Breast Revision Overview
Reasons for Breast Revision Surgery
Patients often had their original breast surgery to achieve a desired proportion, improve self-confidence, facilitate clothing and bathing suit selection, and to look better in and out of clothing. If any of these are compromised because breast or nipple asymmetry or unnatural firmness, then a lot can be done to alleviate these breast problems. Below are the most common reasons for breast implant revision surgery:
- Dissatisfaction with the size of the original implant (implants are too small or too large)
- Dissatisfaction with breast tissue (sagging, breast too wide and extending off onto the lateral chest, more perky shape desired)
- Rippling or wrinkling
- Deflation, rupture or leak
- Bottoming out and other implant malpositions (falling inferiorly or too low, laterally or to the side, too high, or symmastia or “uni-boob” or “bread loafing”)
- Capsular contracture (implant too firm or hard)
- Double Bubble (Double fold on the under surface of the breast)
- Animation effects (undesired motion of breast muscle activity)
A consultation is needed to determine how best to achieve the patient’s desired outcome. It is important to determine whether there is an implant malposition problem or whether there is a capsular contracture causing a malposition because the procedures recommended are dramatically different for these conditions. Only when the desired end result is known can the procedure to achieve that be determined. During your consultation, Dr. Pertsch will evaluate your concerns, identify your specific problem areas, and determine how to best achieve your desired outcome.
Patient’s are asked to find images of models undressed from the waist up at a 45-degree angle to demonstrate their desire outcome: breast proportion, shape, and position. Patients shouldn’t get caught up in finding models with their same height and weight, but focus on the overall breast size, shape, and proportion they seek. We have over 1300 pages with multiple images in our office help save our patients’ from helpful image. Comparing the patient’s current appearance with her desired outcome will help determine which options will best achieve her goal. After seeing images of models depicting your desired result and evaluating your breast issues, Dr Pertsch will show you images of other patients’ “before and after” photographs to help you choose the options that will best meet your needs and desires.
Breast Revision Procedure
Breast revision surgery is performed most often using general anesthesia at our private, state-of-the-art federally/Medicare-certified ambulatory surgery center, ABJ Surgery Center, Inc. The length of surgery varies depending on the options necessary. Drain tubes are often used to speed recovery by reducing swelling and fluid from collecting around the implant.
Breast Revision Options
Implant Projection (pancake → cupcake)
- Above the muscle (subglandular)
- Partially or completely under the muscle
- Breast lift
- Breast tissue volume reduction
- Inframammary (along the breast crease)
- Periareolar (around the areola)
- Transaxillary (within the armpit)
- Breast left/breast reduction scar
Other conditions may be addressed during the same operation, including:
- Implant and breast volume
- Areola and nipple size
- Fullness on the side of the chest
- “Bra fat” (fat that protrudes above and below the brassiere straps near the outer part of the breast and chest) can be reduced
Preparing for Breast Revision Surgery
Once the surgery procedures are chosen, a preop visit allows for a thorough review of all instructions necessary for before and after surgery to best achieve a trouble-free and successful outcome. The patient’s general health may be evaluated by her own physician if felt necessary by Dr. Pertsch in preparation for the anesthesiologist. All normally expected post-surgery issues and their evolution and potential problems are reviewed in detail. An outline including every question Dr. Pertsch has ever been asked is reviewed as well. These outlines are provided for the patient in advance, and a copy is given to the patient afterward.
After breast revision surgery, you may expect to experience some pain, bruising, and swelling, but prescription medications will help to alleviate these symptoms. Incisions are usually covered with light gauze dressings and/or compression garments are applied. Often, a breast stabilization strap will place gentle pressure on the upper breast. For procedures to correct implant malposition, a custom support under bra may be made and worn for six weeks. Breasts can become wet during bathing once any sutures are removed and one day after any drain tubes are removed.
Patients can usually return to work as soon as they feel comfortable doing so. Patients who undergo implant exchange without another procedure might be able to return to work the next day or after long weekend. Patients who undergo more extensive surgery or a combination of procedures may require one to two weeks before returning to work.
Patients can begin walking and moving about immediately after surgery. Aerobic exercise is not advised for about two weeks. If implant position has been supported with capsulorrhaphy or ACD, minimal arm use is allowed for six weeks to allow for adequate healing. Specific postoperative instructions will vary depending on the nature of your procedure(s). These instructions will be reviewed at the time of your final preoperative visit.
Breast Revision Results
Thousands of grateful patients validate Dr. Pertsch’s rare gift for making women look natural and beautiful in an evening gown or a bikini top. You can trust Dr. Pertsch to complete your breast revision surgery meticulously, to repair the work of a less-experienced surgeon, or to reverse the ravages of time, thereby approaching or achieving the breast outcome you desire. Dr. Pertsch has great success in his breast revision patients, and you can rest assured that you have found a surgeon you can trust.