What Are the Complications in Breast Augmentation That Lead to a Revision?

I found out that surgeons don't guarantee their work and it is more likely that I will need another surgery down the row. And if there is a revision needed, I will have to pay for it. That worries me a lot because I will have to come up with a double amount of money compare to the quoted amount. What are the complications in breast augmentation that usually need a revision? And how to avoid those complications? Thank you.

Doctor Answers (8)

Reducing Breast Augmentation Revisions

+2

There are two main problems that cause revision of breast augmentation. By far, the greatest problem is using the wrong size implant. I believe this is usually due to lack of communication between the patient and surgeon. You need to know exactly what you wish and convey it precisely to your surgeon. Your surgeon, in turn must discuss your desires at length with you and guide you to the corrrect choice. The second problem is how the inplant is placed. If the pocket is not made properly, the implant can displace (or may never be in the right position). If the incision is not large enough to accomodate the implant selected, the implant may be injured trying to get it in. This can lead to rupture. (Most ruptured implants, when examined after removal show evidence of old injury.) You, therefore, need to do three things. First decide exactly what you want. Secondly, make sure your surgeon discusses your desires thoroughly with you and you are comfortable with the decision. Thirdly, make sure your surgeon has a redo rate less than 3%. (Good studies have shown that this is very possible with careful planning and technique. This is far below the generally reported rates of 12-20%.)


Highlands Plastic Surgeon
5.0 out of 5 stars 4 reviews

How often does breast implant surgery need revision?

+2

It's not that plastic surgeons don't "guarantee their work," it's that we can't guarantee that patients will follow our directions exactly and completely!

Well, not really, but you get the idea! Any surgeon who "guarantees" anything as variable as a surgical procedure and patient happiness must be charging much more than the rest of us. Most ethical, reputable, and experienced plastic surgeons (American Board of Plastic Surgery-certified) offer revision surgery for no or reduced surgeon's fee, plus the cost of new implants (if needed) and anesthesia.

I always tell my patients that since I have to show up and do the no-surgeon's-fee operation it actually "costs" me what I would have otherwise earned if I were operating on a "paying" patient. Plus, the patient has to pay more than what they did for their initial surgery, meaning BOTH of us suffer a bit when a re-do or touch-up surgery is necessary. NEITHER of us are really interested in that, nor am I interested in the damage to my reputation among patients who might talk to my patient requiring or requesting additional surgery. That is a direct "hit" to my bottom line and my ability to attract patients to my practice.

Sure, if I was a plastic surgeon who operates at a University or major health care institution, I might be on a salary, and other than my own drive to do good work, there is no direct damage to my salary or my referral base, so the incentive to do "our best work" may be greater for someone in private practice.

But, the bottom line in avoiding the need for re-do surgery is choosing not only an ABPS-certified plastic surgeon (not a "cosmetic surgeon" with certification by boards that have little or no training in plastic surgery, or "bogus boards"), but one who has extensive experience in breast augmentation (does more than 100 per year, not just a few dozen).

The main reason patients request revision is size change (almost always larger), followed by position improvement, capsular contracture, and symmastia. Implant deflation occurs only with saline implants, and I recommend switching to silicone gel implants (the latest generation cohesive) should this occur.

Some doctors will tell you that "every" breast implant patient will require re-operation at some point in their life, but this is, IMHO, an exaggeration that is designed to make you think seriously about this surgery (as if you weren't already serious)! This happens truly infrequently in my practice, so I understand your concern, but the reality is somewhat different from your worries. Best wishes!

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
5.0 out of 5 stars 125 reviews

Complications of breast augmentation

+1

Choosing to undergo breast augmentation is a life decision. Implants are medical device and do not last forever. If you get implants and live long enough, you will at some point in your life have to have one or both of your implants changed.  Implants wear out and either rupture or deflate. There are also things that may make it necessary to have surgery sooner rather than later. Revisional surgery may be necessary for size change, capsular contracture, implant failure, implant malposition, asymmetry, hematoma, infection that may require implant removal for a period of time (luckily rare). Going to a plastic surgeon with good training, certification, and in depth experience with breast augmentation will minimize but not eliminate the possibility of these complications. Following all your surgeon's instructions helps to and is just as important.  I hope this helps.

J. Jason Wendel, MD, FACS
Nashville Plastic Surgeon
5.0 out of 5 stars 37 reviews

You might also like...

Breast Augmentation Revisions

+1

The most common revision is malposition of the implant.  I personally have to take care of this problem 3-4 times a year, but that is out of about 200 augmentations a year.  When this occurs I eat the cost and the patient pays nothing.  Still, I always tell a patients that I cannot guarantee my work.  I would recommend that you discuss with your surgeon what his policy is on revisions.  I have come across surgeons that will charge the patient even a surgeon fee to correct an issue that is clearly the surgeons fault.  Most reputable surgeons however will stand behind their work and be fair with you.  Make sure that you see a Board Certified Plastic Surgeon.

Gary Hall,MD

Gary Hall, MD
Kansas City Plastic Surgeon
4.5 out of 5 stars 24 reviews

Breast augmentation complications

+1

Fortunately, complications after breast augmentation requiring additional surgery are relatively rare.  One of the most common causes of reoperation is capsular contracture which usually occurs within the first two years of surgery.  Other causes of reoperation include hematoma (bleeding), infection, deflation/rupture, implant malposition, and dissatisfaction with size.  It is impossible for a plastic surgeon to "guarantee their work" because so many variables are outside of their control.  Other contributing factors to the final result include patient compliance, the status of the patient's immune system, medical problems, and normal wound healing.  Although, it may be troubling for some patients to hear, complications can still occur even when a patient is perfectly healthy and the surgeon performs a flawless operation. 

Kelly Gallego, MD, FACS
Yuba City Plastic Surgeon
5.0 out of 5 stars 33 reviews

Why revise breast implants

+1

The most common cause for breast implant revision is a change in size, most often to a larger implant. Though this is not really a complication, better communication can reduce the revision rate. The common complications we note on this site are implant malposition, and breast asymmetry, followed by capsular contracture. Some of these issues such as implant postion the surgeon has better control over, and issues such as asymmetry require compromises. Fortunately 'real' complications such as bleeding or infection are quite rare.

Best of luck, peterejohnsonmd.com

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 28 reviews

Causes for breast revision surgery

+1

Breast revision surgery is due to several reasons. The most common of these is dissatisfaction, wanting a change in size, or change from saline to silicone implants.

 

Breast implants are not lifetime devices. The warranties on most breast implants are for a term of 10 years. Due to the nature of implants, some secondary surgery is likely at some point in the patient’s lifetime. Among these reasons for revision is implant deflation or rupture. Other common reasons for breast revision surgery include capsular contracture – which requires release of scar tissue through capsulectomy or switching from saline to silicone implants due to rippling problems or just a desire for a softer, more natural feel.

 

Breast changes can be caused by many things such as; pregnancy, weight gain, weight loss, age-related issues, results of previous surgery due to poor implant placement or other problems such as double-bubble, symmastia,(where the breasts merge together in the middle) or bottoming out.

 

Hope this helps! Good Luck!

 

 

 

 

Miguel Delgado, Jr., MD
San Francisco Plastic Surgeon
4.5 out of 5 stars 30 reviews

Breast Augmentation and Complications?

+1

Thank you for the question.

You are wise to consider the potential  complications associated with breast augmentation surgery.

Some of these complications  or undesirable results of breast augmentation surgery that may require revision surgery include: infection, bleeding, rippling/ probability, encapsulation, asymmetry, leakage/deflation, interference with mammography, loss or change of nipple/areola sensation, inability to breast-feed,  implant malposition/displacement, unsatisfactory size or cosmetic results...

Some of these complications and/or  undesirable results of breast augmentation surgery are avoidable,  some are not. 

Patients should weigh the potential risks/complications associated with the procedure against the potential benefits when deciding whether to proceed with the operation or not. Careful selection of a well experienced board-certified plastic surgeon will be important.

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 727 reviews

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.