Why is Breast Revision Surgery More Difficult?
Doctor Answers (8)
Breast revision surgery
Breast revision surgery is sometimes more difficult depending upon what needs to be done. Revisions are done for many different reasons.
More difficult the second time around: breast surgery
It is not always more difficult but frequently there are numerous issues which may make this more complicated. I find that frequently the procedures were performed 5 to 20 years previously and patients anticipate that their breasts are the same or have not changed. Also they may not recall details of the surgery or implants which may be important information for planning the revision surgery. In some instances the first surgery must be undone prior to the desired change. This can result in a more complex situation which can effect healing or the final result. For example when going from a subglandular to a submuscular pocket. From large studies we know that the rate of complications is higher with secondary surgery.
Revision Breast Surgery is not ALWAYS more difficult but commonly is
Revision Breast Surgery is not ALWAYS more difficult but commonly is. Breast implant removal and "going larger with a slightly larger implant, may in fact be simpler than the original breast augmentation. But, in many cases, the surgeon has to tackle a profoundly altered breast anatomy due to the long term effects of large implants combined with thinning tissues. So when dealing with "uni-boobs" (implants which meet in the center, profoundly sagging breasts with an implant right under the breast skin, severely scarred and calcified scarring (capsular contracture) around a ruptured implant with little to no breast tissue, etc the correction of such deformities is much more challenging, time consuming and expensive than a straight forward breast augmentation.
Dr. Peter Aldea
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Any revision surgery in terms of complexity, difficulty and results obtained is dependent on patient factors as well as the previous surgery or surgeries. Patient factors included how the patient scars or heals. Patients with keloid tendencies can have bad skin scars regardless of who the surgeon is. Certainly the more surgery one has had prior to revision surgery and the greater their tendency to scar the more difficult the revision surgery will be. At the first surgery it is usually much easier to develop planes of dissection between tissues. Typically the surgeon can for example separate the fat layer from the underlying muscle by just inserting his/her finger and moving it around. With revision surgery scar may connect these 2 layers and have to be divided by scissors and or scalpel. Frequently the difference between the tissue layers is camouflaged by the scar so the surgeon has to operate at a slower pace in order to identify the anatomy. All this adds to operative time, revision surgery difficulty and recovery time. It can also detract from the end result after the revision.
When going in for revision surgery the prospective patient needs to be wary of surgeons that over promise before surgery and under deliver after surgery. The converse is more desireable.
Difficulties in breast revision surgery
Not all revisions are more difficult than the original surgery. Like going up or down in size is easy IF your current pockets are soft and symmetrical and if your breasts aren't droopy. But if there is a scar issue or an asymmetry issue, the revisions are harder. You almost always get the very best result if the first surgery goes perfectly. Revisions generally are for improvement but fall somewhere short of the very best result.
Breast Revision Surgery
Reoperation on the breasts, or any other body part for that matter, can be more difficult or complicated. Some reasons include: the presence of scar tissue, changes in blood supply to the skin and/or nipple from previous surgery, preexisting implant pockets with dimensions that may need to be altered, overlying breast tissue changes including thinning, or sagging issues that have become apparent. Every case is individualized and treatment plans can vary widely, depending on the issues at hand.
Breast rewvision surgery
Not all breast revision surgery is more difficult than the original surgery. It is very important that the surgeon performing any revision surgery have as much information as possible during the evaluation and planning of the secondary surgery. It has to do with what incisions were made not only on the surface but inside as well to try to protect the blood and nerve supply to your breasts.
I hope this helps
Web reference: http://www.medwardsmd.com/plasticsurgery_questions1.html
Difficulty of Breast Revision Surgery
All revisional surgery is more difficult than the original surgery. This in part due to the fact that the tissues are no longer virginal but rather have scar which has formed due to the initial surgery. Also the problem prompting the revision must be corrected in addition to trying to obtain the originally desired result.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.
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