Breast Revision
Sometimes, the breast surgery just wasn’t right the first time. That’s stressful. It takes a leap of faith to trust another surgeon to make things right. Thanks for taking your trust this far. It’s not easy to try again when things don’t work out. All of the things you’re worried about (a wide cleavage gap, bottoming out, asymmetrical breasts) I’m worried too. That’s why this will work.
Maybe the changes you’ve seen in your breasts are from time’s arrow: changes over many years have changed your breast lift or breast implants that were good from the start. Life’s events like weight fluctuations and pregnancy continue to change the body as we age. Other times, a size and shape that worked for you before, just isn’t right anymore. Perhaps you went too small the first time, or perhaps too big. Perhaps you are looking for a different profile implant, or perhaps there is rippling with your current saline implants. Maybe you’re even “done with implants.” I also see scars and healing that didn’t go well with the first surgeon. Sometimes a scar revision or nipple revision is the solution.
Whatever it may be: Your goals are my goals.
Breast revisions are a group of procedures that correct the results of previous breast surgery that has become unsatisfactory. The revision improves the shape, size and symmetry of the breasts and may include the replacement of breast implants, pocket repair, pocket changes, a breast lift, capsule removal, implant removal or a combination of all of these complex procedures.
Many women come to my office unhappy with the result of a breast surgery performed by another surgeon. The most common complaints are bottoming out, where the implant slides down the chest, lateralization, where an implant sliding towards the armpit, and hardness, where scar tissue builds up around the implant in what is known as capsular contracture. I also often see uneven nipples from a previous lift, and nipples that aren’t round. Anything can be fixed with the right amount of care.
Realizing that the original procedure did not go right the first time and there is a need for a revision is the first step to getting it corrected. I take great pride in the work that I do and take the necessary time to do a correct breast revision in my Orlando plastic surgery office and operating suite.
My Approach: Revising Your BreastsMy primary approach is an assessment of your specific situation and what needs to get done. Breast revision is about fixing breast implants that have caused your breasts to bottom out or become too wide or too low. It could also involve capsular contracture in which your body might have formed scar tissue or capsules around your breast implants. This is often the result of bacteria getting on the surface of the implants, and that is more common when the nipple approach or over-the-muscle implants were placed.
The first step of any breast revision is to establish your goals and develop how we are going to accomplish them. It’s important to me that you feel good about yourself and how you look. A breast revision can reshape and correct the position of your breasts, but might require new scars, say, if a lift needs to be done. We will always talk things through together. We will come up with a detailed plan to address your concerns and decide on what type of implant to use in the surgery, if any. We can choose from moderate plus to ultra high profile, from soft to gummy bear firm (cohesive) gel. All options are available to you.
Breast Revision Method A breast revision is about correcting a problem from a previous procedure. This can mean removing your old implant and replacing it with a new one that may be of a different size. When I do a revision surgery, it allows me to change the size, shape and location of the breasts.
There are different types of incisions I can use depending on your specific procedure. I may make an incision in the breast crease, or might use a full anchor scar around the nipple, down the front of the breast and along the breast fold. The amount of drooping is the key determination. As always, less is more! The less scarring that we can use to achieve your goals the better.
In rare cases, like severe capsular contracture (scarring) around an old or ruptured implant, we will want to allow your body to “cool off” after removing the scar tissue and implants (a procedure known as a capsulectomy). In these cases, we may place a small surgical drain to remove fluid from the old pocket, which should stay in for only a few days. We may also want to wait 3 months between this and your next surgery to replace your implants, that is if you choose to have implants replaced at all.
I take great pride in all of my work and utilize every possible safety measure to give you the best outcome. One key detail of breast revision surgery is to have a bacteria-free pocket. To this end, I use PhaseOne solution--a type of sterilizing fluid--as well as a triple antibiotic wash in the implant pocket. I also avoid touching the new breast implants: they go from the sterile packaging into the sterile implant pocket. Our goal is no future revisions! This is why I maintain a pristine operating room and only use the best materials and the latest technology, such as the Keller Funnel, a sterile implant placement sleeve to avoid contamination of the new implant.
The goal is to provide you with the best, long-lasting results that you will be happy with. Your goals are my goals. You will be able to see a positive change in the appearance of your breasts after your procedure. I make a concerted effort to be gentle with the tissue I operate on for safety reasons and to shorten your recovery time. Kindness matters.
Top 10 Reasons for a Breast RevisionHere are some of the reasons why you might need a breast revision:
Frequently Asked QuestionsAm I a candidate for a breast revision?If you had a breast procedure done before and have become unhappy with the results, for whatever reason, you are a good candidate for a breast revision. You should allow 6 months to elapse between your previous breast surgery and your revision. You should be in good physical health and be a non-smoker. During our consultation, I will listen to your concerns about the reasons you are seeking a revision. My goal is to ensure you understand what a breast revision can do for you and that you have realistic expectations.
What are the results?You can expect the results of a properly performed breast revision to be long-lasting. The breast skin is very delicate, and so expect your breasts to feel a firm and high at first with swelling following your procedure. But your breasts should start to feel softer once the swelling goes down and things settle (“drop and fluff” as it is commonly known). It can take a few months but sometimes up to a year for your breasts to fully settle after your breast revision.
Are there scars with a breast revision?There is typically more scarring with a revision than there was in your original surgery. The scars heal very well but it will take three months or so for them to become lighter. In some cases, we can simply use the breast fold only to correct the breast shape. In other cases we may need to perform a full lift with anchor scar. Your scars usually become inconspicuous after several months and can take up to a year to completely heal. That said, scars never fully disappear, only fading with time.
What are the risks with a breast revision?I am steadfast and uncompromising when it comes to your safety. By operating in my own facility--not a hospital or outside surgery center--I am able to minimize risks as much as possible, which can include bleeding, capsular contracture, deep vein thrombosis, hematoma, implant rupture, infection, numbness, poor healing of the incisions, scarring, seroma, skin discoloration or skin loss. I never cut corners, taking whatever time I need to ensure I get it right. I worry in the operating room so neither of us worries once we are out! Meticulous suture work and gentleness to tissues is the key to good scars and rapid recovery breast surgery.
RecoveryI’m accountable for you. Me, my anesthesiologist that I deeply trust, my OR nurse and scrub tech. These four make up my amazing surgical team, and together we average about 350 surgical cases each year.
Before surgery, we perform blood work, EKGs, and your preoperative clearance. We can do all of this in our clinic. If you are over 40, a mammogram is advised, which can be ordered and covered by your insurance. We prescribe all the medications you may need for your procedure. We give you recovery and transition bras, as well as scar treatments, gels, and recovery creams to help with your healing process, free of extra charge. By having everything in-house, we can cater the best possible experience in a private boutique that gives you everything you need for great results.
If you experience any side effects or problems, you can always call us after your surgery. We have a nurse available 24 hours a day, 7 days a week for any questions or concerns during your healing process. This is not a call center. This is us. We will return your trust with caring. In spades.
Here is what you can expect from your recovery:
Maybe the changes you’ve seen in your breasts are from time’s arrow: changes over many years have changed your breast lift or breast implants that were good from the start. Life’s events like weight fluctuations and pregnancy continue to change the body as we age. Other times, a size and shape that worked for you before, just isn’t right anymore. Perhaps you went too small the first time, or perhaps too big. Perhaps you are looking for a different profile implant, or perhaps there is rippling with your current saline implants. Maybe you’re even “done with implants.” I also see scars and healing that didn’t go well with the first surgeon. Sometimes a scar revision or nipple revision is the solution.
Whatever it may be: Your goals are my goals.
Breast revisions are a group of procedures that correct the results of previous breast surgery that has become unsatisfactory. The revision improves the shape, size and symmetry of the breasts and may include the replacement of breast implants, pocket repair, pocket changes, a breast lift, capsule removal, implant removal or a combination of all of these complex procedures.
Many women come to my office unhappy with the result of a breast surgery performed by another surgeon. The most common complaints are bottoming out, where the implant slides down the chest, lateralization, where an implant sliding towards the armpit, and hardness, where scar tissue builds up around the implant in what is known as capsular contracture. I also often see uneven nipples from a previous lift, and nipples that aren’t round. Anything can be fixed with the right amount of care.
Realizing that the original procedure did not go right the first time and there is a need for a revision is the first step to getting it corrected. I take great pride in the work that I do and take the necessary time to do a correct breast revision in my Orlando plastic surgery office and operating suite.
My Approach: Revising Your BreastsMy primary approach is an assessment of your specific situation and what needs to get done. Breast revision is about fixing breast implants that have caused your breasts to bottom out or become too wide or too low. It could also involve capsular contracture in which your body might have formed scar tissue or capsules around your breast implants. This is often the result of bacteria getting on the surface of the implants, and that is more common when the nipple approach or over-the-muscle implants were placed.
The first step of any breast revision is to establish your goals and develop how we are going to accomplish them. It’s important to me that you feel good about yourself and how you look. A breast revision can reshape and correct the position of your breasts, but might require new scars, say, if a lift needs to be done. We will always talk things through together. We will come up with a detailed plan to address your concerns and decide on what type of implant to use in the surgery, if any. We can choose from moderate plus to ultra high profile, from soft to gummy bear firm (cohesive) gel. All options are available to you.
Breast Revision Method A breast revision is about correcting a problem from a previous procedure. This can mean removing your old implant and replacing it with a new one that may be of a different size. When I do a revision surgery, it allows me to change the size, shape and location of the breasts.
There are different types of incisions I can use depending on your specific procedure. I may make an incision in the breast crease, or might use a full anchor scar around the nipple, down the front of the breast and along the breast fold. The amount of drooping is the key determination. As always, less is more! The less scarring that we can use to achieve your goals the better.
In rare cases, like severe capsular contracture (scarring) around an old or ruptured implant, we will want to allow your body to “cool off” after removing the scar tissue and implants (a procedure known as a capsulectomy). In these cases, we may place a small surgical drain to remove fluid from the old pocket, which should stay in for only a few days. We may also want to wait 3 months between this and your next surgery to replace your implants, that is if you choose to have implants replaced at all.
I take great pride in all of my work and utilize every possible safety measure to give you the best outcome. One key detail of breast revision surgery is to have a bacteria-free pocket. To this end, I use PhaseOne solution--a type of sterilizing fluid--as well as a triple antibiotic wash in the implant pocket. I also avoid touching the new breast implants: they go from the sterile packaging into the sterile implant pocket. Our goal is no future revisions! This is why I maintain a pristine operating room and only use the best materials and the latest technology, such as the Keller Funnel, a sterile implant placement sleeve to avoid contamination of the new implant.
The goal is to provide you with the best, long-lasting results that you will be happy with. Your goals are my goals. You will be able to see a positive change in the appearance of your breasts after your procedure. I make a concerted effort to be gentle with the tissue I operate on for safety reasons and to shorten your recovery time. Kindness matters.
Top 10 Reasons for a Breast RevisionHere are some of the reasons why you might need a breast revision:
- Capsular Contracture. The result of the hardening of the fibrous tissue capsule around the implant, which makes your breasts feel tight, hard and sometimes painful.
- Experience a rupture due to natural wear and tear or an accident and a deflated appearance.
- Your breast implant has bottomed out or moved out of position downwards or to the armpit
- You’re looking to have a different size, whether bigger or smaller, for your breasts
- Rippling of the breast implant, which may be visible or palpable
- Drooping of the breast off of the implant requiring a lift
- Changes to your breasts after a pregnancy or due to weight fluctuations
- Unhappiness with the irregular shape of your breasts
- A goal for symmetry to be addressed because of differences in the size and shape of your breasts
- You want to improve previous scars from earlier breast surgery
Frequently Asked QuestionsAm I a candidate for a breast revision?If you had a breast procedure done before and have become unhappy with the results, for whatever reason, you are a good candidate for a breast revision. You should allow 6 months to elapse between your previous breast surgery and your revision. You should be in good physical health and be a non-smoker. During our consultation, I will listen to your concerns about the reasons you are seeking a revision. My goal is to ensure you understand what a breast revision can do for you and that you have realistic expectations.
What are the results?You can expect the results of a properly performed breast revision to be long-lasting. The breast skin is very delicate, and so expect your breasts to feel a firm and high at first with swelling following your procedure. But your breasts should start to feel softer once the swelling goes down and things settle (“drop and fluff” as it is commonly known). It can take a few months but sometimes up to a year for your breasts to fully settle after your breast revision.
Are there scars with a breast revision?There is typically more scarring with a revision than there was in your original surgery. The scars heal very well but it will take three months or so for them to become lighter. In some cases, we can simply use the breast fold only to correct the breast shape. In other cases we may need to perform a full lift with anchor scar. Your scars usually become inconspicuous after several months and can take up to a year to completely heal. That said, scars never fully disappear, only fading with time.
What are the risks with a breast revision?I am steadfast and uncompromising when it comes to your safety. By operating in my own facility--not a hospital or outside surgery center--I am able to minimize risks as much as possible, which can include bleeding, capsular contracture, deep vein thrombosis, hematoma, implant rupture, infection, numbness, poor healing of the incisions, scarring, seroma, skin discoloration or skin loss. I never cut corners, taking whatever time I need to ensure I get it right. I worry in the operating room so neither of us worries once we are out! Meticulous suture work and gentleness to tissues is the key to good scars and rapid recovery breast surgery.
RecoveryI’m accountable for you. Me, my anesthesiologist that I deeply trust, my OR nurse and scrub tech. These four make up my amazing surgical team, and together we average about 350 surgical cases each year.
Before surgery, we perform blood work, EKGs, and your preoperative clearance. We can do all of this in our clinic. If you are over 40, a mammogram is advised, which can be ordered and covered by your insurance. We prescribe all the medications you may need for your procedure. We give you recovery and transition bras, as well as scar treatments, gels, and recovery creams to help with your healing process, free of extra charge. By having everything in-house, we can cater the best possible experience in a private boutique that gives you everything you need for great results.
If you experience any side effects or problems, you can always call us after your surgery. We have a nurse available 24 hours a day, 7 days a week for any questions or concerns during your healing process. This is not a call center. This is us. We will return your trust with caring. In spades.
Here is what you can expect from your recovery:
- You will recover faster and experience less pain than you did with your previous breast surgery
- We will apply non-stick (Xeroform) dressings or silicone bandages to your incisions
- An elastic bandage or support bra will help decrease swelling and support your breasts
- Medication will be prescribed for pain relief
- Moisturizers can be applied if your breast skin is dry
- Silicone scar gels will be provided to be used after 1-2 weeks
- Limit your regular activities for the first 48 hours after your procedure
- And avoid doing any strenuous exercises for at least one month
- Many of our patients return to work a week or so after surgery; it depends on the type of work that you do.
