Breast Revision / Implant Exchange

Breast revision is a common surgical procedure that restores symmetry and shape to previously augmented breasts.

The surgery is for anyone who wishes to change the appearance of their breasts, whether that be size, shape, symmetry, post-mastectomy, or all of the above. Women often report an increase in confidence and self-esteem following revision surgery.

At Plastic Surgical Arts, we offer several options for breast implants.

Saline - Implants filled with sterile saline (salt water). Available to patients 18 and older, these are typically inserted into the breast and then filled to the volume desired by the patient. In the event of a ruptured implant, you will notice a flattening of the shape and a decrease in size. While not a health risk, removing the silicone shell does require surgery.

Silicone - Implants made from silicone gel, a common opinion is that these look and feel more natural. Silicone implants are available to people age 22 and older for augmentation. A tear or rupture may not be noticeable initially because the gel tends to stay secured within the scar tissue that forms around the implant. While not usually considered an immediate health risk, if you do suspect a rupture, we recommend contacting your surgeon for an examination.

Fat Transfer - Liposuction can be used to remove fat from other areas of your body and injected into your breasts. This particular method is best for those who are looking for a relatively small increase in breast size and have the fat available, typically from the stomach area, flanks, back, or thighs. e surgery is for anyone who wishes to change the appearance of their breasts, whether that be size, shape, symmetry, or all of the above.

Your surgeon will examine your breasts and take photographs for your medical record. He will consider such factors as the size and shape of your breasts, the type of implants you currently have (if applicable), the quality of your skin and the placement of your nipples and areolas (the pigmented skin surrounding the nipples). If your breasts are sagging, a breast lift may be recommended in conjunction with revision.

During the consultation, you should be prepared to discuss your comprehensive medical history. Relevant information includes current and previous medical conditions, drug allergies, previous medical treatments, pregnancy, history, and current medications. Your Plastic Surgical Arts surgeon’s recommendation is based largely on the complete and accurate information you provide during this initial visit. You will be asked whether you have a family history of breast cancer, and about results of any mammograms and breast biopsies.

If you are planning to lose a significant amount of weight, be sure to tell your plastic surgeon. He may recommend that you stabilize your weight prior to undergoing surgery.

If you think that you may want to become pregnant in the future, you should mention this to your surgeon. Pregnancy can alter breast size in an unpredictable way and could affect the long-term results of your breast surgery. There is no evidence that breast implants will affect pregnancy or your ability to breast-feed, but if you have questions about these matters, please discuss them with your surgeon during the consultation.

Your breast revision surgery may be performed at several locations in Lincoln. Sometimes, an implant exchange can be done in the office under a local anesthetic reducing your costs and your downtime.

The specific details of the day of breast revision surgery can vary depending on the complexity of the revision and the surgical facility's protocols. However, here is a general overview of what you can expect:

Preoperative Preparation: On the day of your breast revision surgery, you will typically arrive at the surgical facility or hospital and check in at the reception or admissions desk. You may be required to complete any necessary paperwork and provide any requested information.

Preoperative Assessment: After check-in, you will be taken to a preoperative area where you will change into a surgical gown. A nurse or surgical team member will review your medical history, confirm the details of the revision procedure, and take your vital signs such as blood pressure, heart rate, and temperature. They may also start an intravenous (IV) line to administer fluids and medications during the surgery.

Anesthesia Administration: Once you are ready, the anesthesia team will administer anesthesia based on the planned approach discussed with your surgeon. This may involve general anesthesia to keep you asleep throughout the procedure or other forms of anesthesia depending on the complexity of the revision and your preferences.

Surgical Procedure: After you are under anesthesia, the surgeon will perform the breast revision procedure according to the predetermined plan. The specific techniques and steps will depend on the nature of the revision, such as correcting implant position, adjusting implant size, addressing capsular contracture, or revising the breast shape. The surgeon will strive to achieve the desired outcome based on your goals and individual circumstances.

Recovery and Monitoring: Following the surgical procedure, you will be taken to a recovery area where you will gradually wake up from anesthesia. Trained medical staff will closely monitor your vital signs and provide postoperative care to ensure your comfort and safety. The length of time spent in the recovery area may vary based on individual factors and the surgeon's preference.

Postoperative Care Instructions: Once you are awake and stable, your surgeon or a nurse will provide you with detailed postoperative care instructions. This will include information on pain management, wound care, medication instructions, and any specific restrictions or limitations during the recovery period. They will also schedule a follow-up appointment to monitor your progress and remove any sutures or drains if necessary.

Discharge and Recovery: Once you have recovered adequately from the anesthesia and the surgical team is satisfied with your stability, you will be discharged to go home. It is important to arrange for a responsible adult to accompany you and drive you back, as the effects of anesthesia can impair your ability to drive safely. Make sure to follow all postoperative care instructions and attend follow-up appointments as scheduled.

It's important to note that the above information provides a general overview, and the specifics of your breast revision surgery day may vary. Your surgeon and the surgical team will provide you with detailed instructions and guidance tailored to your unique situation.

Following the procedure, your incisions will be covered with steri-strips and you may be provided with a surgical bra that you can wear throughout your recovery. The steri-strips are to be left on for up to 10 days, or until your surgeon opts to remove them. It is fine to shower with them in place.  You may also wish to wear a soft dressing or unscented sanitary pad over them to keep them dry as well as absorb any drainage.

It is common to hear and feel “sloshing” during your first few weeks following surgery. Do not be alarmed; this is simply fluid resulting from swelling which will absorb on its own. Shooting pains, burning, spasms, and numbness are common and temporary sensations most women experience the few weeks following surgery. Taking minimal pain medicine can help relieve these post-surgical effects. Sleeping on your back or in a reclining position may also be most comfortable and will help relieve pressure on your newly revised breasts.

Infections are uncommon but can occur. If you are experiencing high fevers, excessive drainage from the incisions, redness, or swelling that is not symmetrical with your other breast, you should contact our office at 402-483-2572.

The appearance and feel of your breasts after breast revision surgery will depend on the specific nature of the revision and the goals of the procedure. Here are some general considerations

Improved Symmetry: If your breast revision surgery is aimed at addressing breast asymmetry, the goal will be to achieve improved balance and symmetry between the breasts. The outcome will depend on the extent of the revision and the initial asymmetry, but the aim is to create a more harmonious and balanced breast appearance.

Improved Contour and Shape: Breast revision surgery may involve reshaping or repositioning the breast tissue or implants to enhance the overall contour and shape. Your surgeon will work to achieve a natural-looking and aesthetically pleasing outcome, taking into account your desired goals and the feasibility of achieving them.

Enhanced Breast Size or Volume: If the goal of the revision is to increase or decrease breast size or volume, the surgeon will make the necessary adjustments during the procedure. This may involve replacing or adjusting breast implants, adding or removing breast tissue, or using fat grafting techniques. The result will be an altered breast size or volume that aligns with your preferences.

Improved Implant Position or Capsular Contracture Correction: Breast revision surgery may also address issues such as implant malposition or capsular contracture (hardening of scar tissue around the implant). The surgeon will correct these issues to restore a more natural and comfortable breast appearance.

Healing and Recovery: Initially, you will have some swelling and discoloration; this should disappear quickly, although residual swelling may occur for up to a month’s time. Within two days after your surgery, you should be up and around, although your breasts may feel tight and appear high on your chest. Following the surgery, it is normal to experience changes in sensation in the breast area. Over time, these effects will gradually subside as you heal. The final results of your breast revision surgery may take several weeks or months to fully manifest as the tissues settle and the healing process progresses.

It is important to have realistic expectations and to communicate your goals and concerns with your plastic surgeon during the consultation process. They will evaluate your specific case, explain what can be achieved, and provide a comprehensive understanding of the potential outcomes of your breast revision surgery. Remember that individual results can vary, and it's essential to follow your surgeon's postoperative care instructions for optimal healing and results.

Depending on your job duties, you may be able to return to work within a few days to a week.

Vigorous activities, especially arm movement, may be restricted for two to three weeks.

Sexual activity should be avoided for at least the first week following surgery.

After that, care must be taken to be extremely gentle with your breasts for at least the next month.

Over time, all implants will deflate. The implants, both saline, and silicone (gel) are safe and will not pose any health risks.

Under most circumstances the manufacturer will incur the costs for replacement implants and may also contribute toward surgical fees for up to 10 years following your augmentation.

There is no scientific evidence that breast augmentation increases the risk of breast cancer.

The presence of breast implants, however, makes it more technically difficult to take and read mammograms. This may be a special consideration for women who are at higher risk for breast cancer due to their family history.

Placement of the implant underneath the pectoral muscle may interfere less with the mammography examination, but other factors may also need to be discussed with your surgeon in regard to implant placement.

You can typically expect the same results as your previous breast surgery however, gravity and the effects of aging will eventually alter the size and shape of virtually every woman’s breasts. If, after a period of years, you become dissatisfied with the appearance of your breasts, you may choose to undergo another revision or a breast lift to restore a more youthful contour.