Breast Revision Surgery

We are frequently asked about what can be done to improve the results of prior breast surgery. Perhaps, you have undergone surgery in the past and have been disappointed with the results. Maybe the results weren’t exactly what you had hoped for. Or perhaps the surgery performed didn’t solve the issue that you had hoped would be addressed. In some cases you might originally happy with the results, but over time you have become disappointed with changes that have developed. Dr. Behar is proud to offer surgery to improve the results of prior breast surgery. In fact, it has been our experience that an opportunity to improve what has previously been achieved or not achieved, is an opportunity to turn a disappointed, unhappy patient into a very happy one with a result with which she will be very pleased.

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Your Consultation

During your initial consultation, Dr. Behar will listen to what you would like improved. You can make the most of this visit if you have taken the time to analyze what it is you are unhappy with, as well as what you are pleased with and want preserved. In order to best understand your aesthetic goals Dr. Behar may ask you questions regarding your desired size, symmetry, breast position, presence of sag, and residual symptoms following breast surgery. Only through in-depth consultation and aesthetic analysis will we be able to best understand how we might most successfully accomplish your goals. Our care at Tennessee Plastic Surgery will always be directed towards achieving your goals and helping you understand what can be hoped for and accomplished through aesthetic breast surgery. Dr. Behar feels strongly that one of his primary roles is as a teacher. During your consultation, he will strive to help you understand fully what challenges you are facing and how best they might be overcome. In addition, if you have had prior breast implant surgery, any information you can provide about your implant size and manufacturer would be very helpful in planning further surgery.  Please try to bring that information, if available,  with you for your initial visit.

Your Procedure

shutterstock_247013281-modelMost breast surgery can be performed as an outpatient procedure, whereby you have the surgery and return to the comfort of your home without the need for an overnight stay. Most breast surgery will be performed under general anesthetic for your comfort and to allow Dr. Behar to achieve your goals most comfortably. Typically, you will be provided postoperative supportive garments to help you recuperate safely and comfortably, and to provide support to the surgical results. Specific to the surgery performed for you, Dr. Behar and his staff will help guide you as to how you can most comfortably use these garments and when they no longer will be necessary. Many times, a special garment is only necessary for the first week or so after surgery. Prescriptions will be provided for pain control and, if necessary, for antibiotic coverage to reduce the risks of postoperative difficulties. You will be provided close, attentive follow-up care during which your questions will be answered and your progress monitored. We will always make efforts to care for you as conveniently as possible, but we will never let convenience get in the way of safety. We pride ourselves on being available to our patients should questions arise preoperatively or postoperatively, as we think that answers to your questions can help you recuperate smoothly and help reduce any confusion that could lead to unnecessary difficulties or worry. We ask that you communicate with us if any questions arise so that we can help you as much as possible.

Your postoperative recuperation will vary depending upon the extent of surgery necessary. Often, you may be able to return to your day-to-day activities as soon as a day or two after surgery, while sometimes additional time is necessary to allow for safe, comfortable recuperation. The same can be said regarding when you might safely return to work or to driving your vehicle. We will certainly help you to understand when we anticipate your return to such activities is safe, and will continue to provide ongoing input regarding these issues during your postop visits. In the vast majority of revision breast surgery cases, it is unusual to require more than a week to a week-and-a-half off work at most, unless your work requires strenuous physical activities. Please bring to our attention any questions you have about this so you can make plans before your surgery.

Specific Reasons For Breast Surgery Revision

Asymmetry

While perfect symmetry is not natural, we certainly strive to maximize symmetry following breast surgery. Occasionally, patients after prior breast surgery will discover that one breast is larger than the other, or perhaps might be positioned differently on the chest. If you have had implant surgery, implant size may need to be adjusted or implant position may need to be modified to achieve maximal symmetry. Some patients experience bothersome asymmetry of their nipples/areolae and, if so, adjustments to these important aesthetic components can be performed as desired. If the areola has expanded beyond a desirable diameter, areolar diameter reduction surgery can also be performed. The nipple itself can be reduced in size if desired.

Implant Related Dificulties

While breast implants can reliably achieve your cosmetic goals, at times patients remain unhappy with the size, position or the appearance of the breasts after placement of breast implants. If an implant has shifted out of position, this can be improved through internal suturing techniques to stabilize the implant back into the proper position. If implant-associated rippling and wrinkling are present, then exchange to gel implants or changing the implant position may help to reduce the presence or visibility of these undesirable changes. Implants also have a certain life-span and, in time, implant failure can occur. If you have a gel implant, you may not notice any difference whatsoever in the appearance or feel of your breast following implant rupture, but you may have had it documented by mammogram, ultrasound or MRI imaging. With saline implants, however, you will know within a day or two if implant failure has occurred, as you will lose the augmentation previously accomplished. Implant replacement is a relatively straightforward surgical procedure to return you to your desired breast appearance. In Dr. Behar’s experience, however, exchanging for new implants provides an opportunity to improve further what was previously accomplished through initial breast augmentation. This is one of the most exciting aspects of implant replacement as it provides you an opportunity to further improve your overall breast appearance beyond what you have previously experienced. Capsular contracture (whereby the scar tissue pocket, which naturally forms around implants over time, tightens excessively around the implant) can be a frustrating and disappointing event. While modern surgical techniques can reduce the risk of this occurring, there is no evidence that the risk of capsular contracture formation can be eliminated completely. Should you develop a capsular contracture around a breast implant, however, the most common three findings you will see would involve an apparent reduction in the size of your breast augmentation, a tightness and firmness to the breast (sometimes associated with pain) and a shifting of the implant upward on the chest. These three findings are classic for capsular contracture and may warrant surgical release of the scar tissue pocket and frequently implant replacement. Implant-related sag can develop as well over time following your augmentation. After all, implants do have a certain weight to them, and this can result in laxity developing in your skin and soft tissue envelope of the breast overlying the implant. It may be that after your initial augmentation, you were very happy with the results, but over time you may begin to notice your breast sagging. If this is the case, modifications of the breast augmentation results may warrant implant exchange and/or mastopexy (breast-lift). Please take comfort in the knowledge that most revision surgeries following initial breast augmentation are easier processes to go through than the initial augmentation. The space for the implant has already been created and, therefore, only modifications are necessary. Your return to work and daily activities, therefore, may be quicker than you experienced following your initial breast augmentation.

Unhappiness With Breast Size

Sometimes, following breast augmentation or breast reduction, patients can remain unhappy with the size change that has occurred following the surgery. Dr. Behar feels that one of the most important tools to successfully achieve your goals is the initial consultation. It is during that consultation that your concerns will be noted and specific details will be discovered that will help Dr. Behar best achieve your goals of size, shape and any other concerns or desires you might have. After all, the surgery we perform for you is all about achieving your goals and no one else’s. You will find that Dr. Behar will take as much time as is necessary to best understand exactly what it is that you would like to accomplish and, for this reason, he has been very proud of how few patients of his require revision surgery for a size change. If following breast reduction, you feel you have not been reduced enough or, perhaps, that you have been reduced too much, then adjustments can certainly be made through either additional breast reduction or, perhaps, through breast augmentation if desired. If following breast augmentation, you feel that you have been left smaller than you want to be or that you have been enlarged beyond what you were anticipating, this too can be addressed appropriately with revision breast surgery. It has been our experience that many patients have been disappointed that their own aesthetic goals were not successfully accomplished at the time of breast augmentation performed somewhere else. Please rest assured, however, that every effort will be made at Tennessee Plastic Surgery to discover and achieve your goals for how you would like to look.

Revision Breast Lift

A breast lift is a wonderful operation that repositions the breast into a more youthful location. In a world with gravity and with any breast that have a certain amount of weight, some sag is expected to occur over time. Breast lift can return your breasts to a more youthful shape and position. If you have undergone breast lift to achieve this, but have been disappointed with the results, we are happy to help achieve your cosmetic goals through revision breast lift. If you have undergone a breast lift and were initially very happy with the results, but no longer are (as perhaps return of breast sag has occurred), we are also more than happy to help you return your breasts to the more youthful contour you previously enjoyed. In most cases your prior scars can be used for the revision surgery and therefore no additional scars would be necessary.

Revision Breast Reconstruction

shutterstock_174036758-modelFor those patients who have undergone breast reconstruction following mastectomy, we are proud to help you achieve your goals if you have noticed undesirable changes over time or if you have been disappointed with the results previously obtained. Tennessee Plastic Surgery is very proud to be one of the busier practices in the middle Tennessee area regarding breast reconstruction. Dr. Behar’s over 20 years of experience with countless patients has helped him provide the care needed to achieve successful, attractive breast reconstruction to many women who are struggling with the loss of their breast(s). If the breast reconstruction has been successful, but further enhancement is desired, then revision breast surgery following reconstruction is a great opportunity to take the results to the next level and provide further improvement in the comfort you feel about your aesthetic following reconstruction.