Breast Implant Revision Surgery

There are a variety of factors that go into making these important decisions. Dr. Sharma will discuss all of your options with you. Some factors that play an important role in determining the type, size, and shape of implant include:

• how much breast volume you have to start with
• the thickness of your natural breast tissue
• some of your lifestyle habits
• where your current implants are placed
• the type of nipple projection you hope to achieve
• your physical measurements including the base width of your breast footprint, height, weight, and body habitus
• personal preference for scar placement, desired appearance, volume, implant placement, etc.

Surgery takes place in the operating room with you asleep under a general anesthetic, and can take 2-2.5 hours. Markings are first made before going into the OR to plan the incision location. Once you are asleep the incisions are made very carefully and the previously placed implants are removed. An appropriate pocket either above or below the muscle is developed and depending on the type of revision surgery that is needed, sutures may be used to create a more well-defined pocket to improve the breast shape and appearance. A temporary sizer is typically used to ensure that the selected implant is the best size for you and to ensure good symmetry. Sometimes fat transfer may also be done to the breasts to enhance cleavage lines and help to hide the contour of the implants if there is not much natural breast tissue. Sometimes a breast lift may also be done at the same time to improve the nipple position. All of the stitches are dissolving underneath the skin to give you the best possible scars. Drainage tubes are NOT required. Paper tapes and gauze dressings are applied. You are placed into a customized post-operative surgical bra that we give you at the end of your surgery to provide support and minimize bruising/swelling. After surgery, you will be in the recovery room for a couple of hours and monitored closely. All post-operative instructions and prescriptions will be given to you before going home. You will be able to go home the same day of surgery with a responsible adult.

Recovery is a gradual process. You are encouraged to take it easy but still get up frequently for short walks to reduce the risk of blood clots in the legs from immobility. The first 1-2 days you may need some of the prescribed pain medications, and will be recovering from the anesthetic and medications you were given. Most patients are needing only Tylenol or Advil after that. You will be able to shower directly over the paper tapes after 2 days. Generally it is a good idea to take 1 week off work, depending on what type of work you do. At 2-3 weeks from surgery you will typically feel fully recovered. You will have to avoid heavy lifting and vigorous exercise up until about 6 weeks from surgery. The final breast shape can take up to 3 months before the implants have ultimately settled.

Several studies have proven the safety of breast implants (with the exception of aggressively textured implants). There is no association between breast implants and breast cancer and breast implants do not impair the ability to detect breast cancer. They also rarely impair breast-feeding ability, especially with incisions placed in the infra-mammary fold.

Textured breast implants have been linked to a rare form of lymphoma called ALCL (anaplastic large cell lymphoma), which generally presents with a late seroma often 8 or more years after placement. These types of implants have all been taken off the market for implantation, and we only use smooth implants which have all been shown to be safe. If you have had these types of implants done in the past, Dr. Sharma can assess you if you have any concerns and discuss all of your options with you.

Some patients have also experienced systemic symptoms related to their breast implants, also known as breast implant illness. While this condition is not common, it may be an important consideration in choosing breast augmentation surgery. Dr. Sharma will be able to discuss this in more detail with you, and review all of your options to ensure that you are making a fully informed decision.