Risk for revision breast augmentation may be higher than for primary breast enhancement with implants.
Yes, it is true that the risk for re-operation after revision breast augmentation is higher than the risk for re-operation following primary breast augmentation for risks like capsular contracture and implant malposition to name a few. All three implant companies (Mentor, Allergan and Sientra) have shown this in the data they have presented to the FDA when they applied for FDA approval. A good resource for this information can be found on the FDA website. Why... is a great question. As Plastic Surgeons we can assume that all tissue responds to re-operation by forming more scar tissue and the operation is definitely more complex. Be sure you choose a board certified Plastic Surgeon who has an expertise in primary and revision breast augmentation.
Risks for revision breast surgery
Generally speaking, the risk of capsular contracture and rupture are not higher in revision breast surgery unless the revision is due to a capsular contracture. The risks of asymmetry, infection, exposure of the implant may be higher. The complexity of the surgery is certainly increased and requires expertise.
Risks of Revision Breast Augmentation
On the whole, the risks for postoperative problems are greater in revisions than in primary procedures. This is because many revisions are for problems like capsular contracture. In these cases, because the tissue has already demonstrated a tendency to develop problems, this tendency still remains. When you operate on tissue primarily, there is no preexisting problem and a greater percentage of patients will have tissues that will respond favorably. If the revision is for a size change or some reason other than a complication, the risks are essentially the same as a primary procedure.
Revision Risk Breast Augmenation
It's great you're doing your research. There are variables to answering your question. The answer is dependent on the reason for the revision of the augmentation. If it is because of a complication, your risk goes up. For example, if there is a capsular contracture once, then the chance of another is higher. The surgeon who does the first procedure has healthier tissue to work with. Scaring and blood supply become more of an issue in a revision than in a primary case with any surgery. That being said, a skilled surgeon can still achieve good result with proper technique. I hope this helps!
Thank you for the question.
I believe that this really depends on the PS's experience, normally the results can be successful if they're done correctly.
It depends upon what the reasons are for the revision. If it is to increase your cup size that should have minimal risk. Going from a large cup size to a smaller can be more difficult without a mastopexy. Conditions such as implant malposition, rippling and capsular contracture can be harder to treat but can be treated with good results. The key is to have a good surgical plan and to consult with a plastic surgeon who has extensive experience in breast surgery.
Risks are related to the core reason for revision.
Risks associated with revision-augmentation correlate well with the the core reason to perform revisional surgery. For example, a modest change of implant volume in an otherwise well healed previously augmented patient might predispose to few surgical risks, whereas implant change in a patient with established capsular contracture often predisposes to high risk of recurrent breast distortion.
In regards to breast augmentation, are the risks higher with revision-augmentation patients than primary augmentation patients?
Only in the since that the anatomy that has been disrupted is usually harder to correct for the surgeon. In general, the revisions that I perform are nearly all successful, except in the case of capsular contracture as it is an incompletely understood entity. I have found that the creation of a neopocket or total capsulectomy with an acellular dermal matrix reduces the rate of recurrent capsular contracture.
board certified plastic surgeon who performs hundreds of breast
augmentations each year. Then look at the plastic surgeon's website
after photo galleries to get a sense of who can deliver the results.
Kenneth Hughes, MD
Los Angeles, CA
Are the risks higher with revision augmentation
Hi. Risks of revision augmentation are often significantly higher, depending on what the reason for the revision is and also what the surgery involves. Minor capsule release and change in size is a relatively low risk, but complete capsulectomy/pocket change/ exchange for leaking silicone etc have a much higher chance of problems such as rippling, especially if silicone granulomas have formed in the breast tissue, You should discuss this with your plastic surgeon.
Revision surgery is designed to solve problems with the primary procedure.
Capsular contracture rates are higher in patients who have had CC before,
but capsulectomy, use of textured implants and changing implant from supra to sub-muscular position
can overcome this problem in many cases.
Rupture is not increased in revision surgery.
Infection and hypertrophic scar incidence should not change.
The reason higher rates are described for revision procedures is that the patients who
come in for revision surgery already have problems - so they are a selected subclass of patients
to start. For instance - patients who develop capsular contracture have a 50% chance of recurrence,
so their rate is much higher than the unoperated patients who have a much lower rate.