Maan Kattash MD, Plastic and Reconstructive Surgeon
     
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BREAST REVISION

This procedure is intended to address problems associated with implant itself, its position and or, patientís tissue characteristics†that cover the implant.

Although uncommon, breast implant deflation is one reason why women may need more surgery. The devices, whether saline or silicone, may leak and the woman may notice that one or both of her breasts has changed shape or size. Dissatisfaction with the size of the implants (either too small or too large) is another common reason women have another operation is to change the size of their implants, usually to go bigger.

Other factors that warrant breast revision include:
Capsular contracture and Asymmetry, may lead to one implant feels firmer and higher than the other. Here the implant may not drop into the desired correct position.

Synmastia: Overdissection towards the midline of the breasts in an attempt by the surgeon to create better cleavage.

Implants that are widely spaced apart, lacking desirable cleavage. Opposite to synmastia.

Thinning of the breast tissue or sagging of the breast envelope over time due to loss of elasticity. Other factors that cause the implants becoming more visible, palpable and appear un-natural include: Aging, pregnancy, breastfeeding even sun damage and smoking.

These problems are addressed using one or combination of the following techniques:

  • Implant Exchange: Replacing current implants with new ones that may be smaller or larger. This may also include overfilling to change the appearance of the implants in an effort to reduce rippling.

  • Capsulotomy: Making incisions in the capsule surrounding the implants to release the tight scar surrounding the implant or to change its position.

  • Capsulectomy: Where the tight capsule surrounding the implant is totally removed down to a fresh surface.

  • Capsulorraphy: Reefing part of the loose implant pocket and adjusting it to help in proper re-positioning of the implant. Especially when implants lie in large pocket allowing them to fall in the arm pit area as the patient lays down.

  • Pocket Change: By moving the implants from above the muscle to below the muscle position to provide better soft tissue padding of the implants.

  • Mastopexy (breast lift surgery): Depending on the amount of reshaping that is required. You can read more about Mastopexy (breast lift) on this website

  • Synmastia repair: Repairing the connection between the two breast pockets.

  • Repair of widely separated implants: By dissecting more towards the midline. This may be combined with capsulorraphy or change of implant size.

The patient is sent home in a bra with only light dressings over the incision lines. Sutures around the nipple-areola complex are removed within 7-10 days. Initial discomfort is easily controlled with oral medication.

Light activities may be started in 7-14 days. The sport bra is worn as a dressing "for 3-4 weeks". Driving may be resumed in 1-2 weeks.

Non-contact sports in 3 weeks and contact sports are allowed in 6 weeks.

 

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