NYC Breast Augmentation Revision - Nina S. Naidu, MD FACS

Video: Breast Implant Revision Surgery in NYC

 

Breast Revision Surgery in NYC

Women in NYC choose to have breast implants because they want to look and feel their very best. Breasts are a big part of your femininity and, unfortunately, dissatisfaction with your implants can make you feel self-conscious.

Women 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

Because breasts are a big part of a woman’s femininity, problems with implants can cause a decrease in self-confidence. There are many reasons for breast revision surgery, including:

  • Discontent with their Primary Surgery.

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

  • Asymmetry, Leaking and Deflation.

    Patients frequently breast revision if a saline implant deflates or an MRI indicates a shell leak of 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. Another issue is the “double bubble” effect where there is a groove along the breast below the nipple.

  • Changing Breast Size.

    Breasts can deflate due to pregnancy, weight fluctuation or aging. Often a patient will choose a larger implant to fill in deflated breasts.

  • Implant rippling.

    This can be caused by the 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.

  • 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.

    This condition causes painful scar tissue to form around the implant. The implant and scar tissue need to be surgically removed. New implants (if desired) will be carefully chosen and repositioned to hopefully prevent recurrence in the future.

  • Sagging breasts.

    Breast implants do not correct sagging or alter your areola. Some patients choose to have a breast revision 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 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. To avoid additional surgeries, it is best to wait until you are at a stable weight and are not planning to get pregnant in the near future

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 a breast revision, 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. She will describe your surgery in detail, so that you know exactly what to expect.

At this appointment, you will complete the necessary paperwork for the breast revision surgery. We will also take pre-operative photographs. 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.

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 bloodwork 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; the Ideal® Implant, which is a saline implant with a series of nested shells for a natural feel; silicone gel-filled implants; and cohesive silicone gel implants, also known as “gummy bear” or “form stable” implants, which have an anatomic or tear-drop shape.

Ideal Implants® combine the best of both silicone and saline implants. This unique design combines the natural look of silicone with the safety of saline. Breasts feel and look natural. This simple internal structure is designed to control the movement of the saline and support the implant edges to reduce folding and wrinkling. In addition, the edges have been lowered to better fit the natural curve of the chest wall. Unlike silicone implants, leaks can be easily detected just by looking in the mirror.

Dr. Naidu is very pleased to be one of only nine plastic surgeons in New York City offering the Ideal Implant®. The Ideal Implant® has undergone ten years of development and refinement, including contributions of clinical expertise from many plastic surgeons. It is FDA-approved for cosmetic use in women aged 18 years or older.

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 90 minutes and two hours, and is generally 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 hardened tissues will be 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 make it less likely to ripple.

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 consultation. Dr. Naidu will carefully insert your new implants into the pockets beneath your pectoralis muscle. The incisions will be closed with tiny sutures.

If sagging is a concern, 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. In this case, Dr. Naidu will remove the implants and carefully close the incisions with tiny 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. (Special bandages and drains are generally not used.) 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 strong, independent women who are reluctant to ask for help. These patients need to understand that having a breast revision is major surgery and 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 morning after surgery, you may shower if you leave 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. 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, although they will never complete disappear. Dr. Naidu will provide you with silicone dressings 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, implant rupture, and persistent numbness or pain.

Complications from breast augmentation can be reduced by choosing a skilled surgeon, selecting the correct implant, providing a thorough medical history, and carefully following your pre-operative and post-operative instructions.

Cost of Breast Revision Surgery in NYC

We understand that cost is very important to our clients. Please call our NYC office at 212-452-1230 and we will be happy to provide information about the cost of breast revision surgery, as well as information on financing. 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. She is excited to be one of only nine plastic surgeons in NYC to offer the Ideal Implant®, which combines a natural feel of silicone with the safety of saline.

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 conveniently 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.

The options for new implants include saline implants, which are filled with sterile salt water; the Ideal® Implant, which is a saline implant with a series of nested shells for a natural feel; silicone gel-filled implants; 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 1/2 – 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 bloodwork 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 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. Special bandages and drains are generally not used. 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. The scars will continue to fade and soften for up to one year following surgery, although they will never complete disappear. Dr. Naidu will provide you with silicone dressings 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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