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Breast Revision

Breast Revision Surgery in Newport Beach, Orange County

After undergoing breast augmentation surgery with implants along with its recovery process, the furthest thing from your mind is likely having said implants removed in another surgical procedure.

Year after year, breast augmentation remains the top-requested cosmetic surgery for women due to its ability to safely and naturally enhance the size and volume of a woman’s breasts through the use of synthetic implant devices. However, while these implants are designed to be safe, durable and long-lasting, they are not intended to be permanent fixtures.

Though some women will enjoy the results of their breast implants for decades without issue, the majority of women with breast implants will need to have their implants removed or replaced within the first 10 to 15 years of their augmentation procedure. Despite their durability and longevity, breast implants are not immune from the natural changes that occur to the breasts’ appearance over time, nor are they immune from causing complications or illness themselves. If your augmented breasts are causing you cosmetic concerns, health-related concerns or a combination of the two, Newport Plastic and Reconstructive Surgery Associates offers breast revision surgery to patients who are no longer satisfied with their breast implants.

What is Breast Revision Surgery?

Breast revision surgery, often referred to as breast implant revision, is a surgical cosmetic procedure intended to either removed or replace the breast implants inserted during your initial breast augmentation procedure. There are many reasons why a woman may wish to revise the appearance of her augmented breasts— from changes in aesthetic preferences to health-related concerns. But ultimately, breast revision surgery is performed when a patient is no longer satisfied with the look or feel of their current implant devices.

If you have breast implants, it is more than likely that you will need breast revision surgery at some point during your lifetime. Regardless of your reasons, it is essential to maintain a close relationship with a board-certified plastic surgeon to discuss potential revision options if any changes or complications occur. Dr. Hisham Seify of Newport Plastic and Reconstructive Surgery Associates has unparalleled compassion for his patients and their breast implant concerns, as well as the artistry and skill to deliver breast revision results that look and feel great on the body once again.

Who is Breast Revision Surgery For?

Each breast revision procedure is highly personal and will be tailored specifically to your unique concerns and goals for the outcome of your procedure. Your breast revision may be indicated for personal reasons, such as restoring changes to the appearance of your breasts’ size, shape or symmetry that have occurred over time. You may no longer be satisfied with the look or feel of the implants you selected initially and wish to update the implant texture or implant material. Or, like the majority of breast revision patients, you may simply want to go bigger.

Breast implant revision may also be indicated for medical purposes or complications with your existing implants. The issues that can arise with breast implants, such as capsular contracture, implant malposition, implant rippling and implant ruptures and leaks can make your revision procedure a medical necessity rather than an elective procedure. If you are experiencing any of the following concerns, breast revision surgery may be right for you:

  • Personal aesthetic changes in implant preferences (size, shape, texture or material)
  • Natural changes to the breasts appearance due to pregnancy, breastfeeding, weight fluctuations or age-related concerns
  • Unfavorable results from a prior breast augmentation procedure
  • Concerns about implant rupture, leaks or migration
  • Complications or discomfort caused by capsular contracture (tightening scar tissue around the breast implant
  • Symptoms of breast implant illness

 

Breast Implant Leaks

Both saline and silicone implants can experience leakage or ruptures of the outer shell, which is a common instance that would necessitate an implant removal or exchange. This is typically because of simple “wear and tear” of the implant shell as time progresses. When a saline implant leaks, the outcome is a deflated appearance to the breast, which requires an implant replacement to restore a normal appearance. Although saline is physically harmless, the emotional toll of a saline deflation can be devastating to the patient due to its immediately noticeable deflation.

Silicone implant ruptures are less physically apparent than a saline rupture and are frequently referred to as “silent ruptures” as they are usually undetectable without an MRI scan. However, once detected, ruptured silicone implants also need to be exchanged for the best physical and emotional outcomes for the patient, as there is potential for the silicone to migrate throughout the body if left unaddressed. If you have concerns about a potential leak or rupture, do not hesitate to contact Dr. Seify to discuss your current symptoms and options.

Meet HISHAM M. SEIFY, M.D. PHD, FACS

BOARD-CERTIFIED PLASTIC SURGEON

Dr. Hisham Seify is a renowned board-certified plastic surgeon based in Newport Beach, serving the greater Orange County area. With an impressive background that includes advanced fellowships and prestigious awards, Dr. Seify is committed to delivering the highest standards of patient care. His approach emphasizes attentive listening to patient concerns and offering customized surgical solutions with meticulous attention to detail. Specializing in both aesthetic and reconstructive procedures, Dr. Seify strives to make each patient’s experience positive and transformative.

Breast Implant Illness and BIA-ALCL

Breast implant illness is a catch-all term that refers to a handful of diseases or symptoms experienced by women that are thought to be associated with their breast implants. These illnesses and symptoms may include:

  • Capsular contracture
  • Chronic fatigue
  • Muscle and breast pain
  • Inflammation
  • Cognitive difficulties such as “brain fog” or short-term memory loss
  • Rheumatoid arthritis
  • Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL)

It is believed that breast implant illness often develops as a response to the presence of silicone in the breast. Ruptures, leakages and textured implants are also thought to contribute to breast implant illness. Among the more significant concerns of breast implant illness is a rare type of cancer associated with breast implants, BIA-ALCL. While the exact causes of BIA-ALCL are not yet fully understood, the FDA and global health officials have linked this cancer primarily to both silicone and saline macro-textured and polyurethane breast implants. This correlation has led to the recall of Allergan BioCell textured breast implant products both from the U.S. market and around the world, as these models of textured implants have been attributed to 84 percent of the reported BIA-ALCL cases to date.

As it is not yet known whether developing BIA-ALCL is limited to specific models of textured implants or all textured implants, the FDA does not currently recommend the removal of these implants for women who are not displaying any symptoms. However, it is essential that you consult with Dr. Seify if any changes to your breasts occur after your augmentation to receive a proper diagnosis. Both healthcare providers and patients are encouraged to monitor for symptoms of BIA-ALCL, such as breast pain and swelling that is consistent and long-lasting.

What to Expect From Your Breast Revision Recovery

As with your previous breast augmentation surgery, the recovery process for your breast revision surgery may be a similar experience to that of your last procedure or a more involved process depending on the nature of your revision. Immediately after your surgery, you will need a trusted individual to drive you home and provide assistance with your everyday tasks for the first few days of your recovery. A compression bra will have to be worn over the breasts to help reduce residual swelling and aid in the healing process.

While significant complications are rare, patients can expect to experience swelling, stiffness and discomfort for one to two weeks following their operation. Most patients can return to work within 7 to 10 days of their procedure. Heavy lifting or strenuous activities that involve the use of the arms or chest muscles or raise your heart rate will be to be cleared by Dr. Seify before they may be resumed. In carefully following Dr. Seify’s aftercare instructions and wearing the appropriate compression garments, you can ensure you attain the best possible outcome from your breast revision procedure.

What to Expect From Your Breast Revision Surgery in Orange County

Breast implant revisions are often more complicated than the initial augmentation procedure, and like any surgical procedure, they are accompanied by potential risks and complications that should not be taken lightly. Choosing a board-certified plastic surgeon with the skill and expertise required for this procedure is of the utmost importance to avoid results that could be less than desirable or lead to future breast revision procedures down the road. During your initial consultation at Newport Plastic and Reconstructive Surgery Associates, Dr. Seify will carefully examine the current state of your breast implants and make an expert recommendation as to which surgical procedures will be the most beneficial to you and your goals.

As no two breast revision surgeries will be exactly alike, the surgical approach for your revision procedure will vary by the techniques used in your initial breast augmentation surgery and whether you are having your implants removed or replaced. Your revision surgery may be similar to your breast augmentation procedure or more extensive, depending on your aesthetic or medical concerns. If you are merely swapping out implants, the procedure may be relatively straightforward; however, addressing complications like capsular contracture or relocating the breast implant pocket placement can be a far more complicated surgery. When possible, Dr. Seify will perform the en bloc removal technique, which is when the surgeon removes the scar tissue, or capsule, and implants at the same time to prevent any silicone or bacteria from leaking into the patient’s body during surgery by keeping the implant and capsule intact.

The breast revision procedure itself is performed on an outpatient basis at one of our comfortable certified surgical centers and will utilize local anesthesia with sedation or general anesthesia depending on the extent of your surgery. Breast revisions can take between one to four hours to complete depending on the concern being addressed and whether any additional cosmetic procedures are a part of your surgical plan. In some cases, Dr. Seify can use the same incision lines from your previous breast augmentation procedure to avoid any new scars; however, this will be determined by the new implants you select if they are being replaced and is not always possible. Once the old implants have been removed or replaced and complications have been addressed, Dr. Seify will close your incisions and provide you with detailed post-operative instructions for your recovery process.

Breast revision surgery is also an ideal opportunity to elect for additional breast procedures to further enhance your final results. Women whose augmented breasts have begun to droop or sag over time may opt for a mastopexy, or breast lift, to be performed in conjunction with their breast revision procedure to achieve more youthful and uplifted breasts after their implant removal or exchange. Multiple breast procedures performed concurrently provides patients with the benefits of a single operation and recovery period so you can get back to your day-to-day routine faster with the beautiful curves you desire.

Your Breast Revision Results

The improvements provided by your breast revision surgery will be immediately apparent with your breasts appearing more shapely, voluminous and proportional with your figure. While most residual side effects will subside after about two weeks, swelling in the breasts may obscure the final results of your revision for weeks or even months as your new implants settle into position. Once the breasts have fully settled, they will start to look and feel softer and more natural inside of your body.

The results of your breast revision surgery are designed to be long-lasting; however, as with you original breast augmentation procedure, your breasts will still be subject to changes in appearance due to pregnancy, weight fluctuations or the natural aging process. While your exchanged breast implants can last indefinitely, they are also still susceptible to unwanted complications. For this reason, it is crucial to keep in touch with Dr. Seify regularly to ensure the integrity of your implants is maintained. Follow-up appointments after your breast revision procedure will be required after one week, two weeks, six weeks and three months after your revision procedure, but you should contact Dr. Seify immediately if you have any concerns.

If you are no longer completely thrilled with the results of a prior breast augmentation or you are experiencing uncomfortable complications as a result of your current breast implants, it may be time to consider if breast revision surgery is right for you. To learn more about breast revision surgery and the options available to you, contact the Newport Plastic and Reconstructive Surgery Associates office today at (949) 251-1502 to schedule your in-person consultation.

*The information about Breast Revision was reviewed by Dr. Hisham M. Seify. If you have any questions, please don’t hesitate to contact us using our contact form below.

Newport Beach Breast Revision FAQs

Each Orange County plastic surgeon has his or her own policy regarding redos, touchups, revisions.  As a group, Board Certified plastic surgeons practice plastic surgery as an art form which, incidentally, garners them money.  Therefore, most plastic surgeons want to do touchups as much as their patients want them to do touchups, and therefore minimal charges such as anesthesia fees, etc. are the fee for touchups. It is my personal feeling that touchups are not really touchups because plastic surgery is a process and not an event. I believe that if both plastic surgeon and patient see a second surgery as not a new procedure but a second part of the primary procedure, then both surgeons and patients will be happier.  Reading RealSelf, not only the surgeons’ answers but the patients’ questions and concerns, has given me a new pair of glasses when it comes to plastic surgical procedures.  I believe patients come in requesting an outcome, and when they don’t get that outcome, they feel the plastic surgeon has done something wrong.  That is rarely the truth.  Very often, the plastic surgeon cannot have an apriori understanding of the elasticity of one’s skin or one’s propensity for forming a capsular contracture or a hypertrophic scar.  Therefore, if both plastic surgeons and patients understand that the outcome may take more than one procedure, the patients might be more understanding and the plastic surgeons will not be so upset when the patients dis their best efforts.  Simply put, aesthetic plastic surgery is an outcome.  It always has been and it always will be, and honest communication on the subject prior to surgery will eliminate questions about who pays for a redo.

Plastic surgeons know quite a lot today about what causes capsular contracture and how to treat it. However, capsular contracture around foreign objects in the body, such as breast implants, artificial hips and pace makers, is not completely understood. Two possibilities occur to me. One, that your capsular contractures are secondary to non-pathogenic bacteria in your implant pocket which may not be completely eliminated during your secondary breast augmentation procedure. Another possibility that comes to mind is that your body’s immune system is very strong and will form a thick capsule around any foreign body. Either of these two possibilities can lead to a second and potentially worse capsule than you presently have. Statistically, if you have chosen one of the excellent Board Certified plastic surgeons in San Francisco, then you should have a great result without re-encapsulation. 

I usually recommend waiting at least 6 months for the swelling to resolve and to allow the implants to settle as much as possible. If you feel your concerns can’t wait, I am happy to see you for a consultation earlier to ease your mind and help you understand what can be done.

Capsular contracture is one of the most common concerns of women considering breast augmentation surgery. This complication causes the scar tissue that normally forms around the breast implant, referred to as the capsule, to thicken and tighten around the implant. Capsular contracture may affect one or both breasts. The cause is unknown, but there are preventive measures that can be taken during and after surgery to help decrease your risk.

In the past, breast implants were expected to last 10 years; today’s implants often last 15 years or longer. If you are happy with your breasts and are not experiencing any complications, it may not be necessary to replace your implants. However, Dr. Seify recommends exchanging them every 10 years.

Your recovery period will depend on what needs to be corrected. If you are having a simple implant exchange without correction, your recovery will likely be quicker than for your original procedure.

You may schedule a breast revision simply because you believe, and your doctor is in agreement, that your implants have been in long enough and you’re due for a switch. However, there are a variety of issues that may benefit from a breast revision sooner than the implant’s expected lifetime runs out.

Capsular Contracture

One of the most common complications with breast implants, capsular contracture, is an immune response where the body rejects foreign materials that have been surgically inserted. During recovery, a natural scar capsule forms around the implant to keep it in place. With capsular contracture, this natural capsule tightens around the implant and becomes unusually hard.

Implant Rupture 

Implant rupture occurs as a result of weakened implant folds or trauma to the implant. In these cases, a hole or tear develops in the implant, and it may start to leak. This occurs more in older implants but is also possible in newer ones. Saline implants leak very quickly, and the salt water is absorbed into the body, causing the breast to look deflated. Silicone implants leak more slowly and require an MRI to diagnose. 

Implant Malposition

Implant malposition is when implants move out of the breast pocket, causing the breasts to look distorted or asymmetrical. There are various types of malposition, including high (the breasts sit too high on the chest), lateral (the breasts are positioned towards the sides of your chest), low (breasts bottom out or sink below the inframammary fold), and symmastia (the breasts fuse and form a “uni-boob” in the middle of the chest). Malposition can also cause rippling or make the implant visible or palpable under the skin. 

Lifestyle Changes

Breast shape can be affected by lifestyle changes such as pregnancy, weight fluctuations, and aging.

Style Preferences

It’s also possible that a patient may simply have a preference change. They may want to go bigger or smaller after some time has passed. Some patients may wish to upgrade to one of the newer breast implant technologies available.

If it hasn’t been 10 years since your initial breast augmentation, you may be unsure whether or not you need a breast revision. There are telltale signs that you may want to schedule a consultation with a qualified surgeon to discuss whether a breast revision is right for you.

  • Your breast implants are causing pain or discomfort. This can indicate capsular contracture, rupture or leaking, a developing seroma, damaged lymph nodes, pinched nerves, or poor implant placement. Whatever the cause, persistent pain or discomfort is not normal. Schedule an appointment with your surgeon right away.
  • Your breast implant has ruptured. This is not a life-threatening condition, but a ruptured implant should be removed to prevent further complications, such as infection.
  • You notice movement or rotation. While it’s normal for the implants to settle slightly over time, a dramatic shift in location on the chest wall is not normal. You might notice that the nipple has moved upward due to implant displacement. A round implant moving may be hard to see, but a teardrop-shaped implant that has moved can look unnatural. 
  • You notice a change in the shape of your implant. This can mean the implant has ruptured, shifted, rotated, bottomed out, or displaced. This often only happens to one breast, causing asymmetry that can give the patient emotional distress. 
  • You are dissatisfied with your breast size. Sometimes, patients wish they had gotten larger or smaller implants. Breast revision can address this, but most surgeons will recommend you wait a full year for your body to heal and your implants to settle.

Yes, breast revision surgery can be an effective way to correct capsular contracture. This condition occurs when the scar tissue that forms around the breast implant tightens, leading to discomfort or changes in breast shape. During the revision surgery, your surgeon may remove the capsule (the scar tissue) and possibly replace the implant or adjust its position. It’s important to discuss your specific situation with a qualified plastic surgeon to understand the best approach for you.

Yes, a breast implant revision surgery can often effectively fix asymmetry between breasts by adjusting the size or placement of the implants to achieve a more balanced appearance; however, it’s important to consult with a plastic surgeon to determine if this is the best option for your specific case of asymmetry.

Health insurance usually doesn’t cover breast implant revision surgery because it’s considered a cosmetic procedure. However, insurance may cover the cost if the revision is medically necessary, such as in the following cases: 

  • Capsular contracture

Insurance may cover breast implant removal if the capsular contracture is severe, rated Baker III or Baker IV. 

  • Ruptured implants

Insurance may cover the cost of a new implant if the implant ruptures while still under warranty. 

  • Pain

Insurance may cover revision surgery if the implants are causing severe pain due to nerve damage or the weight of the implants. 

To find out if your insurance will cover the cost, you can check your policy language in your Evidence of Coverage (EOC) or Benefits Booklet. You can also call your insurance company’s member services number. 

Some practices have staff who can help with insurance requests, such as pre-authorization or appealing denials. You can also work with a surgeon who has staff that can answer your insurance questions. 

The breast implant manufacturer may also cover the cost of a new implant if the implant ruptures while still under warranty. Most manufacturers also offer 10 years of warranty coverage for revision after capsular contracture.