Breast Revision

Breast augmentation using implants is one of the most common cosmetic procedures in the U.S., and in most cases, it creates outstanding outcomes. Unfortunately, sometimes a patient can be dissatisfied with the appearance of her breasts after surgery - this can be for a number of reasons such as desire for a different implant size, desire to remove implants entirely, or implant related complications. Dr. Ryan Couvillion, a plastic surgeon in Houston, TX, performs breast revision surgery after giving an in-depth evaluation at SBA Dermatology & Plastic Surgery. It is also important to understand that the results of breast augmentation are not permanent and that they may require replacement or revision. This is because as time passes, the shape of a person’s breasts can change due to factors such as aging, weight changes, and hormonal changes related to menopause.

COMMON REASONS FOR REVISION

This cosmetic surgery is an option to replace or remove an implant that is not functioning properly or is no longer desired. Breast revision surgery may also be performed to change implant size or go from saline to silicone (or vice versa). Some patients may also need a revision of a previous lift, as their breast tissues have changed over time.

ASYMMETRY

This condition occurs when the breasts look uneven. This may be due differences that were initially present and have become more noticeable with age, or an implant that has moved to an unnatural position. An in-depth evaluation will need to take place to determine the cause of the asymmetry and then a revision surgery would be performed to resolve the issue.  Finally, a new set of breast implants may be placed to achieve a balanced look.

BOTTOMING OUT

This is a problem that can happen if one or both implants "bottom out" or drop too low. Sometimes, this is a placement issue from the original breast augmentation, but my also be due to heavy implants which have stretched tissue over time. To correct this, a different placement technique may be considered. For some patients, use of a mesh or their own tissue may be needed to reinforce the surgically created pocket to secure the new implant.

BREAST SIZE

Sometimes, breast revision surgery is as straightforward as getting a different-sized breast implant. During the first surgery, you may have gone too big or too small. A different implant size can be placed to achieve the desired appearance.

CAPSULAR CONTRACTURE

This is scar tissue, occurring when the soft tissue that surrounds the implant becomes thick and hard. While all augmentations do create some internal scarring, most of the time this scarring is thin and soft. In some patients, the scar tissue becomes very hard and can alter the implant position and breast shape, which may cause discomfort and an undesirable appearance. To fix this issue, removing this scar tissue with a partial or total capsulectomy surgery to may be necessary.  This can be accompanied by replacing the breast implants or removing them entirely.

IMPLANT RIPPLING

Implant rippling occurs when you see visible wrinkles and ripples under the skin. This deformity typically forms near the edge of the implant. Rippling is generally found in women who are very thin with saline implants. Many times, this issue can be corrected by simply switching to a silicone breast implant.

IMPLANT RUPTURE

While this represents a small percentage of cases, breast implant rupture can occur. When a saline implant ruptures, the implant will usually deflate quickly. Because of this, visible flattening will be noticeable. Meanwhile, if a silicone implant ruptures, it is harder to detect and may require an ultrasound or MRI. Either way, when a rupture occurs, a replacement surgery or removal surgery will be necessary.

SYMMASTIA

Symmastia occurs when breast implants are placed too closely together. This may be because the breast implant chosen was the incorrect width, shape, or size. It also may be due to implants placed too close together at the initial surgery. Breast revision surgery will repair this visible deformity by using an implant that works with your frame and may also require tissue or mesh reinforcement.

WHAT TO EXPECT WITH BREAST REVISION SURGERY?

Following your procedure and a brief anesthesia observation period, you should be able to go home to begin your recovery. The overall recovery period varies depending on what is involved in your surgery. A revision that needs any type of reconstruction or grafting will have a longer recovery.  Dr. Couvillion and his staff will discuss what you can expect while you recover. In general, breast surgery recoveries are very well tolerated and most patients are able to return to work after about a week.

BREAST REVISION FAQS

How much does breast revision surgery cost?

Your cost for breast revision surgery will vary based on the complexity of your procedure. In your consultation, Dr. Couvillion will listen carefully to your needs and goals before completing a physical examination. After this, he will discuss your choices before creating your treatment plan. The total cost of breast revision surgery will be based on the length and complexity of the procedure, plus any new implants.  As a way to help make your surgery affordable, SBA Dermatology & Plastic Surgery accepts multiple payment types and we will give you information on low-interest medical financing.

Is breast implant removal surgery covered by insurance?

Some insurance companies will pay to remove breast implants in the setting of severe capsular contracture or failure of an implant.  Every company has a different policy regarding breast implant removal, and these are generally published online.  Your cost in the setting of an insurance-approved surgery will vary based on your specific policy. When you meet with Dr. Couvillion, he will help to create a treatment plan to achieve your goals.  Also, most breast implant companies have warranties on their devices, which can pay for some of the costs of surgery and/or replace implants for free.

What if Dr. Couvillion wasn't my original surgeon?

Dr. Couvillion can perform your breast revision surgery even if he was not your original surgeon. Revision surgery is more difficult compared to augmentation surgery, especially if you want significant changes or have problems. This is why it is important to select a Board Certified plastic surgeon, like Dr. Couvillion. Dr. Couvillion also encourages his patients to come back to SBA Dermatology & Plastic Surgery for breast revision surgery after their original breast augmentation surgery if they notice an issue or would like new implants.  If you had surgery elsewhere, it can help tremendously to get the paperwork from your previous surgeon to show exactly what was done.

What about loose skin?

When you are getting your implants exchanged or removed, you may want to have excess skin removed as well. After hearing your goals and evaluating your current implants, Dr. Couvillion can discuss adding a breast lift to remove sagging skin.  This is not an option for everyone, as performing a lift at the same time as removing implants cannot be performed safely for all patients.  Some patients will need to have implants removed first and later have a lift performed.

Will there be new scars?

Whenever possible, Dr. Couvillion will try to make incisions for breast revision surgery in the same place as your original incisions. If this isn't possible, he will place the revision incisions where they are least visible. Revision surgery may use a periareolar incision (along the border of the areola), an inframammary incision (beneath the breast fold) or an incision that is shaped like an anchor. Dr. Couvillion will explain scar care instructions so your new incisions heal flat and blend with your normal skin.

Do I have to change my implants?

Although implants are long-lasting, they may require replacement eventually. Once you've had breast augmentation, it's important to get your implants examined at least once a year so Dr. Couvillion can help you determine if your implants need to be exchanged. With frequent advances in implant technology, you may prefer a new implant type or shape to get a better outcome from breast revision surgery.

CHANGE YOUR MIND

Breast revision surgery is a specialized procedure tailored for your specific needs by plastic surgeon Dr. Ryan Couvillion. If you are not happy with your breast augmentation results or wish for a different result, we invite you to call our Houston, TX office to schedule your appointment at SBA Dermatology & Plastic Surgery. There are numerous factors to consider and Dr. Couvillion will give you a full physical exam, create your revision options, and discuss realistic expectations.

When it comes to aesthetic plastic surgery, it's important to choose a dedicated surgeon who is committed to your desired surgical goals. To meet with our double board-certified plastic surgeon, Ryan Couvillion, MD and his team, call our office at 713.275.9908.