomes his patients to come back to Aesthetica Cosmetic Surgery & Laser Center for revision surgery after their augmentation if you notice an issue or would like new implants.
What about loose skin?
When you are getting your implants exchanged or removed, you may want to have excess skin removed as well. After hearing your goals and evaluating your current implants, Dr. Chang can discuss adding a breast lift to remove sagging skin. If you lose a lot of weight, get pregnant, or breastfeed after augmentation surgery, a revision with a lift will give you better results.
Will there be new scars?
When possible, Dr. Chang will make incisions for revision surgery in the original augmentation incisions. If this isn't possible, he will place the revision incisions where they are least visible. Revision surgery may use a transaxillary incision (in the armpit), a periareolar incision (along the lower border of the areola), an inframammary incision (beneath the breast fold), or TUBA incision (through the belly button). Dr. Chang or a member of his team will explain scar care instructions so your incisions heal smoothly and blend with your skin.
Do I have to change my implants?
Although implants are long lasting, they do require replacement eventually. Once you've had augmentation surgery, it's important to get your implants examined at least once a year so Dr. Chang can help you determine if your implants need to be exchanged. With frequent advances in medical technology, you may prefer the new implant types and shapes to get a better form from breast revision surgery.
Change Your Mind
Revision surgery for breast implants is a specialized procedure tailored for your aesthetic goals by plastic surgeon Dr. Phillip Chang. If you notice a visible defect with your breast augmentation results or desire a different result, we invite you to get in touch with our Leesburg, VA office to make your appointment at Aesthetica Cosmetic Surgery & Laser Center. There are so many factors to consider and Dr. Chang will perform a full physical assessment, create your revision treatment plan, and discuss realistic outcome expectations.