What is Revision Breast Surgery?

Revision Breast Surgery is a catch-all term that is used to describe a procedure performed on a breast that has previously had surgery. There are a number of reasons that someone may choose to undergo breast revision surgery but they generally fall into two categories:

  • To correct an unsatisfactory result from a previous breast surgery, or
  • To correct changes that have occurred since a procedure that you were intially happy with. These changes may include problems such as sagging, rippling, capsular contracture and breast implant rupture.

Breast Revision Surgery can often be complex, which is why many cosmetic surgeons will not perform it. It is also why it is important to choose a surgeon with experience and a history of great outcomes, like Toronto Plastic Surgeon Dr. Mathew Plant.

What are the reasons someone may want Revision Breast Surgery?

There are many reasons that a patient may choose to undergo revision breast surgery. In many cases a patient may have multiple issues needing correction simultaneously, which is why breast revision surgery can often be so complex. Some of the more common reasons that a patient may choose to undergo breast revision surgery are:

Capsular Contracture. 

This is a condition where the scar tissue that naturally forms around a breast implant (the capsule) thickens and tightens, compressing the implant and changing the appearance of the breast and on occasion causing pain. Read more about capsular contracture here

Breast Implant Rupture 

Although breast implants are made to last a long time, they are not lifetime devices and eventually the shell will lose its integrity. There is no specific lifespan for breast implants, but on average they can be expected to last between 10-15 years before needing replacement or removal.

Sagging (Ptosis) 

Time, gravity, pregnancy/breastfeeding and weight fluctuations can cause breasts that were once perky to droop or sag. Even with patients who have previously had a breast lift. Revision breast lift surgery can be riskier than a lift performed on a patient who has never had breast surgery, so it is important to choose a surgeon with experience in revision surgery to ensure you are in the best hands.

Size Change

There are many reasons that a woman may want to increase or decrease the size of her breast implants. In some cases this is the only reason for Revision Breast Augmentation, in other cases a size change is performed because the opportunity presents itself when having revision breast augmentation surgery for another reason.

Scar Revision

For many reasons, scars may end up thicker, wider or darker than expected. In most cases Dr. Plant can perform a scar revision to improve them. This involves removing the old scars and re-suturing the incision in layers to minimize tension while they heal. While scars can often be improved, it is important to know that they cannot be eliminated entirely.

Breast Implant Malposition 

Whether it is the result of a problem with a previous procedure or something that developed overtime, some patients find that one or both of their breast implants may sit too high (superior malposition), too low (bottoming out), too far towards the sides or too close together – in some cases they can even merge into one pocket (symmastia).

Correction of Asymmetry

Many of Dr. Plant’s Breast Implant Revision patients present because they feel that their breasts do not look symmetrical. Whether it was an issue that they noticed immediately after their previous procedure or whether it is something that developed overtime, Dr. Plant often finds himself correcting differences in the size and/or location of the breast implants and areolas. This is usually on the more complex end of the breast implant revision spectrum and may involve a combination of breast lift, breast reduction, breast implant repositioning, replacement or removal and scar revision.

Am I the Right Candidate for Revision Breast Surgery?

If you are a healthy woman who is not satisfied with the shape or size of your breasts and have previously had breast surgery then you may be a candidate for revision breast surgery. If you have a capsular contracture, a ruptured breast implant or any concern with previously augmented breasts then contact us today to book a consultation with Dr. Plant to see what he can offer to help you.

Scheduling a Breast Implant Revision Consultation in Toronto

Dr. Plant is a Royal College Certified Plastic Surgeon who is widely known for actively listening to what his patients are looking for and delivering those results through his meticulous surgical technique. He is an expert in both primary breast augmentation and revision breast augmentation and is one of only a handful of surgeons willing and able to correct problems from Breast Augmentation surgeries performed elsewhere. Contact us today to schedule your breast augmentation revision consultation with board-certified plastic surgeon Dr. Mathew Plant.


FAQs

Frequently Asked Questions

Is Revision Breast Augmentation Surgery safe?

All surgery comes with risks and benefits. Complications can happen with any procedure, however breast augmentation revision is a safe elective procedure when performed by Dr. Plant.

What Can I Expect from Revision Breast Surgery?

When having a revision breast lift or a revision breast augmentation with Dr. Plant patients can expect to see a clear improvement in the appearance and symmetry of the breasts. Since revision breast surgery can involve many different procedures combined into one, patients can expect a plan that is customized to correct the specific concerns they presented with and results designed to achieve their specific goals.

How Long is the Downtime from Breast Revision Surgery?

Recovery from a breast augmentation revision surgery is different for each patient and includes a post-surgical healing period of anywhere from one night to a few weeks. The majority of patients find they feel well enough to resume light activity the following day, but some will take longer to feel back to themselves. During the first 24 hours, you should have some help from family or friends, but after that most patients do not need much assistance. Dr. Plant will prescribe antibiotics and pain medications, however most patients find they only need one or two of the prescription strength painkillers on the first few nights and are comfortable on Tylenol alone relatively quickly.

How Painful is Revision Breast Surgery?

While each patient has different pain thresholds, Revision Breast Surgery is typically described by patients in their post-operative period as much less painful than expected. How painful the procedure is depends in part on the amount of work needed to correct the individual concerns each patient presents with. In general, the more that is involved the more it will hurt, but even the most complex cases are usually quite tolerable. Dr. Plant will be able to give you a good sense of how painful your specific procedure will be after your consultation. Before your procedure he will give you a prescription that includes multi-modal analgesia, a specific protocol designed by pain specialists to address every aspect of the body’s pain response. This includes an anti-inflammatory to minimize the pain reaction at the surgical site, a ‘nerve calming’ agent to slow and minimize the transmission of pain signals from the surgical site to the brain as well as a few centrally acting agents that minimize the brain’s response to the pain signals. On top of this, he uses a long-lasting local anaesthetic at the surgical site so that your body doesn’t even feel the initial incision.

What is the Recovery Process from Breast Augmentation Revision Surgery like?

Each surgeon has a different protocol and Dr. Plant’s is customized to make your life as easy as possible during the recovery process. When you wake up from surgery you will be in the recovery room where you will have your own personal nurse looking after you. She will help you put on your recovery bra that will gently support your breasts for comfort. Once you are awake enough and comfortable you will be allowed to go home accompanied by a friend or family member. Your dressings will be waterproof, so you are free to shower the following morning and because Dr. Plant secures the implants internally, you do not need to wear the bra 24/7 like may be necessary elsewhere. You must follow the specific instructions which include caring for your breasts following the surgery. Dr. Plant will prescribe oral medication to help with any pain and (when wearing a bra) you must wear the recovery bra or a sports bra of your own during the recovery process. You will be able to resume the use of underwire bras at 6 weeks once the incision has fully healed.

When will I see my final results?

As with all surgical procedures, the final results cannot be claimed for one year after surgery, however you will see near final results after 6-8 weeks in most cases. As the minimal amount of residual swelling resolves over the next 10 months the implants take on a softer and more natural appearance and the scars fade

How Long Do Breast Implants Last?

There is no rule when it comes to replacing breast implants. They are not lifetime devices, so they will likely need replacement or removal at some point, but there is no specific expiry date on them, so the need to replace them every 10 years is a very common misconception. The warranty for the implants with most manufacturers is 10 years, so some women will choose to swap them out at that point electively when there are no problems in order to get a new warranty and reduce the potential for needing a procedure at an inconvenient time because an issue has developed. In general, Dr. Plant feels that implants only need to be replaced if there is a problem with them. The most common reasons for needing to replace a breast implant are rupture (which sounds horrible, but is usually just a small pinhole in the shell) and capsular contracture. If you have silicone implants it is worth checking them with an ultrasound or MRI after a few years to ensure there is no silent rupture. If you have saline implants they will deflate if the shell is damaged, so you will know there is a problem that needs to be addressed without any need for medical imaging. Capsular contracture is usually obvious regardless of which type of implant a patient has and can be recognized as a tightening of the pocket around an implant and sometimes pain.

What is Capsular Contracture?

A capsule is the scar tissue that forms around a breast implant as a normal part of the healing process. This is a normal reaction to the presence of any foreign object where the body will try to isolate the object within an enclosure of scar tissue. In most cases this is a good thing because it helps stabilize the implant in its location long-term, keeping it there for long-lasting results. In some cases however the breast can harden around the implant as this capsule thickens and tightens, compressing the implant and changing the appearance of the breast and on occasion causing pain. Capsular contracture is assessed based on several criteria and then classified according to the Baker grading system. There are 4 grades of capsular contracture, and only grades 3 and 4 are considered to be problematic that surgery would be suggested. Grade 1: the breast looks and feels soft, there is no evidence of any hardening Grade 2: the capsule around the implant can be felt. Usually the breast looks completely normal, but feels a bit firmer than expected. Grade 3: the capsule around the implant is palpable and visible. The implant feels significantly harder than expected and the breast will look abnormal. Most commonly it appears overly round and may be sitting higher on the chest than it used to. Grade 4: the capsule around the implant is palpable, visible and painful. This is the worst case scenario where the breast feels hard, looks deformed and causes pain to the patient, either at rest or when touched.

What causes Capsular Contracture and What does Dr. Plant do to prevent it?

The exact cause of capsular contracture is unknown, but it is felt to be related to an increased inflammatory process while healing from breast augmentation. It is most likely caused by a combination of factors including: Genetics that prime a patient’s immune system to react to implants more aggressively than normal, leading to a thicker scar. There is no specific antidote for this, but after surgery Dr. Plant puts patients on two medications that have been shown to have potential in decreasing the rate of capsular contracture to fight against any genetic influence Inflammation from external factors within the pocket, blood being the most likely culprit. To address this Dr. Plant performs a bloodless breast augmentation, cauterizing the blood vessels before they bleed, leaving the pocket clean. ‘Biofilm’ which is a thin layer of bacteria that can form around the implant if it contacts the skin or breast gland while the implant is being inserted. This isn’t enough bacteria to cause an infection, but while the body fights it off the scar tissue can form thicker than it otherwise would. In order to address this Dr. Plant does several things right before inserting the implant - he and his nurses change gloves, he irrigates the pocket with a quadruple antibiotic solution, re-preps the skin just before insertion and uses a no-touch technique with an insertion funnel like the Keller Funnel 2 or the INPlant funnel.

Who Will My Consultation Be With?

All consultations are with Dr. Plant himself, not a salesperson or nurse-consultant. He does it this way for several reasons. First, he feels patients are entitled to meet and get to know their potential surgeon before booking a procedure. Second, he strongly believes that only the surgeon truly knows what they can accomplish in surgery and he does not want someone who doesn’t actually do the operation making promises that cannot be delivered - in particular with complicated surgery like breast revision. Third, patients come having researched the procedure and are prepared with specific questions about the procedure that he feels can only be answered completely by the surgeon

What Can I Expect at My Consultation?

At your consultation you can expect to be greeted upon arrival and asked to provide your OHIP card. Next, you will be taken to the examination room and asked to change into a gown. Once you have changed, Dr. Plant will come and speak with you about your specific goals for your surgery. He will also take a medical history to make sure you are safe for surgery. Once he has a good sense of what you are looking for, he will examine you to see the current state of your breasts. First he will point out what he thinks is causing your concerns in the mirror and take A LOT of measurements. These help him choose the exact right combination of procedures to achieve your desired outcome. After he has examined you he will come up with a customized plan to address your concerns and discuss this with you. He will then provide you the opportunity to ask any questions you have and then will give you pricing for the procedure.

How do I know what size implant to choose if I am going bigger?

Dr. Plant does not believe in simply telling a patient what size implant they should get, so we let you “try on” different sizes to see what you like best. Breast implant re-sizing is done during your pre-operative visit which usually takes place 2-3 weeks before your procedure. Dr. Plant will use a special set of sizers that allows him to know how much volume to add to your current size. These special sizers fit into a sports bra over your existing implants and allow you to see in the mirror what different size implants will look like and then you can choose what you like best. You’ll be able to see what it looks like to have implants that are anywhere from 50cc to 750cc larger than your current ones

How Much Does Breast Implant Revision Cost?

Pricing will vary depending on the exact nature of the procedure you need to achieve your desired results. The cost for the operation has been carefully calculated and will vary with the complexity and length of surgery. In general, you can expect breast revision surgery to cost anywhere from $10,000-$20,000 before tax.

Do I Have to Buy a Special Bra for After Surgery?

No Way! We like to make things easy for our patients, so our pricing is all-inclusive, meaning the price you are given by Dr. Plant is the price you will pay. There are no hidden fees for garments or fancy pre-surgical vitamins that magically appear after you’ve placed a deposit. The only cost you may incur above and beyond the quoted price is what you pay the pharmacist to fill your prescription and this is typically less than $100 for patients who do not have drug coverage.

How Many Follow-ups Are Included and When Will They Be?

While other surgeons limit follow ups, Dr. Plant feels that surgical patients should always have access to their surgeon and not be charged for it. In addition to the standard followup appointments at 1 week, 6 weeks, 3 months, 6 months and 1 year, Dr. Plant is happy to see his patients in follow up as much as they feel is necessary and for as long as he is in practice. Instead of limiting you to a year of follow ups, he actually wants to see you every year to make sure that your breasts are still looking great!

Can I Combine a Breast Augmentation Revision with Other Procedures?

While Breast Augmentation Revision is a very popular procedure on its own, combining it with other cosmetic surgeries is very common. Dr. Plant very frequently combines Breast Procedures with a Tummy Tuck, Liposuction and/or Vaginal Rejuvenation.

Why Does A Breast Augmentation Revision Surgery with Dr. Plant Cost More Than Some Other Surgeons?

In a nutshell, good plastic surgery is rarely cheap, and cheap plastic surgery is rarely good. In order to provide inexpensive surgery costs need to be cut somewhere, and this means using lower quality equipment and/or rushing the procedure to get more done in a day. Breast Revision Surgery is complex and cannot be rushed. We firmly believe that when it comes to Plastic surgery, quality takes precedence over all else, including cost. To ensure the best possible results, Dr. Plant takes as long as necessary to do the work properly and uses only premium products in the operating room. This includes Stratafix sutures, the Keller Funnel and the ONETRAC single-use lighted retractor. He also provides a level of hands-on service that is incredibly rare in this industry - Dr. Plant personally does all consults and follow ups himself. This is in stark contrast to the typical office where the majority of the consult and most of the follow ups will be with a staff member. He also does not place limits on follow ups, whereas some offices will limit patients to a certain number of follow ups, or limit them to a certain timeframe (1 year for example) before they charge you for further appointments. If you have a concern, Dr. Plant will be happy to see you 10 years after your procedure with no additional charges!