Breast Augmentation remains one of the most requested Cosmetic Plastic Surgery procedures. It is important to remember that Breast Implants are not lifetime devices, and that from time to time, Breast Implant Revisions are necessary to maintain optimal results.
Must You Change Your Breast Implants Every Ten Years?
There is no expiration date for Breast Implants. If you are happy with your current results, your breast remains soft, well positioned and perky, there is no reason for revision. I read online often that Breast Implants need to be changed every ten years. This is simply untrue; however, it is good to keep in mind that it may become necessary to change your breast implants, or even remove them, some time in the future.
Reasons For Breast Implant Revision Surgery
Breast Augmentation Revisions come in many shapes. Sometimes clinically there is nothing wrong, but a larger or smaller size is desired. Sometimes implants break or move. Below is an example of Capsular Contracture, which is another common reason to seek revision surgery.
Capsular Contracture
Capsular Contracture is the medical term for when the normal scar pocket which holds the Breast Implant in place becomes tight. A tight capsular contracture causes hardening or distortion of the Breast Augmentation. and usually requires surgical correction.
Cleavage problems – This patient had severe distortion caused by capsular contracture and sagging. She underwent breast augmentation revision with capsulectomies, pocket modifications and a breast lift to correct implant malposition and skin laxity.
The patient above had severe distortion of her Breast Augmentation due to Capsular Contracture. The implants are forced upwards asymmetrically and feel firm. In addition, her breast tissue has fallen off the implants in what is termed a “waterfall deformity.”
Correction was obtained with a complete capsulectomy (removal of the previous capsule), new breast implants and an Inverted-T Breast Lift. The result is symmetrical cleavage and beautiful, perky breasts.
Breast Ptosis – Waterfall Deformity
Ptosis means sagging. All breasts sag over time. Even patients who have breast implants can have breast sagging. If a Breast Implant sags below the natural breast, it has “Bottomed Out.” If the breast implant remains in place, but the breast sags off the implant, it is called a “Waterfall Deformity.” Next is an example of Breast Augmentation Revision for Waterfall Deformity.
Cleavage problems – This patient had asymmetry of the upper poles of her breasts causing obvious breast asymmetry even when fully clothed. Pocket modifications and a lift were used to create a natural breast shape that can still be pushed up when additional, and symmetrical, upper pole fullness is desired.
In the before picture the patient’s right breast is higher and lower than her left, and the left breast is wider and more lateral. Capsular Modification was performed to place the breast implants into their proper and symmetrical positions. Capsular modifications include opening the capsule (Capsulotomy), removing the capsule (Capsulectomy) and closing the capsule (Capsulorrhaphy). In addition, in the above case the breast tissue is lifted back onto the implants. The result is an improvement in breast symmetry and shape.
Did Somebody Say “Bottoming Out?”
Bottoming Out is when the breast tissue remains high, and the Breast Implant slides down behind it. This can happen from incorrect surgical placement, implants which are too large for the body to support or from a flimsy capsule, the opposite of capsular contracture. Correction depends on the cause, but usually involves recreating the inframammary fold (IMF) beneath the breast.
Cleavage problems – This patient had bottoming out of her breast implants causing excessive lower pole fullness and flattening of the upper poles. Her breast lift was revised and implants exchanged to restore upper pole fullness and lift the lower poles.
The patient above has had Breast Augmentation and a Breast Lift or Mastopexy Augmentation. Unfortunately, her implants have dropped too far. To correct this, the inframammary fold was recreated and reinforced with the redundant capsule to support the breast implants higher on the chest.
Sometimes surgical mesh is used to reinforce the capsular reinforcement. This is an off label use for surgical mesh, but can be very effective in selected cases. Smaller breast implants were recommended to further decrease the risk of recurrence. The risk of bottoming out cannot be eliminated completely without permanently removing the breast implants, and sometimes this is a good thing.
Breast Implant Revision Surgery Consultations
Breast Augmentation Revision is often more challenging than the original Breast Augmentation surgery. Whether you have capsular contracture or other issues with your breast augmentation, choose an experienced Board Certified Plastic Surgeon to learn about your revision options. In the San Francisco Bay Area call (925) 943-6353 to schedule a private consultation today.
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