A large portion of Dr. Schneider’s practice involves revising breast augmentations that were previously performed at other Plastic Surgery centers. The reason for patients requesting a breast implant revision include:
- Dissatisfaction with their original results
- Unhappy with size
- Asymmetry in the breasts (one does not match the other)
- The positioning of the implant
- Bottoming out of the implant
- Capsule Contracture – an abnormal buildup of scar tissue around the implant
- A change in the patient’s breast shape due to weight changes, pregnancy, or age
- Visible or palpable ripples
- Patient desires implant removal
Our Approach to Breast Implant Revision
The key to a successful breast implant revision surgery is first understanding the problem that is present. It may not be as obvious as it seems. During the examination, Dr. Schneider will show you what he sees anatomically, he will discuss with you what you do not like, and then you and he will determine the best approach.
Oftentimes patients will come in with complaints of one breast not matching the other breast. Sometimes the breast that the patients do not like is the breast that has actually healed the way a Plastic Surgeon would prefer.
For example, it is not unusual to see a patient who has a slight capsule contracture on one side and no capsule contracture on the other side. The side with the contracture sits a little higher and thus will have more fullness in the top pole of the breast. Many women prefer this look. So in their eyes, the problem is the breast that looks more natural with less fullness at the top.
Some surgeons would immediately presume that the problem is on the side that is higher. But the key to all cosmetic surgery is understanding what the patient wants and if possible, creating a surgical plan that accomplishes this.
Incisions and Techniques
The surgical techniques and incisions that Dr. Schneider uses are as varied as there are breasts. In patients who opt for an implant exchange, either their previous incision can be used, or in many cases, an underarm endoscopic approach can be used. The advantages of this approach we discuss in detail in the breast augmentation section. In Dr. Schneider’s opinion, it leads to a faster recovery.
However, based on what is required, other incisions may be necessary.
Dr. Schneider tries whenever possible to perform a revision using only the patient’s own tissues. Sometimes this means modifying, cutting, removing, cauterizing or stitching the capsule. At other times he may recommend using a material such as galaflex or acellular dermal matrix to reinforce the repair.
All of these options, risks, pros and cons will be discussed with you at the time of your consultation.
Over a period of time, patients may opt to have their implants exchanged. This may be because:
- They desire a different sized implant
- They are dissatisfied with rippling in the implant
- There is deflation or rupture of the implant
- The implant position has changed in one or both of the implants
It is not necessary to replace your implants every 10 years. In fact, Dr. Schneider’s wife only changed her implants when one of her saline implants leaked after 25 years.
In most patients who have had an underarm, endoscopic breast augmentation, the exchange can be performed through this same incision. This is regardless of whether they have saline implants, silicone implants or gummy bear implants.
Sometimes, because of changes that the patient and Dr. Schneider hope to accomplish, a different incision may be chosen. The key regarding which incision is chosen is dependent upon the problem that you and Dr. Schneider discuss, and what the desired goal is.