Breast Revision Surgery

Breast augmentation is a very common operation with some 25,000 being performed in Australia every year. Other breast operations , such as mastopexy ( breast lift) and breast reductions are also common procedures.

For most women, the results and boost in confidence, appearance are great and worth the operation. However, breast augmentation surgery has its downsides and complications. There are number of consequences and complications which may require a repeat operation.

Here is a short list of conditions and issues that some women may face following breast augmentation surgery. Most of these can be improved with corrective surgery and I’ll give you an overview of some of the techniques used to deal with them.

  1. Capsular contracture

    This is the commonest complication after implant surgery and can occur anywhere from a few months to many years after implant surgery. The commonest signs are increasing, dragging or tight discomfort in one breast and a firm feeling to the breast. In severe cases, the contracture (which is actually scar tissue around the implant), can even distort the shape of the breast.

    • The commonest way to deal with contracture is to remove the old implant, remove the scar tissue and replace the implant with a new one. I favour the use of polyurethane implants in this situation as they have a smaller risk of the contracture recurring.
  2. Implant rupture or deflation

    All implants have a finite life span and, as all mechanical devices, they will eventually fail. Most commonly, this is due to wear and tear of the implant capsule. This complication is often silent, ie it doesn’t produce any obvious signs or discomfort. It is usually found on routine ultrasound examination.

    • Unless there is an associated capsular contracture as well, I generally treat this condition with simple removal of the ruptured implant and substituting with a new one. Some patients take this opportunity to reassess the size of their implant as well: some choose to go larger, some smaller.
  3. Double Bubble

    This complication appears most commonly where a large implant is used in a small body frame. The implant projects beyond the natural borders of the breast tissue and creates the visual appearance of two breast contours: one form the implant and one from the natural breast tissue.

    • There are a number of possible solutions to double bubble, including fat grafting, reducing the stretched tissue, breast lift or using a different implant.
  4. Bottoming out

    This condition can occur in larger breast or with the use of larger implants. It looks like the lower part of the breast has dropped and stretched to a fuller and lower position than planned. This is more common if your skin is thin or has previously been stretched, such as during pregnancy or with significant weight loss.

    • Correction of this condition often involves removing the excess stretched tissue. It is also sometimes necessary to change the implant size to better match the position of the breast tissue and the implant. Sometimes, more advanced techniques, like “internal Bra” may need to be used. or uncomfortable.
  5. Waterfall deformity or “Snoopy breast”

    This breast appearance produces an unbalanced look to the breast with unnaturally high and prominent upper pole and empty, flattened lower breast. The nipple is usually positioned low on the breast, leading to an unattractive, unnatural look.

    • There are a number of different techniques available to correct this problem, including using different shape implants, different size implants or breast lift .
  6. Symmastia of “Uniboob”

    Int his condition, the natural separation and gap between the two breasts is absent and produces a bridge of tissue between the two breasts. This makes it difficult to achieve an attractive cleavage and actually makes fitting of bras and clothes difficult.

    • Correction symmastia can be tricky and may involve smaller implants, internal stitching as well as placing the implant into a different pocket under the muscle.
  7. Wrong size

    You may have heard that patients always wish they had”gone bigger”, or used a larger implant. Well, sometimes that is true, but certainly this can also go the other way: sometimes patients choose a large implant, which they then find loo large, too heavy or uncomfortable. “Going smaller” is almost as common as “going bigger”.

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