Any patient that has undergone a previous cosmetic breast surgery and is requiring a new breast procedure, is considered a Revision Case. Whether you have had a breast augmentation, breast lift, or if you experienced a mastectomy for cancer or preventative treatment, there is an immense range of cases that fall under the revision breast surgery umbrella. Not all revisions are a means to correct issues or changes, sometimes revisions are done to rejuvenate the breasts many years after the original procedure.
Due to Dr. Adams’ longstanding expertise and practice with breast implants and plastic surgery, we see many new revision patients from around the world.
Reasons for Revision Breast Surgery
- A simple refresh on current implants in exchange for new implants
- Switching to a different implant type or size
- Revisional correction of issues or changes after a previous surgery
- Rupture of a saline implant
- Implant malposition
- Capsular Contracture, a complication where the natural formed capsule (scar tissue) surrounding the implant begins to harden and contract. Progression may be slow. Severity is rated using a grading system.
- Explant, total removal of implants
- Additional breast lift procedure due to relapse of sagging or stretching after a previous lift
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It is important for patients to know that after any cosmetic breast surgery, the breast makeup will never be the same; the dermis stretches over time to fit the implant and compromises the elasticity of pre-surgery skin, alteration or loss of existing glandular & fibrous breast tissue, changes to the bio-mechanics of the pectoralis muscle, scarring, and neurovascular effects.
Correction of breast implant problems and breast procedures, can be difficult. The likelihood of the necessity for additional procedures increases after a revision surgery than after a successful primary surgery. That being said, Dr. Adams has treated a plethora of breast revision patients with great success, achieving long-lasting results.
Types of Revision Breast Surgery
Revisional surgeries aim to correct various issues after an initial breast surgery or to enhance the breasts as time passes after surgery and body changes occur. There are many valid and fixable reasons to have correctional surgery with Dr. Adams.
Capsular Contracture – As mentioned above, Capsular Contracture is a term used to describe a complication of scar tissue development associated with breast implants. Whenever you implant any ‘foreign’ object into the body, inflammatory mechanisms are triggered to heal the wound and protect the body, creating a capsule of scar tissue around the object. Sometimes, this essential, unnoticeable capsule begins to thicken. The transformation of capsule thickening is not caused by breast implants being dangerous or toxic. Breast implants are as safe and healthy as any implantable medical device, arguably one of the most studied and popular implanted devices on the market. According to Dr. Adams’ research, Capsular Contracture stems from bacteria bio-films or possible genetic predispositions. Capsular Contracture is not deadly or dangerous to your health and will not initiate risks for disease or cancer. It is highly treatable and there are several effective surgical treatment options. However, some patients do experience recurrences after surgery.
Capsular Contracture emerges slowly. Signs of Capsular Contracture are gradual firmness, tightening, unnatural bulging, distortion of shape or implany position, thinning of breast skin due to permanent tissue damage, breast pain, discomfort, and possible restricted range of motion. It can be uni or bilateral.
No matter how skilled your surgeon is, there are risks with any procedure and Capsular Contracture can happen to anyone. However, with specialized surgical technique and antibacterial developments, in addition to research-based post-operative protocols, Dr. Adams has significantly lowered and prevented the risk of Capsular Contracture for his patients.
Dr. Adams is invited from all around the world to speak to other surgeons and committees about Capsular Contracture – what causes it, how to prevent it, and how to treat it. His goal for his patients and in his teaching, is to minimize the necessity for additional surgery and overall, the number of surgeries any given patient has.
Implant Malposition – Another common complication is implant malposition. This occurs when the implant is incorrectly positioned on the chest wall. There are four general types of malposition: “riding high”, “bottoming out”, “symmastia” (aka “uni-boob”), and falling outward towards the armpit region. Malposition can be avoided by proper implant choice, surgical technique, and correct incision and pocket dissection.
Sagging Breasts (Ptosis) – Ptosis is a medical term used to describe sagging breasts. Breasts appear deflated and stretched. This condition is usually seen in women after pregnancy, women who have experienced weight fluctuations, or women who have naturally larger breasts or breast implants that are larger than recommended for their build.
Due to inherent skin quality and proneness to stretch, it may require additional surgery down the road.
Explant – Total removal of implants goes beyond simply removing an existing implant. Explant surgery has more recently gained traction that has been particularly fueled by holistic lifestyle changes, ambiguous medical concerns, and the media. There are several options with implant removal that may assist with the aesthetic outcome or personal satisfaction: fat transfer, where fatty tissue is donated from another site on the body- usually abdomen or hips- and properly injected into the breast tissue, breast lift, total capsule removal (capsulectomy), or leaving the existing capsule to retain partial volume. For whatever reason you choose to remove your implants, it is important to be realistic about the physical and physiological results you will achieve.
If you are removing implants due to medical issues, it is imperative to consider that symptoms may not improve. Research is always evolving, however, there are no current scientific findings of breast implants causing symptoms. We recommend a thorough, honest self-evaluation of your personal health history, daily lifestyle habits and diet, and the traditional effects of aging. It is helpful to consult with your general practitioner, therapist, and/or internist, prior to speaking with your plastic surgeon, to ensure an effective recovery plan. Your overall health and concerns are our top priority, but all factors must be considered and addressed before making a major decision for your body.
What You Should Know About Revision Surgery
Cosmetic breast revision surgery is performed under general anesthesia. The overall length of the procedure ranges anywhere from 30 to 120 minutes or more – depending on the type of revision and amount of reconstructive work required.
The estimated recovery period varies from patient to patient and by cases. You can expect to return to work anywhere from 1-2 days or up to 1-2 weeks, contingent on your surgery and the physical demands of your job. Vigorous exercise or activities should be avoided for 2-3 weeks to prevent excessive blood flow. Bruising and swelling should subside within 3 weeks. Some revisional surgeries require drains and frequent office visits to monitor healing and proper care.
We will discuss the specifics of what you can expect with recovery at your initial consultation with Dr. Adams and provide you with personalized at-home post-operative instructions after surgery.
Revision Surgery is More Complex
After the first breast surgery, it is normal for scar tissue to develop around the implants, as well as surrounding the incision locations. There is a possibility that the existing scar tissue will add to the complexity of the revision during surgery.
Secondary surgery that is required to fix issues stemming from the initial surgery is always considered more complicated and sensitive. One of the reasons is due to the technique and level of expertise of the previous surgeon. Dr. Adams may have to repair the breast pocket or reconstruct the internal breast structure to improve previous damage.
How to get the most out of your revision consultation and complex surgical planning:
1. Contact your previous surgeon to obtain records and Op Reports (if you are unable to contact your surgeon for any reason, please be prepared to provide as many details as possible- previous date of surgery or multiple surgeries, type of surgery, incision location, placement of the implant- above/under muscle, implant information)
2. Fill out requested medical history documents & all consent forms sent by our office
3. Obtain recent, relevant labs or be prepared to schedule appointments for mammogram or medical clearance, if needed
4. Be realistic with expectations and open to recommendations
Preparation is key. Before coming in for the consultation with Dr. Adams, we schedule a complimentary phone call with the Patient Consultant. We offer this pre-consult phone call to all of our new patients to allow for a more personalized, informative experience. During the call, the Patient Consultant will acquire personal details from you, review your health history & previous records, answer questions, and discuss specifics on Dr. Adams’ technique.
Due to the wide range of revision surgery options and the uniqueness of your needs, there is a wide range in surgical costs and requirements. Gathering more information on the front end, enables the Patient Consultant to narrow in on what you can expect for costs and recovery. At your consultation, Dr. Adams will confirm all details and come up with a viable, corrective plan for surgery.
Facts About Revision Breast Surgery
- Incisions – Generally speaking, the surgeon will use the first incisions from the initial breast augmentation surgery. This will help prevent additional scarring. However, if the patient is undergoing revision surgery to get larger implants, or exchanging saline for silicone, it is entirely possible that a larger incision or new incision location must be made.
- Recovery after Revision Surgery – The recovery period is for revision surgery is about the same as you experienced with the first surgery. You should follow the same recovery guidelines and precautions with your revision surgery as you did with your primary.
- Revision Surgery is 100% Customized – Revision surgery procedures are different in that there are many breast implant choices along with the varied reasons for having another surgery. If you are undergoing revision surgery due to complications, the removal/repair of the implant pocket and creation of a new one may be necessary. This type of procedure requires diligent planning and cooperation from start to finish.
Choosing a Plastic Surgeon for Breast Implant Revision
Because of the complicated nature of revision surgery, it is of utmost critical importance that you choose a board-certified plastic surgeon with experience in revisions and breast implant surgery. Dr. Adams is certified by the American Board of Plastic Surgery and has undergone rigorous, specialized surgical training, as well as passed the oral and written final examinations. Many women across the globe have flown to our primary office in Dallas to have Dr. Adams perform their revision surgery.
If you are not happy with your implants or are experiencing complications due to your surgery, schedule a consultation with Dr. Adams. We are currently accepting new patients no matter where you reside. Our primary office is conveniently located just 30 short minutes from Dallas/Fort Worth airport in Dallas, Texas.