According to The American Society of Plastic Surgeons (ASPS), breast augmentation has gone up 22% since 2000 to nearly 300,000 procedures being performed in 2010. And while many of these patients that undergo breast enhancement are quite pleased with their results, there are also patients that may not be. Breast Revision can help both patients who are not happy with their immediate results or who have had breast implants that have aged or changed in the passing years.
According to Denver breast augmentation specialist Dr. Gregory Buford, "Prior to surgery, one of the most common complications is unrecognized asymmetry in the breasts. A few years ago, a study was released looking at asymmetry and the findings suggested that a majority of women have some degree of asymmetry. In reality, in clinical practice, I actually feel that almost all women have some degree of asymmetry. This asymmetry must be identified for appropriate preoperative planning to enable the most optimal outcome."
An experienced and seasoned plastic surgeon who has performed many breast augmentations is sensitive to the nuances and subtle difference in breasts and will adjust their augmentation accordingly to deliver the most symmetric and visually pleasing results.
A common problem that patients who have undergone previous breast enhancement have is one breast may be higher on one side. There could be a number of reasons for this and many ways to correct it, depending on why it appears to be higher.
"Whenever something is implanted into the body, whether it be a hip, joint, or breast implant," Dr. Buford notes, "A capsule will form around the implant because it is a foreign object." The body forms a capsule around the foreign object to protect itself from the implant for as long as it is inside the body. While the capsule is soft the majority of the times, there are cases in which the capsule will harden and distort the implant.
"The capsule can tighten down and actually shrink down to distort the implant and patients see is a superior elevation of the implant and feel a very firm breast. At this point, most people think that their implants have became hard," says Dr. Buford, "However, implants do not become hard and they never do. It is the scar tissue around the implant, the capsule that contracts and distorts the implant, resulting in a overly firm breast."
This can be solved by removing the implant on the effected side and replacing it with a new implant in addition to making changes to the surrounding capsule. It is recommended that an entirely new implant be used since over time, low-grade bacteria can grow on a breast implant while it is in the body which then cannot be destroyed without the removing the implant.
Another option is surgical revision to the capsule that is formed by the body. In most cases, a simple procedure can be performed so that the breast implant drops and expands to a more natural setting. "Through the initial incision, I can score or add a transverse incision to the capsule to open it up and allow the implant to drop," states Dr. Buford.
In more complex cases of capsular contracture, Dr. Buford may remove parts of or the entire capsule and reposition the implant within the breast pocket. This is performed depending on the degree of contracture, thickness of breast tissue overlying the capsule and the ease or difficulty of removal associated with capsule revision.
The last option is switching out the type of implant. As technology improves for silicone gel implants, swapping out saline implants for silicone can quickly augment the look and feel of breasts. "9 times out of 10, that actually works very well. For the 1 time out of 10 that it doesn't work is in patients that have very thin overlying skin or very little glandular tissue to start out with," Dr. Buford states, "In that case, a very effective way, we've found, is to put a sling - an interpositonal graft that thickens the skin between the implant and the breast tissue."
In most cases of breast revision, the procedure takes approximately an hour and most patients experience as little as 24 hours or less of downtime before they can return to normal activity. The majority of patients can control the pain with over the counter pain medication and may experience some incisional pain but no where near the pain of the original surgery.
Of course, the best way to avoid breast revision is get it done right the first time. Denver breast implants specialist Dr. Buford stresses the importance of seeing an experienced physician who specializes in breast augmentation, "It really comes down to artistry. Patients should look for a surgeon that doesn't want to just make their breasts bigger, they should look for someone who will customize their particular breast augmentation to them, to their bodies."