Revision Breast Augmentation
Conveniently located in Southwestern PA, south of Pittsburgh, and easily accessible from central PA, West Virginia, and eastern Ohio
Introduction to Revision Breast Augmentation
Revisional and corrective breast augmentation surgery applies the arts of plastic surgery for a client who has had prior breast enlargement procedures but is not happy with the current appearance of her breasts. Implant malposition issues such as Double Bubble, Bottoming out, Capsular Contracture, Symmastia, and Snoopy deformity are some of the corrections Dr Pautler specializes in fixing.
For more information about Revisional and Corrective Breast Augmentation, view the Frequently Asked Questions.
About Breast Augmentation Revision
Dr. Pautler uses precise plastic surgery planning and meticulous techniques to correct challenging plastic surgery problems. Dr. Pautler can deliver highly satisfying results by using either saline and silicone breast implants, careful repair of the pockets in which the implants are positioned, and in some cases a breast lift or skin tightening. For more information and to schedule your consultation contact our Pittsburgh area plastic surgery practice today.
Breast Revision Indications
Women may need revisional or secondary breast augmentation surgery due to:
Discomfort with implants
Over time you may become uncomfortable with your implants and want them removed, downsized, or replaced with a different type of breast implant such as silicone gel which may have a more natural feel. After pregnancy or significant weight loss, breast tissue can become thinner, and saline implants may feel rippled under the skin. This change affects both the look and feel of the breasts. Switching to silicone gel implants will help achieve a smoother and more natural appearance.
Malposition
Over time implants can shift, one may sit higher or lower than the other, or they may become too high, too low, too close, or too far apart. These revisions require precise recreation of the implant pocket to a more optimal position. Occasionally an implant replacement is required, but in some cases the same implant can be used.
Gravity, Stretching or Unevenness
Breast implants that are placed in front of the muscle can minimize scars (because the implant fills up the empty saggy breast envelope and obviates the need for a lift) however, the breast implants can fall or stretch the breast tissue downward over time, and render the implants visible and palpable. This can happen with sub muscular implants as well, if a large implant is used on a thin small breasted patient.
Rupture
Breast implants eventually can rupture, or fail, and need to be replaced. This is true for both saline and silicone gel.
Capsular Contracture
In the rare case that tightening of the natural capsule your body forms around the implant occurs, the capsule will need to be removed to provide a more pliable pocket in which the implant can be positioned.
Through revisional breast augmentation surgery, you can improve the shape, symmetry and position of your existing or new breast implants.
Why Choose Dr. Pautler for Breast Augmentation Revision in Pittsburgh?
Over time, pregnancy, weight fluctuations, and aging can compromise breast support, causing implants to shift or lose shape. These changes can affect the appearance and comfort of the implants, making a revision surgery necessary.
Dr. Pautler has over 25 years of experience dealing with these issues, including bottoming out, double bubble deformity, and implant malposition. As a female plastic surgeon in Pittsburgh, she understands her patients' desires and emotions, allowing her to create a personalized treatment plan.
She earned her medical degree from Columbia University and trained in general surgery at Yale New Haven Hospital in Connecticut. She also pursued a fellowship in plastic surgery at Dartmouth Hitchcock Medical Center.
Dr. Pautler is genuine, approachable, and committed to building honest connections with her patients. Her sharp mind, quick wit, and personable nature make every interaction meaningful. She’s also straightforward, offering honest advice without sugarcoating. Her dedication and expertise earned her recognition as a Top Doctor by NewBeauty in 2023.
One of the key techniques Dr. Pautler uses is the GalaFLEX P4HB internal bra, a bioresorbable scaffold that reinforces weakened breast tissue, preventing implants from moving or losing shape. Depending on the patient’s needs, we may only add the scaffold to lift the breasts without changing the existing implants or combine it with new implants to enhance stability. As the scaffold gradually dissolves, it stimulates collagen production, strengthening the surrounding tissue for long-term support.
What Happens During a Breast Revision Consultation?
The process begins with a comprehensive evaluation of your current implants and any concerns you may have. Dr. Pautler will assess the condition of the implants, surrounding tissue, and any complications such as shifting, rippling, or sagging. Ideally, you should know your current implant information, including size, type, and brand, as it will help us identify and create an accurate treatment plan.
If you’re 34 or older, we may recommend a mammogram to assess the health of your breast tissue and ensure there are no underlying issues. This precautionary step provides a clear picture of your breast anatomy and eliminates trial and error. Additionally, previous operative notes from past breast procedures can offer helpful insights, such as implant placement and surgical techniques. However, these notes are not always necessary since a physical examination and imaging can provide sufficient information.
After evaluation, Dr. Pautler will highlight specific issues affecting your breasts and explain the surgical options available. She will then create a personalized treatment plan detailing the approach and expected results. If new implants are recommended, she will provide a range of implant samples so you can choose the best size, profile, and shape to achieve your desired look.
Thereafter, Dr. Pautler will showcase before and after photos of previous patients to help you visualize the expected results and evaluate whether her work aligns with your expectations. You are encouraged to ask any questions you may have at this point. This ensures you are fully informed and confident with the procedure.
What Will My Breast Revision Recovery Be Like?
Recovery after breast revision surgery varies depending on the procedure performed. For most patients, the initial breast augmentation tends to be the most uncomfortable, as the tissue and muscle must stretch to accommodate the implants. However, during a revision, the tissue has already adapted, making post-operative discomfort more moderate.
If your revision includes a breast lift (mastopexy), you may experience more initial tightness and soreness, which typically improves within 48 hours. For capsule repairs, discomfort may feel different since sutures are often placed along the bottom outer half of the implant pocket. You may feel a deep ache or pulling sensation, which subsides with healing.
Dr. Pautler recommends rest, oral pain medication, and ice therapy to ease discomfort in the early days. Most patients can resume light daily activities within two weeks, while intense physical activity such as strenuous exercise and heavy lifting are restricted for about seven weeks to avoid straining the healing tissues.
Moreover, refrain from sleeping on your stomach or sides, as this can put pressure on the breasts and affect implant positioning. Smoking and alcohol consumption should also be avoided, as they can slow down healing and increase the risk of complications. Sun exposure can darken scars and make them more noticeable, so keep incisions covered and apply sunscreen once they are fully closed. Additionally, avoid wearing underwire bras until cleared by Dr. Pautler, as they can irritate incisions and disrupt proper healing.
Following these precautions will help ensure a smooth recovery and long-lasting results. Dr. Pautler and her team will monitor your progress through follow-up visits to achieve the best possible outcome.
When Will I See My Results?
For most breast augmentation procedures, results are noticeable immediately after surgery, especially if the revision involves correcting implant position, addressing asymmetry, or exchanging implants.
However, the final outcome takes time. You will achieve it once the swelling subsides and the breasts settle into their new shape.
As the tissue relaxes and adjusts, the final shape and contour of the breasts become more refined. Incisions, which initially appear red, raised, or slightly firm, will soften and fade over several months, blending seamlessly with the surrounding skin.
That said, every patient heals differently, and factors such as skin type, the nature of the procedure, genetics, and post-operative care can influence scar appearance. Moreover, some individuals may be prone to keloid or hypertrophic scarring, which can cause raised, thickened scars. Dr. Pautler will provide guidance on scar management techniques, including topical treatments, silicone sheets, and sun protection to ensure a smooth healing.
Pittsburgh Revision Breast Augmentation Before and After Photos
See the results for yourself
Pittsburgh Revision Breast Augmentation FAQs
Have a specific question? Contact us!
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 underfilling 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. Some patients may also develop a thicker, more rigid capsule around their implants, which may cause firmness, discomfort, or changes in breast shape over time. Others form a very thin, stretchy capsule that may provide less support, potentially leading to implant shifting or sagging. In both cases, revision surgery can correct these concerns, restoring balance and comfort.
Regarding a patient who presents dissatisfied with her previous augmentation, how do you establish trust when she has not had a good prior experience?
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.
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 implant 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 augmentation. 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.
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