Why Do I Have to Wait 4 Months to Do a Revision

I got implants in november. I felt too large with 300 cc and i switched to 250 cc silicones instead of saline after 4 months. Now I still feel too large after almost 3 months. I still feel hardness under my incision site which is scar tissue? but the last recovery was a breeze. I have decided I like smaller breasts (i was naturally a 34c) I want to switch to 125 cc but my dr said i hav to wait until its been 4 months to prevent capsular contracture. Why is this so?

Doctor Answers (11)

Wait for Breast Revisionary Surgery?

+2

Thank you for the question. 

There are both physiological and “psychological” reasons to wait on having  revisionary surgery. From the physiological standpoint, it takes many months ( and even up to one year) to see the final results of surgery. factors such as swelling,  tissue contraction,  skin redraping,  implant shifting etc. come into play.

From the psychological standpoint, patients undergo an “adaptation period"  during which time they get used to the changes that the surgical procedure has brought about. For example, it is very common for patients to feel that they are too big or too small;  severe emotional swings can also occur. Obviously, it is best for patients not to be making important decisions while they are experiencing these emotional “ups and downs”.

Having revisionary surgery too soon exposes patients to additional risks both from the physiological/anatomical complication standpoint as well as from the psychological/patient satisfaction standpoint.

One of the important assessments the plastic surgeons make prior to surgery is the determination of patients' motivation and goals. This communication prior to surgery is critical in  helping to achieve patient satisfaction and avoid the need for further surgery.

For example, if patients are not  self-motivated individuals I had to have a procedure done,  it is more likely that they will be dissatisfied with the results of surgery ( no matter how well it is done).  Also,  if physician/patient communication is not optimal,  than the chances of patient dissatisfaction is also increased.

In regards to breast size with breast augmentation I find the use of goal pictures to be very helpful.    I have found that the use of words such as “natural” or “C cup” means different things to different people and therefore prove unhelpful.
 Also, as you know, cup size varies depending on who makes the bra; therefore, discussing desired cup  size may also be inaccurate.
 

This communication becomes important again when contemplating revisionary breast surgery.

I hope this helps.


San Diego Plastic Surgeon
5.0 out of 5 stars 793 reviews

Waiting for revision

+2

It takes around 4-6 months for the breast tissues to soften up following breast augmentation, and each additional surgery is only going to add more variables and complexities to the situation: more chance for complications; capsular contracture,  scar tissue,etc.  Although waiting may seem difficult, it has many advantages: the breasts may look much better to you at that later time; it gives your more time to evaluate your feelings about your size and appearance, and of course, it allows the tissues to recover.  I have never regretted counselling patients to "wait".  I would also sit down and have a very thorough discussion with your surgeon as to what both of you want to accomplish with additional surgery. Good luck

Jerry Lugger, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 2 reviews

Why wait for revision

+2

Generally it takes up to 6 months for tissues to soften and edema to resolve after surgery.  If you revise the area too soon your may have to have additional surgeries due to the uncertainty of edema and induration in the area.  Donald R. Nunn MD Plastic Surgeon.

Donald Nunn, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 5 reviews

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Let the tissues soften first

+1

Hello,

 

It is best to let the tissues soften before revision surgery. This takes at least 3-6 months. Some surgeons wait a year.

 

 

Best Regards,

 

John Di Saia MD

John P. Di Saia, MD
Orange Plastic Surgeon
5.0 out of 5 stars 24 reviews

Revision augmentation

+1

Revision augmentation is best after the tissues soften up. This may take 4-6 months for the breasts. 

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 18 reviews

Breast Implants too big? How long should you wait to change them?

+1

Hi Anna
I have to agree with Dr Tholen, 50 cc is a pretty minimal volume change.  But I also agree with your doctor, many woman's breast will continue to shrink for 3-6 months after breast augmentation surgery as the swelling and any fluid around the implant reabsorbs.  I'd wait at least 4-6 months to be sure you make the best decision possible regarding size.

Daniel P. Markmann, MD
Baltimore Plastic Surgeon
5.0 out of 5 stars 77 reviews

Breast Augmentation too large?

+1

I'm sure both you and your surgeon want you to be happy with your breast augmentation. You may find that after three months you don't really want another operation. After all, 125 cc is not very much, and may not be worth your while.

The hardness you feel under your incision is the result of healing from two surgeries, and you might find that this worsens with a third operation. Scar tissue takes a year or two to mature, and at that point you may no longer notice firmness in the area.

Hugh McLean, MD
Mississauga Plastic Surgeon
4.0 out of 5 stars 5 reviews

Waiting (again) before another revision is a good idea!

+1

Anna, I am sorry you felt too large with 300cc implants and your surgeon did not advise you that a 50cc drop in volume would give you an imperceptible change. I would have told you that your 300cc implants added just over a cup in bra size to what you started with (I believe it takes about 250cc to equal one cup size), and that to see a real difference, you would need to reduce by at least 100cc. Even this amount (100cc) would drop your overall cup size by less than a half a cup. 50cc is the exact amount of 3 tablespoons and 1 teaspoon of volume. Put this amount in a glass and you will readily see why you "still feel too large." Not enough change!

Switching from saline to silicone was a good move, but switching to 125cc silicone implants (besides being expensive and additional--minimal--risk) gives you only 1/2 cup size increase over your natural C-cup pre-op breast size. Are you sure this is what you want? Do you really want a lift but were hoping to avoid the scars and cost? (Not doing too well on the cost part with a third operation and set of implants, are we?!) You may be finding out what so many find out the hard way--implants don't "lift" sagging breasts. They can "fill" loose skin and reduce deflation or the appearance of sagging, but without skin incisions to remove loose skin and reshape the breasts, implants only add volume. So then you have to ask, "How much?"

Also, 125cc implants have a base diameter of 10.0cm (moderate profile; moderate plus and high profile are even narrower!), which is probably at least 2 inches per side narrower than your breast base. In addition to an unnaturally wide and usually unattractive cleavage, this means your implants will slide around in the pocket, not that you have a "higher risk of capsular contracture." The latter may have just been an "excuse" your surgeon used rather than to tell you you seem to not really know what you want, and that surgery is not like exchanging a blouse that you decide you didn't really want!

I also agree you should wait, if only to let all your swelling settle, and to allow your emotional decision-making processes catch up to your rational decision-making processes. Perhaps you don't really want implants at all. Perhaps you need consultation with other experienced board-certified plastic surgeons who are not "caught up" in the surgical decision-making process in their zeal to make you happy, when you aren't even sure what that will take yourself! Be patient and best wishes!

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
5.0 out of 5 stars 144 reviews

Wait 4 months for the revision

+1

It takes at least 3 months for the tissue to calm down after surgery.  You may also have some fluid in the pockets where the implants are.  You want to wait long enough for this fluid to be absorbed and the swelling in the tissue to go down, otherwise you may put an implant in that is too small.  You may find that after a few month - after the swelling has gone down that the size is perfect.  Every time you redo the surgery there are increased risks - more possibility of scarring and capsular contracture.  You also do not want to put an implant in that is too small for your base diameter, this can leave you droopy and in need of a lift.

Hilton Becker, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 6 reviews

Timing of revision surgery

+1

It is prudent to allow some time for tissues to settle before further surgery. You have already had two operations within a period of four months - waiting a bit longer will allow the scars to soften and swelling to disappear. Both will make the revisional surgery easier and the outcome more predictable.

Anindya Lahiri, MBBS
Birmingham Plastic Surgeon
5.0 out of 5 stars 6 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.