Revision or Corrective Secondary Breast Augmentation

Every breast augmentation patient needs to accept the remote possibility of needing a revision at some point in her life after the initial augmentation. Issues that tend to increase this risk are implant placement above the muscle, very large volume implants (because they are heavy), and under filling of saline implants. However, there are factors that are beyond the surgeon’s control and are unpredictable, such as unusually stretchy tissue or asymmetric chest walls that make symmetric breast augmentation impossible. Equally unpredictable are the effects of gravity, pregnancies, weight gain/loss and breastfeeding.

Dr. Pautler is dedicated to being objective, reassuring, professional and sympathetic to a patient’s disappointment and frustration with her previous cosmetic surgery experience. Dr. Pautler takes the time to educate each patient on all procedures and answer any questions she may have.

The overall costs of a breast implant revision surgery will vary depending on each patient's specific situation. In general, a breast revision surgery will cost more than a primary breast augmentation procedure. However, in some cases, the implant cost is covered by a manufacturer’s warranty and the price may be comparable to the original surgery.

Several factors determine the overall cost of the procedure including the geographical location, surgeon’s experience, and variation in facility fees associated with the surgical procedure. Due to cost of living differences, the cost of breast revision surgery in Pittsburgh will differ from locations with less demand and lower operational costs. The experience, skills, and reputation of the surgeon can result in variations in surgeon fees. Similarly, surgical facilities differ in overall cost which can impact the total expenses of the procedure. 

Breast implant revision is a personal decision for every patient to make and can be due to several factors. 

• Rupture of breast implant. When an implant has ruptured, surgery is required to remove the existing implant to prevent complications and replace the implant to restore the contours of the breast.
• The implant is malpositioned. An implant may fall below the breast crease (double bubble), “bottom out” (a stretch of the skin between the nipple and the crease which results in more implant below the level of the nipple), overly lateralize (too far to the side) or medialize (too far to the middle) requiring a revision surgery to correct. These issues are all related to stretching of capsule, muscle and skin and can affect one or both breasts and cause asymmetry.
• Development of capsular contractures.  Tight scar tissue can distort the contours and natural position of the breasts requiring a surgical procedure to improve.
• Unhappy with breast appearance or size. In some cases, patients may not be happy with the size or appearance of their augmentation procedure. Some patients want to look more natural, whereas others want to look more “enhanced.”

An internal bra refers to the addition of an absorbable surgical scaffold material usually made from the same material as suture. It is a mesh like product placed between the implant and the surrounding breast tissue to support and prevent stretch. An internal bra is often used in revisional cases such as bottoming out and double bubble repairs. The internal bra is also frequently used to support thin or stretchy tissues when very large implants are chosen.

The recovery time after a secondary revision surgery will depend on the extent and type of surgery. For a surgery requiring implant replacement, the recovery may consist of an initial downtime of five to seven days, whereas, an implant removal and breast lift would require 10 to 14 days of downtime. 

After the initial recovery period, most patients can return to work and light activities. During follow-up appointments, Dr. Simona V. Pautler, your Pittsburgh plastic surgeon will monitor your healing and progress you back to normal activities as indicated.