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NYC Breast Implant Revision

Breast Implant Revision Videos

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Breast Revision Surgery in NYC

Women in NYC who have previously undergone breast implant surgery may find that the shape and feel of their implants has changed with time. Patients choose Dr. Nina Naidu when they want to change the size or type of their implants; to replace a leaking or ruptured implant; or to correct complications from their primary Breast Augmentation (such as capsular contracture). Dr. Naidu’s goal is to perform breast revision surgery that gives you a more youthful breast contour and enhances your appearance.

Aesthetic and reconstructive surgery of the breast comprise a large part of Dr. Naidu’s NYC plastic surgical practice. She has a special interest in breast augmentation, revision and reconstruction.

Breast Revision Before & After Photos

Breast Augmentation Revision Before & After Photo - Nina S. Naidu, MD FACS

Breast Augmentation Revision Before & After Photo – Nina S. Naidu, MD FACS

Reasons for Breast Revision Surgery in NYC

There are many reasons for breast revision surgery, including:

  • Dissatisfaction with the Primary Surgery

    The patient is unhappy with the size, shape or appearance of her breasts.

  • Asymmetry, Leaking or Rupture

    Patients frequently seek breast implant revision if a saline implant has deflated or an MRI indicates a shell break in a silicone implant. Breast revisions can also be performed if the breasts no longer appear symmetrical.

  • Dislike Implant Placement

    Sometimes patients have implants that were placed over the muscle initially or which may have shifted into an unnatural position. Implants may be positioned too high or low on the chest wall, or positioned too close or far apart. In some cases, the implant has moved beneath the natural fold beneath the breast, creating the “double bubble” deformity.

  • Changing Breast Size

    Breasts can lose volume due to pregnancy, weight fluctuations, or aging. Patients may opt to change implant size to correct this change in size.

  • Implant rippling

    Implant rippling can occur secondary to thinning of the breast tissue due to pregnancy or aging, or if a saline implant has partially deflated. Often rippling is resolved by choosing a different type of implant and positioning the implant beneath the pectoralis muscle on the chest.

  • Personal preference

    Some patients realize that they should have chosen a different size (or shape) of implant. Other patients are at a new stage of life and want an implant that looks or feels more natural.

  • Capsular Contracture

    Capsular contracture refers to firm and sometimes painful scar tissue which can form around the implant. If the scar tissue is soft, it is generally treated with ultrasound treatments or observed. Painful scar tissue typically needs to be surgically removed. New implants (if desired) will be carefully chosen and repositioned to hopefully prevent recurrence in the future.

  • Breast ptosis

    Breast implants alone cannot correct breasts which have fallen lower. Some patients will opt to have a breast lift as part of their breast implant revision surgery to lift their breasts and/or change the size of their areola.

  • Remove implants

    Some women no longer wish to have implants, and may elect to have them removed.

Your First Consultation with Dr. Naidu in NYC

The first part of your breast revision process is a comprehensive consultation in our NYC office. Dr. Naidu will get to know you and your aesthetic goals. She will want to know the details of your primary surgery and why you are seeking a breast revision. If you have any information about the initial surgery, such as the size and manufacturer of your implants, or the operative report from your initial surgery, please bring this with you to your appointment.

During your consultation, you will need to tell Dr. Naidu about your medical history and your use of medications, nicotine and/or alcohol. She will look at your existing implants and the quality of your skin. She will measure the base width of your breasts and determine the amount of existing breast tissue. These measurements will determine how your surgery will be performed.

If you plan to be pregnant or breastfeeding in the future, Dr. Naidu will explain the impact that motherhood will have on your breasts, so that you can make an informed decision about having a breast revision.

Pre-operative photographs are taken at this visit. These photographs are an important part of your surgical planning and are considered part of your medical record. They will never be shown to other patients without your written permission.

Dr. Naidu will explain your options for your breast revision and whether you are a good candidate. Your candidacy for breast revision depends on your anatomy and goals, as well as the decisions made during your primary surgery. Dr. Naidu will fully answer your questions and address your concerns. Dr. Naidu will never pressure you to have surgery.

Your Second Consultation with Dr. Naidu in NYC

If you decide to proceed with breast implant revision surgery, you will have a second consultation with Dr. Naidu in our NYC office. At this appointment, Dr. Naidu will recommend the best size and style of implants for your revision. Implant sizing in conjunction with sizers will be done to select a size and shape with which you are comfortable. She will describe your surgery in greater detail, so that you know exactly what to expect. Paperwork for surgery will also be completed at this visit.

Depending on your medical history, Dr. Naidu may advise you to discontinue certain medications prior to surgery. If you are a smoker, you must not smoke for eight weeks before or after your breast revision. For your safety, Dr. Naidu will request the medical records from your primary surgery if they are available. Prior to surgery you will be required to obtain routine blood work and preoperative clearance from your primary medical doctor. Dr. Naidu may also order additional screening tests, including a mammogram.

Types of Breast Implants

Your options for new implants include saline implants, which are filled with sterile salt water; and cohesive silicone gel implants, also known as “gummy bear” or “form stable” implants, which have an anatomic or tear-drop shape.

The specific implant size and shape will be determined based on your preference and your anatomy. In almost all cases, the implants are placed beneath the pectoralis muscle to provide better coverage, improve mammographic visualization, and decrease the risk of capsular contracture.

Breast Revision Surgery in NYC

Breast implant revision surgery is performed on an outpatient basis, either in the hospital or in an ambulatory surgery center. The surgery lasts between 60 and 90 minutes, and is performed under general anesthesia. General anesthesia is very safe and makes certain that you will be completely comfortable during your breast revision.

In most cases, the incision site from your primary surgery is used to reach your implant. Through this incision, the old implant is removed and the tissues are evaluated for scarring. Any firm scar tissue is removed.

The pocket for the implant may need to be changed. If you wish to have larger implants, the space will be surgically enlarged. If you desire smaller implants, the space will likely need to be reduced with sutures. In some cases, a new pocket will be created for the implant underneath the pectoralis muscle. This will provide improved coverage of the implant and decrease the risks of rippling and visibility.

If the prior implants were too close or too far apart, the scar tissue from the capsule will be manipulated to create a pocket that will place the implants in the appropriate position. If needed, an acellular dermal matrix product will be used to provide additional support.

The size, shape, style and materials of your new implants will have been determined at your first consultation. Dr. Naidu will carefully insert your new implants into the pockets beneath your pectoralis muscle. The incisions will be closed with several layers of sutures.

If your breasts are ptotic (have dropped lower on your chest), a breast lift may also be required. In this case, Dr. Naidu will make additional incisions around the areola (the pigmented skin surrounding the nipple) and from the areola to the crease under the breast. Dr. Naidu can also reduce the size of the areola without performing a breast lift.

Finally, some patients may elect to have their implants removed without replacement. In this case, Dr. Naidu will remove the implants and carefully close the incisions with sutures after removing any firm scar tissue.

Breast Implant Revision Recovery

Following your breast implant revision surgery, you will wake up in the recovery area with small dressings on the breasts. If you have had scar tissue removed, drains may be placed for 3-4 days. Once you are fully alert, you will be transported to another area where you will be given something to eat.

Once you have recovered, you will be allowed to go home the same day. You must have a responsible adult to escort you home and stay with you for the first night after your surgery.

Dr. Naidu will give you specific instructions to follow after your surgery. She will give you a prescription for pain, as well as instructions about how to take care of your incisions. Many of Dr. Naidu’s patients are very independent women who are reluctant to ask for help. However, some degree of post-surgical assistance will be required. We strongly recommend that you create a plan to take care of yourself and your family, so that you can focus on your recovery.

The day of or the morning after surgery, you may shower, leaving the tapes on your skin intact. Most patients do not complain of severe pain following this surgery, but note that their breasts feel sore for several days. Swelling can be reduced by applying ice packs to your breasts. Pain medication is prescribed for any discomfort.

You will return to our NYC office between three and five days after your surgery. Drains will be removed at this time if these were placed during surgery. Most sutures will dissolve on their own. Walking is permitted the day after breast implant revision surgery, but strenuous activity and heavy lifting should be limited for two weeks.

Swelling will be present for three to four weeks after surgery and may persist for up to three months. Your scars will continue to fade and soften for up to one year following surgery. Dr. Naidu will provide you with a silicone scar cream to use on the incisions to assist with scar reduction.

Complications of Breast Revision Surgery

During your consultation, Dr. Naidu will explain the risks of a breast revision so that you can make an informed decision about this surgery. As with other surgeries, the risks of breast revision include bleeding, infection and scarring. Specific risks of breast revision are the same as with your primary surgery. These include capsular contracture (scar tissue around the implant), rippling of the implants, and implant rupture.

Complications from breast augmentation can be reduced by providing a thorough medical history and carefully following your pre-operative and post-operative instructions.

Cost of Breast Revision Surgery in NYC

Please call our NYC office at 212-452-1230 and we will be happy to provide information about the cost of breast revision surgery. You will be provided with the exact cost of your procedure following your consultation with Dr. Naidu. While insurance does not generally cover the cost of breast revision surgery, in some cases removal of the implant may be covered.

Choosing Dr. Naidu for Breast Augmentation in NYC

Aesthetic and reconstructive surgery of the breast comprise a large part of Dr. Naidu’s NYC surgical practice. She has a special interest in breast augmentation and in reconstruction of the tuberous breast. Since 2006, Dr. Naidu has served as a clinical investigator in the Breast Implant Follow-Up Studies (BIFS) trials. In addition to breast augmentation with fat transfer, Dr. Naidu offers her patients the full range of breast implants.

Dr. Naidu completed her undergraduate studies at The Johns Hopkins University and obtained her medical degree from Cornell University Medical College. After completing her general surgery and plastic surgery training at New York Presbyterian – Weill Cornell Medical Center, she performed an additional year of fellowship training at the University of Pennsylvania. Dr. Naidu is Board Certified by the American Board of Plastic Surgery and is a Clinical Assistant Professor of Surgery at Weill Cornell Medical College.

Schedule a Breast Revision Consultation in NYC

Our office is located at 1021 Park Avenue in NYC. If you’d like to learn more about a breast revision – and whether it is right for you – please call our office at 212-452-1230 and schedule an appointment.

Breast Implant Revision

Breast implant revision surgery, which commonly involves removal and/or replacement of saline or silicone breast implants, is performed to change the size or type of your implants and to correct any complications from your primary breast augmentation. The overall goal is to restore a youthful breast contour and appearance.

Patients frequently request revision of their prior surgery if their saline implants have deflated, or an MRI has indicated a shell leak of a silicone implant. In some cases, patients wish to change the size of their implants or correct an underlying asymmetry. Capsular contracture, which is the formation of scar tissue around a breast implant, may change the shape of the implants. Changes in the breast tissue secondary to pregnancy, weight loss, or weight gain may also necessitate a change in the way the implants sit on your chest. Some patients wish to remove their implants permanently. In some cases, a breast lift may be performed at the same time.

Procedural Steps

In most cases, the original incision is used to open the space in which your implant currently resides. Through this incision, the old implant is removed and the tissues are evaluated for scar tissue. If there is a significant capsular contracture with hardened tissue, this will be excised at this time. The pocket for the implant itself may need to be changed; if you wish to have a larger implant, the space will be surgically enlarged, while if you desire smaller implants, the space will most likely need to be reduced with sutures. In some cases, a new pocket will be created for the implant to provide improved coverage and limit visibility and palpability of the implant edges. If the prior implants were too close or too far apart, the scar tissue from the capsule can be manipulated to create a pocket with implants in the appropriate position. An acellular dermal matrix product is occasionally used to provide additional support.

Implants can be permanently removed at this time as well, if desired. If your implants are large and your skin has stretched out, a breast lift may also be required. In this case, additional incisions around the areola (pigmented skin surrounding the nipple) and a vertical scar extending down from the areola to the crease under the breast will be necessary.

Your options for new implants include saline implants, which are filled with sterile salt water; and cohesive silicone gel implants, also known as “gummy bear” or “form stable” implants, which have an anatomic or tear-drop shape. The specific implant size and shape will be determined based upon both your wishes and your specific anatomy. In almost all cases, the implants are placed beneath the pectoralis muscle to provide better coverage, improve mammographic visualization, and decrease the risk of capsular contracture.

Surgery and Anesthesia

Breast implant revision surgery is performed on an outpatient basis, either in the hospital or in an ambulatory surgery center. The surgery lasts 1- 1 1/2 hours, and is generally performed under general anesthesia. Many patients worry about the risk of general anesthesia, but it is very safe and it assures that you will be completely comfortable during surgery. Prior to surgery you will be required to obtain routine blood work and in some cases preoperative clearance from your primary medical doctor. A mammogram is required if you have a family history of breast cancer or if you are 35 years of age or older. Dr. Naidu will take medical photographs of your breasts in the office. The evening prior to surgery, you should not eat or drink anything after midnight. This ensures that you will have an empty stomach prior to surgery, which is very important for your anesthesiologist to care for you safely. You will need to have a responsible adult available to escort you home after surgery.

Breast Implant Revision Recovery

Following your breast implant revision surgery, you will awaken in the recovery area. Once you are fully alert, you will be transported to another area where you will be given something to eat prior to discharge. A responsible adult will need to be available to escort you home. The day of or morning after surgery, you may shower while leaving the tapes on your skin intact. Patients are seen in the office 3-5 days following surgery. Most sutures placed will dissolve on their own. Drains are sometimes used if the capsule has been removed. Walking is permitted the day after breast implant revision surgery, but strenuous activity and heavy lifting should be limited for two weeks. Most patients do not complain of severe pain following this surgery, but note that their breasts feel sore for several days. Pain medication is prescribed for any discomfort. Swelling will be present for the initial 3-4 weeks after surgery. Dr. Naidu will provide you with silicone scar cream to use on the incisions to assist with scar reduction.

Breast Implant Revision

Although breast implants are very stable devices, patients may require re-operation on their breasts at some point. Studies have shown that some of the most common reasons for re-operation following breast augmentation surgery include capsular contracture, hematoma, seroma, and size change.¹ In my practice, I frequently see patients who present for evaluation of implants which may have been placed many years prior. They sometimes note increasing firmness of one or both breasts secondary to capsular contracture, deflation of an implant, or they wish to change the size of their implants. In some cases, patients simply do not wish to have their implants any longer.

Implant removal is usually very straightforward. Under anesthesia, the initial incision is opened, and the intact implant is removed. The exception is cases in which the axillary, or armpit, incision has been used, in which case a new incision on the breast is often used to remove the implant. In cases of very old and ruptured silicone implants, the gel may have to be manually extracted, which can be a little messy. The pocket is then washed out with triple-antibiotic solution, and any adherent scar tissue is removed. If the patient does not wish to have new implants placed, the incisions are closed over a drain. I use a drain in these cases, as the body sees an empty space to fill with fluid, and it’s best if this fluid is drained out primarily rather than being allowed to sit. The drains are usually removed after 4-5 days, and then the skin and soft tissues are allowed to recover. Although I was taught in my training that the skin will not recover its initial elasticity and shape following removal of breast implants, in my experience it almost always does recover most, if not all, of its original form, which is a testament to the remarkable “memory” of the skin and tissues.

If a patient does wish to have new implants placed, the implant pocket is adjusted as needed, and new implants are placed. The implant pocket may need to be adjusted to decrease the size (if a smaller implant is being placed), increase the size (for a larger implant), release scar tissue, or to make other revisions to the shape of the space that was holding the prior implant. In some cases, the implant pocket is changed, for example, from under the breast tissue to under the muscle. The space is then washed out again with triple-antibiotic fluid, and new implants are placed under sterile conditions. The incisions are then closed, and small dressings are applied.

Generally, breast implant revision surgery is associated with an easier recovery. Most patients are able to return to their regular activities within several days, and to exercise within 2 weeks. The vast majority of patients would agree that although they may not have anticipated a second surgery on their breasts, it was worth it for both the health of their breasts and implants.

 

Breast Revision Before & After Photos

Breast Augmentation Revision Before & After Photo - Nina S. Naidu, MD FACS

Breast Augmentation Revision Before & After Photo – Nina S. Naidu, MD FACS

 

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Rating: 5NYC Plastic Surgeon - 5 Star Reviews

Dr. Nina S. Naidu Reviewed by Nicole L.

“Amazing person and exceptional doctor is how I would describe Dr. Nina Naidu. From Pre-Op to Post-Op care, Dr. Naidu and her staff made the process easy and comfortable. Dr. Naidu’s demeanor, talent, and work is phenomenal. I have never had surgery before this and thought I would be nervous, but I wasn’t, because of her! She is so knowledgeable and confident that she made me feel at ease. We had discussions on different sizes that I wanted to be reduced to but I trusted her implicitly to make the final decision to get me to a size that was appropriately proportioned for my build. The results were exactly what I wanted! She far exceeded my expectations, they are perfect!”

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FAQs: Breast Implant Revision

 

How long do I have to wait after my initial implant surgery to have a revision?

If you feel that you need a revision of your breast implant surgery, you should wait at least 6-12 months to assess your results. Breast implants need at least this period of time to settle in many patients.

What can I expect as I recover from a capsulectomy?

Following capsulectomy, expect to feel sore for up to one week. In many cases, the capsule is removed from the muscle, which creates a moderate amount of inflammation. You will also likely have drains in place for 4-5 days. Limit exercise for 2 weeks after surgery.

How can I tell if my breast implants are bottomed out?

The term 'Bottoming out' refers to the descent of the breast implants below the infra-mammary fold. This can be corrected by securing the fold to the chest wall with permanent sutures.

What can I do to stop repeated capsular contracture development after breast augmentation procedures?

Some patients unfortunately are more prone to capsular contracture than others, and there is no way to guarantee that this will not recur. In general, however, breast implants should be placed under the muscle through an infra-mammary incision to lower the risk of capsular contracture. All existing capsular material should be removed, and new implants should be used.

My breast implants are sitting too far apart; can this be fixed with a revision?

In patients who have breasts which naturally sit far apart, it is not possible them bring the implants closer. Larger implants will add more volume to the inner aspect of the breasts but will not physically change the breast location.

I had a breast augmentation with saline implants nine years ago and I am now experiencing pain/discomfort in my breasts; do I need to have them replaced?

If you have pain in your breasts, you may have capsular contracture which is compressing the implants and changing the shape. It is best to begin with an examination to determine the diagnosis and establish the need for replacement.

I had my implant surgery a year ago and when I flex my pectoral muscle my breast looks deformed; is this normal? Should I have a revision done?

Implants placed below the muscle can sometimes create an animation deformity in which the implant moves with muscle flexion. This can be corrected by removing the adherent scar tissue on top of the implant, or moving the implant to a plane on top of the muscle.

I have implants that are placed submuscularly; can these be moved subglandularly during a revision?

Implants can be changed to different plane during revision surgery, but the need should be weighed against the risks and benefits. Subglandular placement has a higher rate of capsular contracture, but avoids the risk of animation deformity. Submuscular placement is more preventive of capsular contracture and allows for easier mammograms.

How can I fix rippling of my breast implants?

Rippling can occur with saline implants which have not been overfilled, and with some textured silicone implants. Either the implants can be changed to smooth round silicone gel implants, or fat can be grafted over the implants to camouflage the rippling.

I want to have my large breast implants removed and smaller ones placed; do I have to worry about having loose skin on my breasts afterwards?

The risk of loose skin depends upon the quality of your skin and the amount of volume change a patient is undergoing. If there will be a large amount of residual skin, a breast lift may be required at the same time to remove the excess tissue.