Women who undergo cosmetic breast surgery should always be counseled by their surgeon that there is a high likelihood they will need breast revision surgery at some time in their lives, especially many years after the initial breast augmentation. Many of my patients are surprised to find that there can be huge differences in the revision rates and the total number of surgeries a given woman will have over a lifetime. These differences depend on many factors, but the most important one is which surgeon they choose to perform the surgery.
Common Reasons for Breast Implant Revision
There are many reasons a woman might choose to get revision breast augmentation surgery. Breast augmentation revision surgery may be needed for the following reasons:
1. To Correct a Less-Than-Desirable Result
Women sometimes regret their original implant size or dimensions and want breasts that are larger or smaller, or perhaps wider or narrower, or even more or less projecting. In some cases, the implants may sit too low on the chest or too far apart, or the breasts are asymmetrical. Revision surgery in these cases typically involves a proper assessment of the patient’s breasts, her chest wall, and her frame. Implants can be replaced, and breasts can be narrowed or widened or even repositioned on the chest to some degree.
Typically, breast implant replacement or revision is focused on correcting any issues that were created during the initial surgery as well as making sure to optimize breast size and appearance for each patient.
2. To Improve Satisfaction With Breast Appearance
Breast implants don’t last forever. Women who were happy with their original breast augmentation results may become disappointed years later as age, weight changes, pregnancy, and the stress of breast implants cause changes to the appearance of their breasts.
One of the most common conditions we treat is implant visibility — usually in the form of visible rippling of saline implants seen through the skin. As the breast tissues thin with age, the implant can become more visible, causing rippling in certain positions, or in extreme cases, in any position. Ideally, the implant should be hidden beneath healthy breast tissue and skin so that the breast feels and looks natural.
In most cases, a patient may choose to change from saline to the latest generation of cohesive silicone gel implants that resist rippling and might need to combine a breast lift or fat grafting with the revision procedure to achieve the desired outcome.
3. To Address a Complication
Even though they’re rare, complications that occur following breast augmentation can require revision surgery to correct them. The most common complication is called capsular contracture. Scar tissue forms a capsule around all implants, but with capsular contracture, the scar thickens and contracts abnormally, making the breast feel unnaturally firm. In some cases, the condition becomes painful. Other less common complications include abnormal scarring, implant rupture or leakage, bottoming out, and symmastia (“bread loafing”).
The unique challenges posed by complex revision surgery include scar tissue, previous incisions, and the potential of a compromised blood supply, among many other factors based mostly on the quality of the patient’s tissues.
The Secret to Long-Term Results
One of the secrets most patients don’t know, even savvy ones, is that most plastic surgeons don’t follow their patients for very long after surgery. As a consequence, these surgeons are focused on short-term “results,” not caring or even knowing how patients actually end up after everything is fully healed and settled. Many times, surgeons deceive themselves into thinking that a 6-week “result” is the actual result that matters, and this short-term focus often works to the patient’s disadvantage in the long run. It is a well-known fact of cosmetic surgery that final results are typically not evident or stable until at least one year after surgery, and in some cases, much longer.
So why would these surgeons focus on such short-term assessments of their work? If you think about a typical surgeon’s practice, it is advantageous to see many “new” patients to operate on—“follow-up” patients take time away from the new ones. From a financial standpoint, it “makes sense” to only follow patients for a short time and move on to the next patient to operate on.
Additionally, patients are only given a very short time to voice any concerns or complaints about their results, and after a few months, the patient may be out of luck finding any sympathy for her concerns. Many patients are told that, after a short time (typically a few months), if they experience any problems that will require additional surgery, these “problems” will be treated as a new problem that requires additional payment.
Patients are blamed for unacceptable results when these results are many times only the normal course of healing. The real problem, of course, is that the surgeon was aiming for a short-term result, not anticipating or caring that a longer-term focus was necessary to achieve the desired result. In literally thousands of cases, we have seen that patients referred to us for “secondary” or revision breast surgery received a surgery that looked good “on the table,” without regard to how the patient would ultimately look after the healing process was really complete.
Sometimes, the Wrong Surgery Was Performed
The most common complaint we’ve seen with patients who are unhappy with their original surgery elsewhere is that the wrong surgery may have been performed in the first place.
The most common scenario is a woman who wants a breast augmentation but also needs a breast lift, and the surgeon performs only a breast augmentation without performing a proper lift. Our experience is that very few, if any, women are happy with the long-term results of this approach.
The patient may look relatively acceptable for a few weeks or even a few months after surgery, but after swelling goes down and settling has stabilized, the patients are left with larger, heavier, and lower versions of the breasts they started with. The patient may have been able to avoid the additional scarring of a lift, or avoid the extra expense, but in the end, looking at the prospect of a wasted surgery and now needing corrective surgery that costs much more than first-time surgery, what did she really get, and what did she really save?
How The Wall Center Approach Differs
As we explain in another blog post, The Wall Center is a breast revision surgery destination because our approach is much, much different. We are aiming for long-term results measured not in days, weeks, or even months but in years. We spend time with our patients discussing which options will work the best, keeping each patient’s specific circumstances in mind, and designing a personalized approach that will work best for her for the longest period of time.
Frequent Breast Augmentation Follow-Up
We ask that our patients continue to follow up with us throughout their lifetimes, typically every year or two, depending on the specific surgery. It is this long-term concern for our patients’ surgical results that allows us to recommend surgical plans that minimize the total amount of surgeries a particular patient will have over her lifetime.
This approach requires honesty, and many times, frank discussions with our patients about why we may need to recommend a surgical plan that may be different from what the patient originally expected. Even if a patient doesn’t care if an oversized and inappropriate breast augmentation won’t hold up for more than a few months, we do, and we always try to perform the right surgery for a patient, keeping in mind each patient’s specific circumstances.
Experience With Complex Breast Augmentation Revision
Women are often referred to us for secondary or revision breast enhancement procedures because our surgeons have a tremendous amount of experience and a proven track record of success performing these more complex operations. While the overall satisfaction rate for women who get breast implants is very high, there are a number of reasons women are referred to The Wall Center for revision surgery. You can see more of our patients’ real-lift results in their breast revision before-and-after photos.
Learning About Your Breast Revision Options
Patients who believe they might be good candidates for breast revision surgery should schedule a consultation to learn about what options are available. Because surgeons from outside the area often refer patients to The Wall Center, we offer virtual consultations for patients who are serious about pursuing corrective surgery but cannot travel to Shreveport for a consultation.
You can request a consultation online or call us at (318) 795-0801 to schedule an appointment with one of our experienced surgeons.
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