Introduction: What is a Revision Breast Surgery?
Revision breast surgery is a corrective surgical procedure to improve or change the shape or look of your breast following a previous breast removal (mastectomy) and, breast reconstruction, an augmentation/ breast implant surgery, a breast reduction or a breast lift . It can potentially be a more complex surgery than your original surgery, although it could also be a simple fix. The goal of revision breast surgery is to restore your breast's natural appearance and improve upon what has already been done.
What is an Ideal Candidate for a Revision Breast Surgery?
Revision breast surgery is recommended:
- If you have had a previous breast surgery and are unhappy with the results.
- If your previous breast removal or reconstruction surgery resulted in breast soreness, numbness, pain, or asymmetry.
- If you develop complications from previous breast surgery such as implant rupture, capsular contracture, improper positioning, or displacement of the breast implant.
- To change the implant size- either increase or decrease your breast size.
- To change the implant from silicone to saline and vice versa.
- To rectify scar formation in your breast following a previous surgery.
- To enhance your aesthetic appearance.
Preoperative Assessment
Before your procedure, a detailed medical history is obtained, and a thorough physical examination is performed. During your consultation, your doctor will advise you to stop smoking, if you smoke, to avoid post-surgical complications and delayed healing. You should eat a healthy diet and avoid any restrictive dieting during this time. You should inform your doctor of all medications that you are taking and about significant medical conditions, allergies and previous surgeries if any.
Depending on your age, exam, family history and breast health history you may require breast imaging prior to your procedure.
Photographs will also be taken during pre-operative consultation to submit for insurance, to be used in surgical planning and for before and after comparison. Your goals will be discussed, and realistic expectations will be set. After discussing surgical options, we will make an individualized surgical plan together that best suits your goals.
This is the best time to ask all your questions so that you can feel comfortable and confident going into surgery.
Procedure:
Revision Breast Surgery
Breast revision surgery is performed under general anesthesia either in an outpatient or hospital setting. In the pre-operative area markings will be done with a surgical markers to make sure that we address all of your concerns which are best visualized in the upright position.
Once in the operating room the preoperative markings will be used as guides for incisions and we will do the appropriate procedure to meet your needs; there is no standard procedure in breast revision as every patient is different and has their own unique surgical plan.
In each of these procedures your incisions will be closed with dissolvable sutures that will be under the skin and you will have either surgical glue or surgical tape over your incisions which take about 1-2 weeks to fall off.
You will potentially have drains in place after surgery based on the type of procedure that your have done that will usually be removed in 1-2 weeks.
Risks and Complications of Revision Breast Surgery
Breast revision surgery is a relatively safe procedure; however, as with any surgery, the following risks and complications are possible:
- Anesthetic risks
- Blood clots in the lungs or legs, cardiac and pulmonary complications
- Breast scarring
- Pain in the breasts
- Changes in sensation in the breasts or nipples
- Infection
- Bleeding (hematoma)
- Fat necrosis
- Asymmetric appearance of nipples or breasts or suboptimal aesthetic results
- Incomplete healing in the nipple area
- Delayed healing
- Accumulation of fluid in breast tissue (seroma)
- Possibility of revision surgery
Recovery after Revision Breast Surgery
Most people can go home the same day of surgery if no complications are noted, however in some more complicated cases you may need to stay a few days in the hospital. In general, postoperative care instructions and recovery involve the following:
TAfter breast revision surgery there will be some temporary pain, discomfort, bruising and swelling. Medications will be prescribed to relieve pain. You will wear a contoured elastic garment for extra support around the chest/breasts. Upon discharge, patients will be instructed about proper wound care and how to manage their drains at home if they have them. For women having breast revision, you should avoid underwire bras for at least 6 weeks while healing if your incisions are underneath the breasts. Stitches are usually dissolvable and internal. Specific post-operative care regimen to minimize scarring will be discussed with each patient. Strenuous physical activity and heavy lifting over five pounds is discouraged for six weeks post-operatively – details of this limitation will be discussed with you specific to the surgery that you will be having. You will likely be able to resume work in 1 to 2 weeks depending on what kind of job you have and how you are feeling. Full recovery may take up to one year and you need to have follow-up appointments to ensure a positive surgical outcome.
Summary
Breast revision surgery can help to improve self-image and confidence. Depending on exactly what kind of surgery you need to have you may have improvement in symptoms such as pain or you may feel that your appearance in clothing has improved. As always with any breast surgery your final results may take a few months to show although you will notice a significant change in the immediate post-operative period.
