Breast Revision Beverly Hills

Conveniently located to serve the areas of Beverly Hills and Los Angeles

Contents

Description

Women elect to undergo breast revision surgery for a number of reasons. Breast implants do not come with a lifetime guarantee, and although the most breast implants last an average of 10 years, there are many occasions where complications (ie. Capsular contracture, implant rupture or deflation) necessitate a revisionary surgery within a shorter time frame. In some cases, the health of the breast implants is not the cause for the revisionary surgery. Some women elect to have a second breast surgery to increase or decrease the size of the original breast implant, or to change the shape, type, projection, or placement of their implants. At Gabbay Plastic Surgery, located in Beverly Hills, CA, Dr. Joubin Gabbay M.D. is highly experienced performing all variations of breast revision surgery, and will listen carefully to your goals and surgical objectives, and then formulate a treatment plan to bring your goals to fruition. Dr. Gabbay wants you to be 100% satisfied with your breast surgery, and will take great care to correct and resolve the problems that have inspired you to seek out a secondary surgery.

Options

Secondary breast revision surgery may sometimes be more difficult than your original breast surgery, which is why it is imperative to select a skillful, experienced plastic surgeon for this type of procedure.  Dr. Gabbay understands how to circumnavigate challenges such as the presence of excess scar tissue during breast revision surgery, and utilizes techniques to minimize scarring and to prevent future complications. Dr. Gabbay uses advanced techniqeus in order to minimize any pain or discomfort for his patients, and to shorten the required post-operative recovery period.

Breast revision is a corrective surgery, aimed at resolving issues or complications from a previous breast surgery. At Gabbay Plastic Surgery, Dr. Gabbay will work tirelessly to ensure you achieve the exact aesthetic look you want for your breasts, and will also restore your breasts and breast implants to good health, correcting any problems of capsular contracture, rupture, or deflation. If you would like additional information about a secondary breast revision surgery, please contact Gabbay Plastic Surgery today. We look forward to discussing all of your breast revision option with you, and setting up a complimentary, initial consultation with Dr. Gabbay.

Indications

It is natural for breast shape and appearance to undergo a number of changes over time, but when you are disappointed with the way your breasts look or have health complications because of a previous breast surgery, a breast revision procedure may be the best option.

Some of the most common aesthetic and/or health-related reasons women seek out breast revision surgery include:

  • Breast Volume and/or Shape Change: weight fluctuations, age, pregnancy, and breast feeding can lead to changes in the shape or volume of your breasts
  • Saline Breast Implant Deflation: saline breast implants can rupture or leak, causing implant deflation
  • Silicone Implant Shell Leak: silicone implants can rupture and leak, which can be detected with an MRI
  • Breast Implant Exchange: for various reasons, some breast augmentation patients request to change their implant type (from saline to silicone or vice versa) to address their personal cosmetic or health concerns
  • Capsular Contracture:  a common complication of breast augmentation surgery, capsular contracture results when the scar tissue around the implants hardens
  • Implant Malposition: if the pocket that surrounds the breast implant is too large, it will allow the implant to shift in position, leading to implant malposition
  • Shifted Breast Implants: when implants do not have enough support from the surrounding muscle, they may shift, causing asymmetry.
  • Infection or Allergy: although it is very rare, in some cases a woman’s body may reject a breast implant, causing an infection
  • Implant Coverage Problems: if the breast tissue covering the implant is too thin, you may see rippling of the implant through the skin
  • Symmastia: if the pectoralis muscle is cut during the original breast augmentation surgery, this can cause the breast implants to fall towards the sternum at the center of the chest, creating unnatural looking cleavage and a “uniboob” appearance
  • Bottoming Out: this complication occurs when nipples appear too high or an inframammary fold appears unnaturally low.  This condition occurs more frequently in patients with very thin breast tissue because the implant can pull the breast downward causing it to bottom out
  • Double Bubble: the double bubble complication occurs when the breast implant drops below the natural fold of the breast, causing breast tissue to hang and droop
  • Breast Implant Removal: for women who have determined that they no longer wish to have breast implants, breast revision surgery can be performed to remove the implants and/or perform a breast lift on the remaining breast tissue
  • Correction of Scarring Associated with Primary Breast Surgery: excess scarring from breast surgery can be ameliorated surgically
  • Implant Size Revision: women who are not satisfied with the size of their original implants may elect to have breast revision surgery to increase or decrease their implant size

If any of the above concerns apply to you and you are in good mental and physical health, you may be a candidate for a breast revision surgery at Gabbay Plastic Surgery.

Evaluation

Because every patient’s motivation for seeking out breast revision surgery is different, Dr. Gabbay will work with you to design a comprehensive treatment plan that is customized to meet your individual needs and goals.  You should come to the consultation prepared to discuss your current and past medical history, including any information about medical conditions, drug allergies, previous surgeries you have had (including breast biopsies), and the medications or supplements you currently take.  If you are planning to lose a significant amount of weight, you should tell Dr. Gabbay, as he may recommend that you stabilize your weight prior to undergoing breast revision surgery.  If you are planning a future pregnancy you should mention this as well, because pregnancy can alter breast size in an unpredictable way and could impact the long-term results of your breast revision surgery.

Procedure Details

Breast revision surgery can take from 1-4 hours and is performed under general anesthesia or IV sedation.  The specific technique used during your breast revision surgery will depend upon your surgical goals and the breast issues that need to be addressed. During a surgery to correct capsular contracture problems, the capsule and breast implant may be removed from the pocket and a new breast implant will be inserted (in some cases, a new pocket will be created for the breast implant).  In cases where an existing breast implant has ruptured or lost shape, the breast implant will be removed and replaced. If the ruptured implant is silicone, the remaining silicone material will be removed from the pocket, and the pocket will be thoroughly cleaned and sterilized prior to the insertion of a new implant. To address issues of aesthetically problematic changes in breast shape, a breast lift may be performed in conjunction with the insertion of new breast implants. If the breasts do not require a lift, the “dual-plane” technique may be used for re-augmentation, in order to improve the shape and overall appearance of the breasts.

Following your revision surgery, a thin tube may be temporarily placed under the skin to drain any excess blood or fluids, and gauze or bandages will be applied to your incisions.  The use of an elastic bandage or support bra will help minimize swelling and support the newly revised breasts.

Recovery

In general, recovery from breast revision surgery will be similar to your original breast augmentation healing process.  For the first 2-3 days, any discomfort will be controlled with oral pain medication, and it is important that during this time you rest and keep your arm extension to a minimum to help prevent the muscle and tissue from stretching or separating.  Bruising and swelling are common after this type of surgery and should subside within a few weeks. Most patients return to work after 1-2 weeks, although you will need to avoid reaching or lifting for an additional 3-4 weeks.  It is crucial that you follow all of Dr. Gabbay’s post-op instructions and attend your follow-up visits in order to avoid infection and other complications. Your scars will be pink for several weeks, but will eventually fade and after the swelling period ends, your breasts will begin to feel softer and more natural.

Although rare, potential breast revision surgery complications include: hematoma, capsular contracture, rippling, rupture, infection, bleeding, loss of nipple sensitivity, and immune system disorders.

Frequently Asked Questions (FAQs)

What is breast revision surgery?

Breast revision is a surgical procedure designed for women who are having issues with their breasts after previous surgery. The most common reason women seek this procedure is to correct the problems from breast augmentation that include scar contraction, hardening, deflation, rupture of the breast implant, breast changes from natural causes, and/or a desire to change the type or size of implant.  The objective of breast revision surgery is to improve the breast and make it better than it was before.

Is breast revision surgery painful?

Breast revision surgery is usually more complicated than the initial surgery, and may be more uncomfortable, especially if scar tissue is removed or a breast lift is required.  Any discomfort can easily be controlled with pain medication.

Is breast revision surgery performed very often?

Over three million women in this country have undergone breast enhancement procedures and whether the surgery was performed incorrectly or the outcome was poor, there is a growing increase in the need for revisional breast surgery.  If you do not like the way your breasts look because of a previous surgery, Dr. Gabbay has performed hundreds of successful breast revisions, and he is extremely qualified to correct the problems that are making you unhappy with your breasts.

What is the most popular breast revision surgery?

According to the FDA, 37% of all breast revision surgeries are performed on women who are unhappy with the size of their original breast implants.  Breast implant revision surgery is a procedure designed to correct complications from a previous primary breast augmentation procedure that created a cosmetic or a physical problem that poses a health risk.  This procedure commonly involves the removal and/or replacement of the original breast implants.

How do I know if breast revision surgery is right for me?

If you are dissatisfied with the appearance of your breasts or if you are experiencing pain and discomfort due to complications from your initial breast surgery, breast revision surgery is probably right for you.  The first step when deciding if breast revision surgery is for you is to schedule a consultation with Dr. Gabbay at Gabbay Plastic Surgery.   Some women choose to have their implants replaced, while some will simply opt for removal, depending on their individual needs; and what is best for you will be determined during your consultation.

What problems can breast implant revision correct?

Some of the problems that breast implant revision surgery can correct include capsular contracture, improper implant placement, implant rupture or leakage, implant wrinkling, or an unnatural appearance. Older silicone implants should be inspected periodically to see whether or not they need to be replaced due to age.

How is breast implant revision performed?

There are many techniques for breast revision surgery, but usually for implant removal and/or replacement, Dr. Gabbay will make incisions in either the crease below the breast, around the areola, in the armpit, or possibly through the navel. This procedure is performed with great precision and delicacy in order to prevent the patient from needing a secondary revision, and the best course of treatment for you will be decided during your preliminary exam.

How long does breast revision surgery take?

A breast revision surgery can take from 1-4 hours depending on circumstances, such as your personal anatomy, the technique used, and the type of complications you have.

How long will the results of breast implant revision surgery last?

Breast implant revision results are long-lasting; although you should plan to make periodically visits to Gabbay Plastic Surgery, so Dr. Gabbay can make sure that your implants are not posing health risks, and to help prevent any complications.

What are some of the possible risks/complications of breast implant revision?

All surgery carries the possibility of complications such as infection, unsatisfactory results, excessive bleeding, and adverse reaction to anesthesia.  For breast augmentation revision surgery, the risks include the possibility of hematoma, capsular contracture, sensitivity loss, rippling, rupturing, and/or leakage.

Who is an ideal candidate for breast implant revision?

In addition to possessing complications and problems associated with a previous breast surgery procedure, the best candidates for breast revision surgery are women who are in good physical health, psychologically stable, not currently pregnant or nursing, and they have realistic expectations that include looking for improvement not perfection.

What should I expect when I go home from my surgery?

You will be tired and sore with limited mobility after your procedure, and that is why it is advised that you have help for the first few days.  Any discomfort can be controlled with pain medication, and your breasts will be bandaged for protection and support.  It is important to rest and take all medications prescribed. If you follow all of your post-operative instructions, swelling will subside within 10 days and most patients return to work in 1-2 weeks, with restrictions.

How does corrective breast augmentation work?

Revision breast augmentation procedures are customized to address your particular concerns and complications related to your breast implants.  Breast implant revision surgery often involves implant removal or exchange, and may be combined with reconstructive procedures to stop implant migration, or remove hardened tissue around the implants.

What breast revision procedure will take the longest recovery period?

Recovery after revision surgery is usually similar to your first breast surgery, unless you require a complex revision surgery, such as repair of capsular contracture or symmastia.   Patients who have had their implants relocated from the subglandular position- to the submuscular position, may need a longer recovery time as well to allow the chest muscles to heal.

What is capsular contracture?

After breast augmentation, it is normal for scar tissue to form around breast implants, but in some patients that scar tissue contracts too tightly and distorts the implant.  This condition is called capsular contracture, and it can occur months or years after the first implant surgery.  Traditional treatment of capsular contracture involves simple removal of the scar tissue and replacement of the breast implant, although, other techniques may be an option.

How do I know if my implant has ruptured?

Detecting a rupture in a saline implant is usually very easy because once the outer shell is breached; the sterile saline will drain out of the implant.  Silicone implants have a more cohesive material (which does not leak out if the outer shell becomes ruptured), and the recommendation for detecting a silicone implant rupture is regular MRI screenings.  With either type of breast implant, you should pay close attention to any changes, and report possible problems to Dr. Gabbay immediately.

What happens during the breast augmentation revision procedure?

Prior to your surgery, Dr. Gabbay will work with you to design a personalized plan to treat your specific areas of dissatisfaction, and once you have been placed under anesthesia, he will likely use the same incision to remove your old implants and replace them with new ones.  In cases of complications such as capsular contracture or implant malposition, the procedure will be more complex.

What will my breasts look like if I decide to have my implants removed altogether?

Implant removal or sometimes even replacement with a smaller implant carries the risk of an undesirable cosmetic outcome, especially for women who have had large breast implants for several years.  When breast augmentation is performed, the breast skin stretches to hold the implants, and when the implants are removed: the skin will not shrink down to its original size meaning that you will be left with sagging skin.  For this condition, Dr. Gabbay may recommend a breast lift to remove excess skin and tissue.

How soon can I have breast augmentation revision when I know I have problems with my first augmentation surgery?

This will depend on several factors. Some women may have concerns as soon as several months after their initial augmentation surgery, while other issues may take up to several years to manifest. If you are not satisfied with the results of your breast augmentation, the decision and timing for revision surgery will depend on Dr. Gabbay’s recommendation.

Can I change the size of my implants through breast implant revisions?

In breast implant revision surgery, your implants can be changed to either increase or decrease the size of your breasts to your desired size, or to correct problems that occurred after your prior breast augmentation.

Can breast implant revision surgery correct implant deflation?

Patients may experience implant deflation caused by a small tear of the implant that results in fluid loss, and breast implant revision surgery can correct ruptured or deflated implants bringing back fullness and shape to your breasts.

What type of procedure will Dr. Gabbay use for my breast revision surgery?

The type of procedure you have will depend on the problem or problems that you have with your breasts.  Some of the most common scenarios involve capsular contraction (scarring around the breast implant) and in this case the scar tissue needs to be removed and the implant will be replaced.  If your implants are deflated or ruptured, the breast implants will need to be replaced and if the breast tissue becomes loose from pregnancy, a breast lift or larger implants may be required.  Many techniques are used in combination with breast revision such as capsulorrhaphy, capsulotomy, capsulectomy, repositioning of implant sub-muscularly, use of ADM’s (Acellular Dermal Matrix), and mastopexy. In addition, shape and size discrepancies and areolar asymmetries can be addressed as well during breast revision surgery.

If I have a problem after breast implant surgery, do I have to have a breast revision?

Many patients live with breast problems after breast augmentation and wait to have breast revisions when the issue becomes too uncomfortable or aesthetically unpleasing.  The exception is if a silicone implant ruptures, because the silicone implant releases silicone slowly, and it should be removed as soon as possible to prevent the silicone from spreading outside the breast capsule and into the breast tissue.  The silicone implants today have “conforming gel” which decreases the risk of rupture.

Is a second revision breast surgery ever needed?

Unfortunately, over a woman’s lifetime it is hard to predict the issues she will have with her breast implants, and in some cases, an additional revision surgery is necessary.

When will I be able to exercise after my breast revision surgery?

Most patients can return to work within 1-2 weeks, and exercise can usually be resumed in approximately 5-6 weeks.

What are some of the most common complications of breast augmentation?

Some complications following breast augmentation may occur with any surgery while others are connected to the augmentation procedure and the most common and treatable complications include: capsular contracture, wrinkling knuckling, implants mal-position, deflation, ptosis/drooping, double-bubble deformities, and an exaggerated pectoralis major muscular flexion deformity. The vast majority of these can be corrected, and in addition, shape and size discrepancies and areolar asymmetries can be addressed.

Can my breasts be corrected in any other way besides surgery?

Sometimes the corrections you are hoping for can be achieved with a relatively simple surgical procedure (liposuction) with or without minor surgical excision through previous scars.  When major changes are required however, it is important that you have the problems corrected with surgery and this will be determined during your consultation.

If only my implants need to be replaced, how will Dr. Gabbay perform my surgery?

Usually, your old incisions will be used to access your breast implants, but in some cases a new incision underneath the breast may necessary. Your existing implants will be removed, and new ones will be placed.Depending on the original pocket size, location, and the shape it is in, Dr. Gabbay may need to modify or create a new one.  If there is extensive scar tissue, this will be removed and the tissues surrounding the implant may need to be repositioned, to allow for better positioning of the implant itself. The incisions are typically closed with internal sutures, and surgical adhesive and/or tape are applied as dressings.