Breast Augmentation Revision is used to maintain the aesthetic results of breast enhancing surgery. As we discussed last week, Breast Implants are not lifetime devices, and we reviewed the common situations in which the breast implants themselves are the reason for revision surgery. Revisions due to problems with breast implants account for about one-third of all breast augmentation revisions.
Another third of Breast Augmentation Revision Surgery is caused by changes of the soft tissue of the breasts. To be fair, these types of changes also cause women without Breast Implants to seek cosmetic breast surgery.
Breast Augmentation Maintenance
There are three reasons for Breast Augmentation Maintenance:
- Changes related to the Breast Implants
- Changes related to the Breast Tissue
- Changes related to the Patient Goals
One third of Breast Revisions are Breast Implant related including Capsular Contracture, Breast Implant Deflation and Breast Implant Malposition, which we discussed last week.
One third of Breast Revisions are Breast Tissue related issues include breast sagging, changes in breast volume and the general changes related to aging, changes in weight and pregnancy. We will discuss these today.
The final third of breast revisions are volitional. In these cases, there is no physical problem. Volitional revisions are caused by a change in Patient Goals. The most common reasons are to accommodate the desire for a larger or smaller augmentation.
Today I will review Breast Augmentation Revision for changes in the breast tissue.
Breast Tissue Maintenance
There are three reasons for Breast Tissue Maintenance:
- Changes related to a change in Breast Size
- Changes related to Breast Sagging
- Changes related to other Breast Surgery
Breast Size related revisions include Breast Implant Exchange to add back volume lost with weight loss or after pregnancy, and Breast Implant Removal, or exchange for a smaller breast implant, to compensate for natural breast enlargement. Breast volume loss or gain can occur with age, pregnancy or changes in weight gain.
Breast Sagging is treated with a Breast Lift. Acquired loss of breast volume from a breast biopsy or mastectomy is another breast tissue related reason for Breast Augmentation Revision, and may be treated with fat grafting or complete breast reconstruction.
Breast Tissue Maintenance – Size
Breasts change as we age. Breast Implants are a reliable way to add volume to the breasts; however, they do not prevent aging of the breast tissue or skin.
Breast Implant Revision Surgery – In this case, my patient’s breast enlarged and dropped. A breast implant exchange for smaller implants was performed with revision of her previous breast lift (mastopexy).
The patient above was unhappy that her breasts dropped. Gravity is a weak force, but persistent. To combat gravity, her breast lift was redone. To help prevent recurrence, smaller breast implants were placed. The result was smaller, perkier breasts, and an improvement in her breast lift scars.
Breast Tissue Maintenance – Sagging
As we age, our skin loses elasticity and strength. It atrophies and becomes thinner, often beginning in our twenties. Stretching of the skin with pregnancy or changes in weight further compromise aging elastic and collagen fibers.
Breast Implant Revision Surgery – This patient developed a “waterfall deformity.” Her natural breast tissue has fallen off her breast implants. This has nothing to do with the size of her implants. The breast tissue sagged over the years like a normal breast does.
Breast sagging, or ptosis, often presents as a “waterfall deformity.” As shown in the Breast Implant Revision Before and After Pictures above, my patient’s implants are still in the correct position; however, her breast tissue has fallen off them. A Breast Lift or Mastopexy was used to lift the breast tissue up and to reshape it around the breast mound formed by her breast implants. The result is a happy patient with firmer, lifted breasts.
Breast Tissue Maintenance – Other Surgery
One in eight women will develop breast cancer during her lifetime. While breast cancer is less likely in women with breast implants, it happens. Treating breast cancer usually involves removing breast tissue. Sometimes the entire breast is removed with a Mastectomy, and Breast Reconstruction is an option.
Other times, a Lumpectomy is performed. A lumpectomy is less radical than a mastectomy, and can be used for smaller and less aggressive tumors. Unfortunately, the removal of the tumor often leaves a depression in the breast.
Breast Augmentation Revision – In cases of breast cancer, the breast can be left deformed. Revision surgery and fat grafting was used to help improve the shape and symmetry of the breasts.
In the case above, the patient had tissue removed from behind her left nipple and the inferior pole of her breast. Improvement in breast contour was achieved with the use of Fat Grafting. Fat was transplanted from her trunk into the depressed area in the center of her left breast. The fat provides filling and support for the previously concave and folded nipple areola complex. While not perfect, fat grafting allows for better contour correction than breast implants alone. For Breast Reconstruction, often a combination of breast implants and fat grafting is used to achieve the most aesthetic results.
Breast Implant Revision Consultations
Breast Implant Revision Surgery is offered at our San Francisco Bay Area Plastic Surgery Center. If you are considering Breast Augmentation, or Breast Augmentation Revision Surgery, call (925) 943-6353 today and schedule a private consultation appointment.
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