Breast Implant Revision

There are several reasons why a woman would be a candidate for breast implant revision following breast augmentation.

Some women who’ve had breast enlargement never obtained the results they desired from day one.  Facing such problems as breast asymmetry, capsular contracture, or other complications that detract from their breast appearance. Obviously, breast implant revision makes sense for these women so they can finally enjoy the enhanced breasts.

Dr. Sorokin sees a large number of ladies that really needed a lift to get a nice result, but simply got an augmentation. While perhaps the reason was to avoid scars, or perhaps the original surgeon never even suggested a lift, the end result is the same. An implant doesn’t really lift the sagging tissues of a breast and sometimes a mastopexy (lift) is the proper procedure.

Some women need revision breast surgery to correct capsular contracture. Capsular contracture occurs when the scar tissue that naturally forms around the breast begins to tighten and constrict around the implant, creating a hardened breast feel and unnatural appearance. Over the years medical science has come up with more and more ways to prevent and treat this dreaded complication. For surgeons who follow newer techniques rates of capsular contracture are very low compared to the past. Use of antibiotic irrigation in surgery, changing gloves several times during surgery, meticulous control of bleeding, avoidance of blunt dissection during pocket creation, use of Keller Funnels and other newer techniques have allowed us to lower but not eliminate risk. Treatment can involve massage, vitamin supplementation, and medication and yet sometimes surgery is needed to remove this scar tissue. Unfortunately once capsular contracture is present, it is a difficult problem to treat and recurrence rates are high.  Dr. Sorokin enjoys the challenge of treating this complicated issue and is happy to meet with you to discuss options.

Other women seek breast implant revision to repair an implant that has deflated or ruptured. Women with saline implants know almost immediately when their implant has ruptured – rapid deflation of the implant occurs. While the saline is harmlessly absorbed by the body, deflation creates a cosmetic issue. For Dr. Sorokin’s patients in this situation, he can replace the deflated breast implant with a similar saline model or can perform a more extensive procedure to replace both implants if the patient is interested in converting to the new generation of silicone gel implants. Detection of leaks in silicone breast implants is more difficult. The breast will often change size or shape but the change can be subtle. Many women who are very observant of their bodies can notice these changes however it is certainly not an all or nothing phenomenon like it is with saline. The newest recommendation for leak surveillance is to get an ultrasound starting at 5 years and then every 2 years..

Other ladies have implant positioning concerns such as bottoming out. Sometimes the implants were placed too low in the original surgery due to creation of a low pocket. Sometimes the natural breast tissue simply is not strong enough to support the implant. Options for repair include suturing techniques, internal bras and internal support with implants such as Alloderm, Strattice, or Galaflex. This is actually one of the more common reasons ladies come to see Dr. Sorokin.

A common request for revision surgery is simply size exchange. Some ladies feel they are either too small or too big. More often than not they wish they had gone larger. Some ladies come to me and say their surgeon made them larger than they wanted to be! Either way, size matters when it comes to final implant selection. While this is a relatively common reason for revision breast surgery throughout the country, our goal is to understand each patient’s goal prior to surgery to prevent this from happening.

Synmastia is when the implants are located too close to the midline and actually can touch each other and is often described in lay terms as “Uniboob”. Repair of this unfortunate outcome can lead to a much more natural, pleasing breast enhancement.

Still other women who are initially happy with their augmentation results will need breast lift (mastopexy) after several years to reposition breasts that have begun to droop following pregnancy, weight loss, or even the natural aging process.

Implant revision surgery is a technically challenging procedure that in most cases requires greater surgical skill than the original breast augmentation.

Women who need revision often have:

• Significant internal and external scar tissue
• Stretched or thinned out skin on the breasts
• Altered breast and chest wall anatomy
• Altered blood supply and musculature
• Unknown original surgical techniques
• Leaking breast implants

All of these factors can limit reconstructive options and require Dr. Sorokin to employ customized corrective techniques to restore an attractive appearance. There is no cookie cutter breast implant revision these are all very customized procedures depending on existing result and desired outcome.

Regardless of the reason you are considering breast implant revision, Dr. Sorokin will take the time during your consultation to evaluate your cosmetic concerns and recommend a surgical solution that is most likely to advance your breast enlargement goals.

Dr. Sorokin tells all of his breast enlargement patients that breast implants are not lifetime devices. Most likely, if you choose breast augmentation, you will need a subsequent surgery to revise or replace your implants at some time. Simply put, implants do not last forever.  Both the implant and the natural breast around the implant are aging, and sometimes a little help from a plastic surgeon is needed! While a surgeon can take steps to minimize the risk of problems such as capsular contracture and implant deflation, these risks cannot be eliminated entirely.

Current models of saline and silicone gel implants are highly durable and can be expected to last many years. But it is important that women who choose breast augmentation follow all safety precautions and take proper care of their implants. Dr. Sorokin strongly recommends patients who receive silicone gel implants follow the FDA guideline related to periodic ultrasound screening to detect “silent rupture” of their implants, and return to him for their breast implant revision procedure if a rupture is detected.

To learn more about breast implant revision, request a consultation in Philadelphia. You can also call to set up an appointment. Dr. Sorokin is dedicated to helping you achieve and maintain your desired breast appearance.