According to the American Society of Plastic Surgeons, patients should remove or replace their breast implants anywhere from 10 to 20 years after the initial procedure. However, breast implant revision surgery in Scottsdale and Phoenix may become necessary at a sooner time for patients with health- or cosmetic-related concerns. For example, if breast augmentation does not deliver natural-looking results, or sagging has occurred despite the surgery's recency, the corrective benefits of breast implant revision can help.
Do You Need Breast Revision Surgery?
Here are the common signs you need to call your plastic surgeon and discuss the possibility of undergoing breast revision surgery.
1. Ruptured Breast Implant
Intense physical pressure, such as sudden impact to the chest during a car accident, the implant shell aging and weakening, surgical error, or rarely, the pressure exerted during a mammogram, can cause a ruptured implant.
A ruptured saline implant causes the affected breast to deflate almost immediately, which makes it easy to detect. The saline inside the implant is the same as IV fluids, allowing the body to absorb the solution without causing serious health risks. Still, if you wait too long, scar tissue can build and tighten around the ruptured implant (capsular contracture). As a result, removing the damaged implant may require more work.
As for a ruptured silicone implant, in many cases, patients remain unaware until the results of an ultrasound or MRI scan reveal the problem. The viscous silicone gel inside an implant leaks out significantly slower compared to saline, allowing it to go unnoticed for several months or years.
Although a ruptured implant is not a life-threatening emergency, removing the damaged implant is critical to prevent infection or excessive scar tissue formation.
2. Capsular Contracture
Scar tissue development is a normal part of the healing process following the placement of any medical implant or prosthetic. Generally, this process is a good sign because the scar tissue capsule helps support the implants and prevents them from slipping or rotating within the breast pocket.
In some cases, however, the body mistakes the medical implant for a dangerous foreign object. As an act of defense, the body generates excessive amounts of scar tissue to isolate it. Called capsular contracture, this overproduction of hardened tissue around the implant can impair the success of your breast augmentation surgery.
Capsular contracture has four grades ranging from normal to severe. Grade I is asymptomatic (producing or showing no symptom) and does not change the results of breast augmentation. Grade II presents minor symptoms, such as the breast appearing normal in shape but feeling abnormally firm or hard.
Grades III and IV capsular contracture cause hard, misshapen, and overly round-looking breasts. Grade IV capsular contracture may also cause mild to severe pain. Patients experiencing these symptoms may require implant revision surgery to alleviate all symptoms.
Related: Dr. Guerra’s Best Practices for Capsular Contracture Prevention
3. Bottoming Out
If the skin and tissue are struggling to support the breast implant, it is possible for the implant to "bottom out" or drop below the inframammary crease. This condition is more prevalent among patients with large or heavy implants. However, post-surgery pregnancies and sagging skin due to aging can also cause an implant to bottom out.
The primary cosmetic concern here is, unlike when the breasts droop naturally over time and the nipples fall along with the breast tissue, bottomed-out implants cause the nipples to remain high or move upward as the implants settle lower on the chest. In most cases, patients can also feel and see the outline of a bottomed-out implant.
Breast revision surgery corrects bottomed-out implants by either repositioning or removing the implants. If you decide to remove your implants, a breast lift may be necessary to address any loose or hanging skin.
Related: 7 Mistakes to Avoid When Getting a Breast Lift
4. Breast Implant Malposition and Rotation
Breast implant displacement is a complication characterized by an implant moving to a different location on the chest wall.
An implant can change positions in many ways. In lateral displacement, the implants are moving far away from the midline of the chest as a result of the breast pocket being too large compared to the implant's size. Symmastia, or breast implants merging in the middle of the chest, is a rare complication resulting from excessive tissue removal near the breastbone, causing the muscle between the breasts to separate and leaving little or no cleavage.
A large implant pocket can also cause implant rotation. While patients may not be able to tell if a round implant has flipped over, teardrop-shaped breast implants yield a top-heavy, unnatural appearance when rotated. Breast revision surgery can reposition the implants, as well as tighten and reduce oversized breast pockets.
5. Uneven Breasts
The shape of an implant can change due to different causes, including ruptures, bottoming out, rotation, or poor placement. The complication is usually asymmetrical, meaning the breasts will look different from one another. While breast asymmetry does not pose any health risks, it can cause the patient significant emotional distress.
Related: Breast Asymmetry Correction in Phoenix, AZ: Know Your Options
6. Change of Mind
While 93 percent of breast augmentation patients are satisfied with their results, some patients experience a change of heart. If you want to remove or change the size of your implants, most surgeons will suggest waiting for about a year following your procedure before proceeding with revision surgery. The waiting period will allow your breasts to heal fully and give your breasts enough time to settle into their final position before you make a decision.
7. Discomfort and Pain
Uncomfortable or painful breast implants can signal several issues that require implant revision surgery, including capsular contracture, a developing mass (seroma), pinched nerves, damaged lymph nodes, or poor implant placement. If you have silicone breast implants, pain may be an indication of leakage, rupture, or contracture.
For some patients, pain is not the issue. Uncomfortable breast implants due to poor placement, or perhaps the implants are too large for the patient, can cause self-esteem issues and feelings of regret, especially since the main reason most patients have breast augmentation surgery is to boost their confidence.
Related: Breast Implants 101: How Big Can You Go?
Never tolerate persistent pain or discomfort, as it is not a normal result of plastic surgery. If you are experiencing either – or any of the signs mentioned in this article – schedule a consultation with Dr. Scott Ogley, our breast implant exchange specialist in Arizona.