Breast Revision Surgery Melbourne
Unfortunately, despite your very best research and the extensive consultations prior to surgery, sometimes the results of your breast surgery are not as you had expected.
In these situations many patients find that they are considering returning to the operating theatre for secondary or revisional breast surgery.
Before embarking upon this surgery it is important to understand the risks of additional surgery and the reasons why your surgery did not achieve the results that you were expecting.
It may well be that there was a simple healing problem, or that the tissue within your breast stretched post operatively. These are usually very easy to correct and as long as the ultimate aim of your breast surgery remains the same, this repair can usually be performed safely, quickly and with minimal downtime.
Sometimes however, your result is quite different to what you expected.
In these situations you need to take a step back and revisit your aims prior to surgery.
The most important part in the preoperative consultation is for you to be able to clearly articulate and explain the shape and look of your ideal breast, the breast that you would like to obtain after surgery.
In many cases of patients seeking revisional surgery, there has often been a miscommunication between you and your surgeon.
It is particularly important in revisional breast augmentation that you have a clear understanding of what went wrong. Often we find that patients didn’t fully understand the impact of the decisions they made preoperatively, or weren’t able to clearly explain the result they were seeking.
In our experience, breast augmentation patients make 8 decisions that directly influence their post operative result. Of these decisions, the choice of implant, its position (either behind or in front of the muscle) and the implant size are the most critical. If one of these 3 decisions is wrong, then almost all patients will return seeking revision surgery. The other 5 decisions are important, but usually don’t result in a patient seeking to have their surgery revised.
If this is the case, and one of the 3 decisions is wrong, then it is usually a straightforward matter to correct the surgical plan and by repeating the surgery, simply adjust the surgical pocket or implant size, or its shape to achieve the result that you desire.
What is breast implant revision surgery?
Breast implant revision or revisional breast augmentation surgery is a surgical cosmetic procedure involving the removal or replacement of the breast implant and modification of the breast implant pocket to correct complications arising from the previous surgery.
Why might I need revisional breast augmentation?
You may need revisional breast surgery if you have experienced the following:
- There may have been a simple wound healing problem or that the breast tissue has stretched post operatively. These are usually very easy to correct and as long as the ultimate aim of your breast surgery and the size that you are seeking has remained the same. This repair of the soft tissue and skin can usually be performed safely, quickly and with minimal downtown. In most cases this surgery can be performed as a day case.
- Implant mal-position. Progressively after surgery you may have noticed that your implants have moved or drifted away from their original position causing asymmetry. The most common movement is for your implants to move down and out, resulting in a wider gap between your breasts and a lack of volume in the upper pole. The most common reason for this movement is aggressive upper body exercise in the early post-operative period. Correction of this asymmetry or mal-position is a little more complicated and involves returning to the operating theatre where under sterile condition and under a general anaesthetic the implant is removed and the pocket surrounding the implant is modified and re-enforced to re-position the implant back into its correct central location. Because this surgery involves removal of the implant, it is critically important that you keep the wounds clean and dry for a minimum of 2 weeks after surgery and that you refrain from upper body exercises for a minimum of 8-12 weeks after surgery.
- Change in the desired appearance. Occasionally despite long consultations with your surgeon about your desired outcome and your ideal breast size, the result delivered by your breast augmentation is not what you expected and you would like to change your breast size or shape. The reasoning behind this difference between your expectations and actual outcome can usually be traced back to a miscommunication between your surgeon and what they believed you were expecting and your ideal breast size. It may be that you were initially conservative in your breast size selection and that having gone through the surgery and having got used to your breast implants upon reflection you believe actually you could go a little larger. This is a very common post-operative experience with almost all patients experiencing a desire to increase their breast implant size to some degree. It is critical therefore that you allocate time to carefully and clearly explain to the surgeon the size and shape that you are expecting from your breast augmentation surgery, before surgery, and that wherever possible you and the surgeon look at images or photographs together so that you can clearly explain the result that you are seeking. In our practice we use implant sizers which allow you to place different size implant sizers into your bra and then see the effect those different implants have on your bust in different clothing. We also use a 3-dimensional photographic computer program called Vectra which allows us to show you the impact of different size implants, different shape implants in different positions, that is above or behind the muscle on your breast in a 3D model. These images can be saved onto a computer memory stick, allowing you to look at these images at home.
Changing your breast implant size is a relatively straight forward procedure but does involve a return to the operating theatre, another general anaesthetic and removal of the old implant and insertion of the new implant. As with implant mal-position it is critical that you keep the wounds clean and dry for a minimum of 2 weeks and refrain from excessive upper body exercise for 8-12 weeks after surgery.
Who is a good candidate for breast implant revision?
Breast implant revision is one of the most common repeat or revisional surgeries performed in plastic surgery. It is more common in patients whose weight has changed significantly prior to surgery and is particularly likely if you have undergone significant weight loss. Additionally, if your breasts were very large when you were breast feeding, the ligaments in and around your breast will have stretched meaning that you are more likely to require breast revision surgery. As with any breast surgery it is critically important that you do your research and that you have a clear understanding of the result that you are seeking both in the size and shape of your breast. Images which depict your ideal breast size and shape are incredibly helpful in allowing you to communicate clearly with your surgeon so that he or she understands the result that you are trying to achieve. We would not recommend you undergo breast revisional surgery whilst you are pregnant or breast feeding, if you have a serious illness or infection, if you have breast cancer or if you have an abnormal mammogram.
What are the risks of breast revision surgery?
Even a simple revision still requires a return to the operating theatre and a general anaesthetic. Whilst the risk of a general anaesthetic can be minimalised, it is important that you do not smoke, that you are otherwise fit and well and most importantly that you are as close as possible to your ideal body weight. You should allow sufficient time for your body to heal and have arranged time away from work for a minimum of 2 weeks after surgery for minor revision and 6 weeks away from work for more significant breast revision surgery. If you have young children at home you will need to coordinate for someone to help you in their care for 2 weeks after minor surgery and 6 weeks for more significant revisional surgery.