Breast revision surgery is performed to modify a previous breast surgery such as breast augmentation or breast augmentation with a lift.
— Dr. Mark Anton, Newport Beach Plastic Surgeon
A breast revision can include an implant exchange, an implant exchange with a lift, or an explant. Sometimes a breast revision is performed to correct complications arising from a previous surgery, like capsular contracture. Other times, breast revision is done to improve the appearance of a breast that has changed over time due to the natural aging process, pregnancy, breastfeeding, weight gain or loss.
A Breast Implant Revision is performed to correct the existing issues that cause a patient to be dissatisfied with their current breast implants. Some feel their breasts are too large, not large enough, poor shape, implants are encapsulated, hard and painful and/or ruptured. There are many reasons that a patient may be unhappy with their results but most cases are always correctable.
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Sometimes there are no complications with the original breast surgery, but breasts do change over time due to age, pregnancy, breastfeeding, weight gain or loss. Many women opt for breast revision surgery to restore a desired or more youthful appearance to their breasts.
Some women decide they want smaller or larger implants or that their breasts have become too saggy with age. A breast revision can improve the shape, size, projection, and symmetry of the breasts plus restore a woman’s body confidence.
Dr. Anton has performed hundreds of breast revision surgeries at his Newport Beach practice. The majority of his breast revision work is patients who have had surgery elsewhere with another surgeon and are unhappy with their results or are experiencing complications such as:
Revision surgery of any kind increases the risk of further complications. This is why it is important to choose your plastic surgeon wisely. Dr. Anton’s breast revision rate is less than 1% due to his extensive Breast Fellowship training along with the surgical skills and techniques he applies to each procedure. His success rate in even the most difficult breast revision surgeries makes him one of the top breast revision surgeons in Newport Beach.
The dynamics of each breast revision can differ greatly depending on the nature of the previous surgery, the patient’s own tissue, and the difficulty of the correction. Dr. Anton has corrected several Breast Implant cases from other practices and has been able to achieve an outcome that patients did not think possible. During your consultation for breast revision Newport Beach plastic surgeon Dr. Anton he will discuss the options available for your breast revision surgery which could include:
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There is a lot of misinformation today about implants and their safety.
Dr. Anton was one of thirty-five physicians across the country to conduct the original study on the safety of silicone breast implants. In 1997 the United States government published a 440-page document declaring silicone breast implants to be safe and not have an adverse effect on women’s health.
Despite these findings and the overwhelming evidence to support the safety of silicone in other medical devices such as joint replacements, chin and cheek implants, heart and brain shunts to name but a few; women continue to be concerned that their implants are causing health risks. This is primarily why explant breast revision surgery is on the rise. Before making a decision to have your implants removed, it is important to get all the facts.
Recently, the FDA recalled textured implants because they were found to cause BIA-ALCL (breast implant-associated anaplastic large cell lymphoma). To be clear, the FDA is saying that textured breast implant surfaces are associated with a 0.3%-2.6% current lifetime risk of developing lymphoma of the breast capsule, not breast cancer.
When caught early, this type of lymphoma is usually treated by a breast revision surgery to remove the implant along with the scar capsule. Though the cases of BIA-ALCL are limited to textured implants only and have a very low rate of occurrence, if you notice any of the following symptoms, consult with a plastic surgeon right away:
If you discover that you do have a textured implant, that isn’t a cause for panic. Aspiration of the fluid may be done and tested for “CD-30”, which will either confirm or rule out this diagnosis. Probabilities show that BIA-ALCL is extremely unlikely and if it is ruled out, you can leave the implants in place or have them simply exchanged for smooth gel implants.
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Breast Implant Revision can take approximately 2 to 4 hours, depending on what is involved and the state of the pre-existing implants. This procedure is done under general anesthesia.
The previous incision site is commonly used or a small incision is made on the lower edge of the areola. This area tends to heal extremely well and fade quickly. Implants are placed under the muscle and can be either saline or silicone gel depending on preference.
The most common breast revision surgeries are breast implant exchange and breast implant exchange with a lift. Both of these can be used to correct complications from a previous surgery or to address breast changes due to age, pregnancy, weight gain or loss.
During your consultation for breast implant revision Newport Beach plastic surgeon Dr. Anton will discuss your desired changes and outcome, this will continue throughout the pre-operative proccess. Prior to surgery, you will be provided with instructions and exercises to help you determine what breast size you are most comfortable with. This is a personal and individualized process for each patient.
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An implant exchange requires the old implant to be removed and replaced with either a silicone gel or saline-filled implant. For our Newport Beach breast implant revision patients with implants on top of the muscle, Dr. Anton suggests placing the new implant under the muscle in the submuscular implant placement, as this reduces the risk of capsular contracture and rippling, plus offers the most natural appearance.
When placing the implant under the muscle or exchanging an implant that was already under the muscle, Dr. Anton creates or modifies the pocket where the implant will sit. If necessary, the muscle is released just below the lower breast pole in a precise manner that enhances the shape of the breast and the cleavage area. Existing pockets are modified to make them large enough for the implant to move freely and naturally.
Internally, Dr. Anton creates a “support bra” from the dermis to help hold the new implants into position. The Nipple Areolar (N/A) complex can be modified with a crescent lift for symmetry or to slightly raise (1-2cm) the nipple(s) to a more youthful position. Incisions for a breast revision with implant exchange are typically placed below the breast fold in the inframammary fold (IMF). Another option is the lower areolar incision if it was used in the previous surgery and there is no sign of contracture.
Dr. Anton’s signature Layered Breast Lift involves an internal and external lift. Internally, a “support bra” is created from the dermis (thick layer of living tissue below the epidermis which forms the true skin). The thickness and integrity of the dermis allow it to lift and hold the breast into position, which further supports the external lifting of the skin.
Externally, skin is removed through either a Lollipop or Anchor incision. A lollipop incision begins around the N/A complex and follows vertically downward to the base of the lower breast pole. An anchor incision begins around the N/A, follows vertically downward to the base of the lower breast pole and continues horizontally under the breast fold. The length of the horizontal (IMF) scar depends on the amount of skin that needs to be removed to create the most natural and youthful breast revision results. Scars heal especially well in the breast area due to the nature of the tissue and the direction of the incision. All sutures are absorbable.
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The second most common breast revision surgery is implant exchange with a lift (mastopexy). This surgery can also be used to correct complications from a previous surgery or to enhance the appearance of a breast that has changed over time.
A breast lift addresses ptosis or breast sagging. Very often when choosing to replace an implant with a smaller one, a breast lift will be required or if the shape of the breast has changed over time. In a breast implant revision with lift and implant exchange, Dr. Anton performs a Layered Breast Lift along with replacing the implant.
Explant is the third type of breast implant revision surgery. This involves the removal of implants and can include a lift (see details above). Explant breast implant revision surgery can also include the removal of the capsule but in most cases, it is preferred to leave the capsule in place. Ruptures, capsular contracture, health matters, or other breast surgery complications may encourage patients to explore removing their implants.
During your consultation for breast revision Newport Beach plastic surgeon Dr. Anton will explain the pros and cons of removing your implants and, if necessary, the capsule. In general, he advises patients to leave the capsule as long as it is healthy, meaning it is not too thick, calcified or looks suspicious in any way. The scar capsule helps maintain the blood supply to the breast and gives it a little volume to help with shape and form. If the scar capsule is left, Dr. Anton uses it to create an internal support sling to enhance the shape of the breast.
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Most patients wake from surgery feeling tired, groggy and just want to rest. You will be wrapped in a compression bandage and you may feel some mild to moderate pain that is usually alleviated by prescribed pain medication. Overall, most patients feel their surgery was less painful than anticipated and are able to discontinue pain medication after 4-5 days.
It is typical for breasts to feel tight immediately after surgery; this will gradually subside through the healing process. Approximately one to two weeks later your implants will relax into their proper position and be able to move freely. This process can take longer in certain patients.
Most patients are able to return to light sedentary work 4-5 days after surgery. Your activities will be restricted for a full two-week period including no lifting, bending or straining of any kind. You will be advised during your post-operative appointments regarding these restrictions. The healing process varies from patient to patient and activity level is decided upon on an individual basis.
To reduce post-surgical breast revision complication and risks, it is important that you follow your post-operative instructions and not engage in any activities that raise your blood pressure or heart rate for two weeks, including:
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Breast revision surgery is done in an accredited outpatient facility under general anesthesia using board certified anesthesiologists. After surgery, you will be wearing a surgical bra that is to be worn day and night, four to six weeks after surgery. Implant exchange patients will follow the breast implant exercises at home several times a day for the first few weeks postoperatively.
Dr. Anton does not use drains in his any of his breast revision procedures. He opposes the use of drains as they provide an opportunity for bacteria to enter the body and this can lead to post-operative complications like capsular contracture, scarring, and infection. Instead, Dr. Anton cauterizes blood vessels and creates tiny blood clots to mimic the body’s own natural healing response.
It is very important to the overall result of your breast revision surgery to follow the advice of your surgeon and to honor the body’s natural healing process. This includes taking your medications as prescribed. Many patients do not like taking pain medications because they can have the adverse effect of causing constipation. However, pain poses additional stress to the body and interrupts the healing process.
We do offer our breast revision patients Exparel, an intra-operative pain medication that numbs the treated area for up to four days postoperatively and can minimize post-surgical pain. Exparel is not a substitute for pain medication, but it can shorten the duration and the amount of medication required.
Downtime after breast revision surgery can be the hardest part, especially for the patient who is used to a busy life. We suggest mapping out your downtime period with pre-made, healthy meals, bone broth for mineral replenishment, audiobooks or your favorite programs for entertainment. Downtime is self-care and an important part of your overall surgery plan.
Get a private and personalized consultation with Dr. Anton in his beautiful practice in Newport Beach, CA.
20331 Irvine Avenue Suite E6, Newport Beach, CA 92660