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Breast Surgery @ Kamol Hospital - Thailand Cosmetic & Plastic Surgery


Breast implant Revision



Breast implant Revision

in Bangkok, Thailand

          Good augmentation surgery result relates to breast size, breast shape, balance, and position. Anyways, limitation to good results from breast implant surgery may be from the elasticity of the skin, internal structure, or less trained- surgeon. The breast augmentation needs to revise.

          Breast implant revision is a surgical procedure for correcting or revising prior to cosmetic or reconstructive breast surgery to restore a youthful breast contour and appearance. The breast implant revision involves changing the size or type of their implants and correct any complications results from prior surgery.

 

Why have to do breast implant revision?

          There are many reasons for surgery a breast implant revision, both medical and cosmetic. Kamol Cosmetic Hospital concerns the safety and satisfying outcome. We have to evaluate a patient's needs to ensure that the aesthetic results will be the best suit for each patient. The following breast conditions are amenable to correction in detail.

          1. Implant size problems

          Some women with breast implants want to change the size of their breasts. Someone wants their breasts to be smaller from the prior implant. For exchanging larger implants to smaller is more concerned about the redundant breast skin and sagging breast or ptosis. The surgeon will be accompanied by a breast lift procedure to manage the excess skin as a result of downsizing breast implants. The implant capsule needs remove in the same operation.

          If someone prefers to upsize a breast implant, the surgeon will concern the positioning of the prior implant. If the implants are in submuscular, the surgeon will keep this position, and create a bigger pocket for the new implant.

          If the prior implants are in sub-glandular, the surgeon will change the positioning of new implants to submuscular and create the new pocket, then insert the new implant into the new pocket. In operation, the surgeon has to remove the capsule implant to prevent the double bubble effect of the new implant.

 

          2. Ruptured/ Leakage Implants

          Breast implants like any products, leakage, or rupture will occur. Saline breast implant might be a leak at the valve by slowly or lost breast volume immediately. Saline implant leaks on one side and causes an asymmetry.It is usually evident to the patients. Silicone implant rupture is more difficult to identify, need to check ultrasound, mammogram, or MRI.The surgery will be done to remove and replace the new implant.

 

          3. Capsular contracture

          Capsular contracture is a tissue reaction to form the capsule around the implant. This capsule can become thicker, harder, and tighter, leading to capsular contracture. This scar tissue reduces the movement of the implant, give the breast an unnatural appearance, and feel discomfort. The treatment of capsular contracture, the surgeon removes the scar tissue around the implant, and the new implant will place in a different position relative to the chest muscle. (see more)

Shows Breast implant Capsular contracture

Picture 1. Shows Breast implant Capsular contracture

 

          4. Upward position Implant

          The prior breast implant is too high when compares with the nipple. The patients need to move the implant downward to balance the chest.The revision for the upward breast implant provides by cutting( Capsulotomy) or removing( Capsulectomy) the capsule implant and create a new pocket to lower than the prior positioning, which concerns the nipple center insert the new implant, then adjust to balance for the nipple center.

Shows Breast Upward position Implant

Picture 2. Shows Breast Upward position Implant

 

          5. Lateral displacement of the implant.

          The prior breast implant seems to be too far apart to produce the desired appearance of cleavage. The implant sits to be behind the natural breasts, make the breasts look too wide to provide the cleavage that patients want.

          The surgical procedure to correct this condition will be operated by internal incision and stitches to minimize the side of the previous pocket and toward the body's midline. The new implants will shift them toward the midline.

 

          6. Bottoming out of breast implants

          Bottoming out of breast implants is a result of the breast augmentation surgery, that may occur. This condition will become from loss elasticity of skin or weak internal muscle or less trained surgeon, make the breast implant look too low, and the nipple looks too high. The bottoming out can be fixed by involving change the implant and then make the pocket upward, elevate implant, and suture the lower border pocket.

Shows Bottoming out of breast implantsShows Bottoming out of breast implants

Picture 3. Shows Bottoming out of breast implants

 

          7. Rippling

          Rippling will occur in particularly thin individuals; ripples from a breast implant can be visible on the skin surface. One option to treat ripples is fat grafting to increase soft tissue volume underneath the skin. Another option is to use AcellularDermal Matrix ( ADM ) to lay the soft tissue. Both techniques can increase more capacity to camouflage the ripples.

 

          8. Symmastia or Uniboob correction

          Symmastia is a result that may occur from breast implants surgery. The implants inserted too close to each other. It may be an effect of too large an implant inserted in a thin woman with a small rib in circumference. Symmastia can fix by extending laterally outward from the midline breastbone to create more space between the implants. This procedure will be incisions under breasts and expand the previous pocket to the lateral side. The midline of the chest fixed by sutures. The breast result will be separated.

Shows Breast implant Symmastia or Uniboob correction

Picture 4. Shows Breast implant Symmastia or Uniboob correction

 

          9. Concerning about BIA- ALCL(Breast Implant-Associated Anaplastic Large Cell Lymphoma)

          BIA-ALCL is a rare and highly treatable type of lymphoma that can develop around the breast implants,maybe occur in patients who have breast implants with textured surfaces. BIA-ALCL is a cancer of the immune system, not a type of breast cancer.

          Common symptoms include breast enlargement, pain, asymmetry, a lump in the breast or armpit, skin rash, breast hardening, or a large fluid collection. The symptom will occur from 1 year to 8-10 years if you have any symptoms to see the doctor for evaluation. You need to remove the implant, and tissue scar around the breast implant includes a lump. You need to remove the implant, and tissue scar around the breast implant include lumps and treatment.

 

A good candidate for breast implant revision

  • Cosmetic concerns with the result of previous surgery due to poor implant or other problem
  • Capsular contracture requires to release scar tissue through Capsulectomy or Capsulotomy
  • Good physical health
  • Realistic in their expectation
  • Psychologically stable
  •  Not currently pregnant or nursing
     

Preparation of breast implant revision

  • Consult with the surgeon for your unsatisfying and expected results. The surgeon and patients will discuss and evaluate how to solve the needs together. The breast implant revision is complicated. There are many techniques to revise the breast implant, depending on the causes and the patent's needs. The surgeon will explain, including incision scar located, shape, size, and positioning.
  • A physical examination, blood test, chest x-ray requires.
  • Stop smoking at least two weeks before and after surgery
  • Stop taking any anti-inflammatory medications such as Aspirin, Ibuprofen at least two weeks. Also, avoid herbal supplements and vitamins, which may increase with bleeding during and after surgery.

 

Procedure for breast implant revision

          Please keep concerns. The second surgery is more complicated than prior to breast augmentation. For several reasons, such as the presence of scar tissue make it more difficult to predict a good result, in addition to the stretching of muscles or anatomical changes caused by the prior implant. That is the challenge for the surgeon.

  1. The operation is done during general anesthesia.
  2. The procedure is done a surgery depends on the reasons, breast revision usually swap out the old implant for the new one. It can include a breast lift, release of scar tissue, and change the size, shape, and location of pocket(space for the implant sits)
  3. The surgeon will close the incision and bandage it with the adhesive and surgical tape.

The operation time is 1-4 hours depends on a complicated breast implant from the previous.

 

Post-operative care for breast implant revision

          The post-operative care for breast implant revision is similar to their previous breast augmentation, to minimize any post-operative discomfort after surgery, which can be done as follows;

  • Keep clean and dry the incision wound 2-3 days after surgery.
  • Apply a cold compress to control bruising and swelling
  • Sleeping with torso slightly elevated to control bruising and swelling
  • Take medicine for pain relief.
  • Take stitches off seven days after surgery.
  • You will need a follow-up with every appointment. 
  • You should wear a compression bra for extra support and positioning to prevent fluid accumulation, control swelling.
  • Please don't lift the things over 2-3 kilograms within six weeks. The lifting will make the implants move it up.
  • Avoid strenuous activities for at least two weeks.

 

Risk and complication for breast implant revision

Any operation might be complications include

  • Keloid from the incision scar
  • Bleeding
  • Bruising
  • Itching
  • Soreness
  • Poor healing
  • Asymmetry
  • Infection, if you notice warmth and redness in your breast due to fever, you might have an infection, contact the surgeon as soon as possible
  • Shortness breathe, or chest pain
  • Decreased or Lost Sensation
  • Capsular contracture might need the second surgery
  • Skin waves, and sagging
  • Implant Failure
  • Risk from anesthesia

 

Recovery for Breast Implants Revision

          The recovery is similar to the previous breast implant, with minimal discomfort. In most cases, recovery time for breast implant revision is short can return to work within a few days with a modulate discomfort. However, The length of breast implant revision recovery will depend on the type of surgery performed.

  • Placement, the recovery time is the same as the primary breast augmentation. It will take more time, maybe 4-5 days, if the size of the implant is bigger. The discomfort symptoms include pain, stiffness, swelling, and bruising. It may take several weeks or months for new implants to settle the final result, such as numbness tingling around the incision.
  • Recovery after breast implant replacement with lifting, the recovery time will take more time for discomfort, can return to work, maybe one week: healing process, sensation around the incision area, swelling, pain, or seroma. The patients need to take a compression bra to support to improve swelling, excrete seroma, and to keep the positioning.

During the breast implant revision recovery, patients should avoid moderate to strenuous exercise and heavy lifting at least six weeks.


Breast implant Revision Before & After


See more Breast implant Revision Before & After





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