Implant revision is not a popular procedure, but it usually is a necessary one. Before having augmentation, patients often wonder why someone would need revision surgery (unless an implant ruptures, obviously). But whether the cause is a less-than-ideal job done by another surgeon or a simple desire to change the size of the implants, there are a variety of reasons Dr. Herte performs implant revision surgery.
With any surgery, there is scar tissue. Every time the skin is cut, it will scar to some degree as part of the healing process. Scar tissue forms under the skin, as well, in procedures such as liposuction. And when you place a foreign object under the skin, the body reacts. In the case of a placed implant the reaction is called the “capsule” and it is made up of calcified cells and scar tissue. If this capsule becomes very thick and causes the implant to shift or the breast to feel very firm, or if there is pain from the constricting scar tissue, this is called capsular contracture. If the capsule is very calcified, Dr. Herte will remove it along with the implant. If it isn’t, she will most likely leave it in place.
Opting for a different size
When it comes to judging the final size and shape of their augmentation, Dr. Herte advises patients to wait a full year before opting to change the implants. This allows any swelling to fully pass, and it allows the implants to settle into their final position (they start out higher on the chest before settling). At that point, if the patient still wants to change her implant size, Dr. Herte will enter through the original incision. If a larger implant is desired, she will increase the size of the pocket, the space in the breast to hold the implant. If the patient seeks smaller implants, she will reduce the size of the pocket holding the implant. In reduction of size, Dr. Herte may also recommend a breast lift to minimize any sagging or stretching.
Not all surgeons have the depth of experience that Dr. Herte has with augmentation surgeries. Sometimes a less experienced surgeon will place the implant pockets either too far away or too close together and the patient is not happy with the placement. In these cases, Dr. Herte will reconstruct new pockets for the implants with better positioning.
Occasionally, particularly with saline implants placed atop the chest muscle, the implants show rippling and the edges might even be felt. In these cases, Dr. Herte enters through the original incision and replaces the implants with better muscle coverage. This may involve switching implant types and/or placing them in new breast pockets. Silicone implants, with their more cohesive gel, do not wrinkle as much as saline implants.
When a patient decides she no longer wants to have her implants, they are removed through the same incisions. Dr. Herte will also remove the capsule in most cases, particularly if it is calcified and thick. As with downsizing, she likely will recommend a breast lift at the same time to remove excess sagging skin and breast tissue.
Experience counts in a high-profile surgery such as breast augmentation. This isn’t the time for short cuts or discounts, as you’ll be the one who lives with your implants. Your expectations need to be realistic, of course, but this is a case where experience is critical to your end results.
Do you have questions about augmentation? Call us at 702-732-9600 and let’s talk about it.