Planning Breast Augmentation Revision
Although revision breast surgery is infrequent when the breast augmentation is done by a board certified plastic surgeon, many breast augmentation procedures in California are being done by none board certified plastic surgeons. As such, in our practice, we often see patients who seek breast augmentation revision for breast asymmetry, breast implants that have shifted under the arm pits, or are placed too low on the chest (bottoming out). These problems require a more extensive breast surgery that often involves:
1.) Removing the breast implants.
2.) Switching the implants from over the chest muscle to under the chest muscle etc.
3.) Changing the implant size and composition (exchanging saline implants to cohesive silicone gel implants.
4.) Adjusting areolar size and/or position.
5.) Revising scars.
6.) Lifting the breasts.
7.) Tailoring and reconfiguring the breast pocket to better fit and support the implant. This procedure involves resuturing the implant pocket to itself and sometime to the rib cage. If the implants are too central, as in the case of symastia, then central pocket suturing and closure is needed. If the implants are too low, then lower pocket suturing and closure is performed in order to reconstruct the inframammary crease at a higher position. If implants move under the arm pits, then outer pocket suturing and closure is necessary. These maneuvers are termed capsulorraphy which means closure of the implant capsule.
8.) Sometimes in addition to capsulorraphy, additional internal support is needed. This is essential for those patients who have little remaining breast tissue to cover the implants, for those who have large implants that are heavy, for those who’s previous capsulorraphy has failed, and for those who do not have much breast tissue and capsule to close the capsule successfully. In these case, additional support is created by utilizing bioengineered scaffolding or cadaver derived matrix to cover the implants and to reconstruct an internal bra to hold the implant in place. Examples of these type of material include:
Each breast will often require a different set of approaches to achieve the final symmetry.
Corrective breast surgery is a complex procedure, and Dr. Agha spends a significant amount of time with you analyzing your problems, learning about your concerns, and explaining your surgical options and likely outcomes.
Dr. Agha’s approach is to individualize treatment, addressing your specific needs and goals, ensuring that you have a full understanding of the issues involved so that you are able to make an informed decision.