Breast Surgery Revision - San Diego, CA

On occasion, even careful planning and excellent surgical technique can produce disappointing surgical results or unmet expectations following breast enhancement surgery procedures such as breast reduction or breast augmentation. Breast revision surgery may help women who are disappointed with their results immediately after breast surgery as well as those who have seen unwelcome changes in their outcome over time. At Manish C. Champaneria, MD, FACS, Dr. Champaneria performs breast revision surgery for his own San Diego-area patients and patients who have had their breast surgery performed elsewhere. Almost every woman with breast implants will undergo implant removal with or without revision surgery sometime in her lifetime. The three most common reasons for breast implant removal are change of size and shape, implant leakage or rupture, and capsular contracture. Implants may also need to be removed if a woman is diagnosed with breast cancer.

Breast revision corrects circumstances in regard to breast implants. The surgery focuses on removal, replacement, or making a switch from saline to silicone-based implants. Listed below are the most common cases where a patient may be a candidate for this treatment.

Individuals who wish to undergo breast augmentation do so to increase breast size primarily for aesthetics. However, after breast augmentation, some women may be dissatisfied with their results and opt to revert back to their normal breast size. Others may want to remove their implants because of health concerns or other personal reasons. Breast revision surgery is a process where the implant is removed and the skin over the breast is tightened to make sure the breast sits in a natural position and looks normal.

Despite the guarantee that implants are safe and leakages are rare, there are cases when a shell breaks down. If it is filled with saline, the solution will be absorbed by the body, and there will be a noticeable deflation of the breast. In the case of silicone implants, the gel will settle where it is originally placed and the only way to verify it ruptured is with an MRI because the gel doesn’t deflate. This is also the reason why a patient with silicone implants must undergo routine MRI scans.

The tissues surrounding the implant may develop scars over time, which creates a capsular contracture. The scar tissue tightens around the implant, which causes the implant to be displaced. The patient will feel severe hardening of the breast, which can be a discomfort. This is corrected by a capsulectomy in which the scar tissue is surgically removed. Based on statistics, there are more occurrences of contracture with saline implants compared to silicone-based ones. 

A noticeable rippling can sometimes be seen underneath or on the side of the breast. This is generally more common among patients who have very low tissue volume and who are thin.  Although not really a complication, the unnatural wrinkling may cause discomfort and an unsightly appearance. Rippling is most common with saline implants. 

When an implant moves out of the intended pocket, it may cause the appearance of a double breast where a significant crease is noticeable. Implants not properly placed may drop and extend past the breast’s crease or rise, forming an odd volume on top of the breast. Sometimes implants are displaced by severe capsular contracture or a tightening scar tissue. Patients who experience this will go ahead with a revision surgery as this condition is usually noticeable when wearing tight-fitting clothes.

Breast implants vary in size, texture, shape and base. Some patients may be unhappy with how the breast looks and may consider a revision surgery to improve the appearance according to preference. It may be another size increase or a switch from a rounded implant to a more natural looking teardrop shape. Some patients also later realize that they’d rather have silicone instead of saline. All preferences will be considered to modify the augmented breast.

Revision surgery is tailored according to the cosmetic issue the patient is addressing. With this treatment, a major correction is done to the augmented breast in conjunction to scar tissue removal, if applicable, or a breast lift if there is sagging. There are instances when a strattice (a tissue matrix device) will be needed to act as an internal underwire if additional support is required. Ultimately, the correction aims to fix the issue that’s the source of the patient’s dissatisfaction.

Breast revision surgery is performed with general anesthesia in an accredited surgical facility. The patient may be sent home after treatment depending on the severity of the case. It is recommended to have someone who can drive the patient home and who can provide support within 48 hours. Patients can resume to their normal routine on the second week. It will take a few more months for the effects of the revision to become noticeable and the breast to develop a natural feel and look.