Breast Implant Revision
Breast implants and augmented breast shape changes with time. Sometimes this reflects a change in patient’s own skin and breast tissue as a result of aging and gravity. In addition, breast appearance may change as a result of formation of scar tissue around the implant. As breast augmentation has become a popular procedure , we have seen many patients benefiting from breast implant revision. These benefits include enhanced cosmetic appearance of the breasts and reduced physical discomfort caused by implant complications. Some of the implant complications include capsular contraction, rupture and leakage, wrinkling, implant displacement, and infection.
In addition to the physical discomfort cause by the implant complications, the aesthetic appearance of the implant may also be affected. The capsular contracture and erroneous implant placement may cause the breast to look unbalanced, wrinkled, indented and deformed.
Capsular contraction is a result of the tightening of the breast tissue capsule surrounding an implant resulting in firmness or hardening of the breast. Capsular contracture is classified by Baker Grades. Grades III and IV are the most severe. Grade III is more firm than normal and looks irregular in shape. In most cases Grade III requires additional surgery because of unnatural appearance. In Grade IV capsular contracture, the breasts appear to be severely firm and painful with distortion in the shape of the breast. This complication requires additional surgery to improve the appearance as well as to alleviate the pain.
Breast implant revision surgery can address the distortion in shape by releasing or removing the scar tissue (capsule). The revision can help recreate the soft and natural shape of the breasts and address implant malposition and visible irregularities.
Furthermore, as native breast tissue and skin changes with respect to the implant, patients may require some form of breast lift to fine tune the breast shape and improve the aesthetic appearance of the breasts. The breast lift can be performed at the same time as revision of the capsule.
There are several types of breast lift that can address the issues: if there is only minimal droopiness of the breast, a simple breast lift consist of a lift around the nipple and areola with no scars on the breast. More severe breast ptosis (droopiness) may require a more extensive lift. The scar may extend vertically on the breast and may also extend under the breasts as well. Generally, the scars heal well with time. Occasionally, scars require treatment with topical creams or lasers to improve texture and pigmentation.
Many women who have had breast augmention in the past decade have saline implants. Saline implants are generally more firm and may exhibit more rippling than silicone implants. Since their FDA approval two years ago, silicone implants have become the more natural choice. Silicone is closer to natural breast tissue in terms of palpability and touch. It can also achieve a more natural tear-drop shape. Many women present for revision of their implants and request a change from saline to silicone implants.
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