What is the Recovery Time for Breast Revision for Implant Repositioning

Question

i had a breast lift and augmentation with 240cc filled to 270cc, 1 year ago. I feel my implants sit to low and to far to the side. How painful and how long is the revision surgery for this problem/

Roy Kim, MD · Answer

Depending on what needs to be done, breast revision surgery is generally less painful, with a shorter recovery time, than your original breast augmenation surgery.

	 

	To revise your particular situation, I would consider removing your breast implants, and using the scar tissue that has formed around your breast implants to change the size of your breast implant pocket.  The scar tissue around your breast implants is called the "breast capsule".  The edges of this capsule can be used to make your breast implant pocket smaller on your side, and smaller at the bottom.  When your breast implants are put back in, then your breast implant position will be more towards the middle, and higher, than what you currently have.

	 

	If this maneuver is insufficient, then a new pocket has to be created.  This completely new pocket will be made to place your implants more towards the middle, and slightly higher. 

	 

	The revision surgery with just capsule manipulation should not hurt that much, and recovery should be only a couple of days with pain medication.  With creation of a new capsule, your breast revision surgery may be more painful, but still should be less than your original procedure.  Usage of a pain pump will help with pain recovery after surgery. 

	 

	Thanks for the great question, and best of luck with your recovery!

Jed H. Horowitz, MD, FACS · Answer

Post-operative healingThis is usually not very painful

Patients
will feel sore and tired during the first 48 to 72 hours following surgery.
During these first few days, the patient should engage in light activities,
refraining from lifting or raising the arms above the head.

Swelling
and bruising will subside during the first week after surgery and will be
controlled by pain medication. The initial surgical tapes will be removed a few
weeks after surgery during a post operative visit. Patients typically may
return to a work a few days after surgery (only a light workload during the
first two weeks). Showers are permitted on post op day #3 if there are no
drains.

Scars
will progressively fade throughout the first year following surgery.

Richard J. Bruneteau, MD · Answer

A wide variety of revisional breast procedures are
currently available to treat secondary breast deformities.These procedures are generally associated
with less pain and shorter recoveries than the patients’ original operative
procedure.Your
pictures suggest recurrent breast sag and inferior breast implant
malposition.Correction of this
deformity may require a capsulorrhaphy to raise the implant into normal
position and adjust the height of the infra-mammary fold.In addition, the vertical distance between
the nipple and the infra-mammary fold may require shortening as well.If
you’re concerned about the appearance of your breasts it’s important to consult
your plastic surgeon.Your surgeon
should be able to formulate a treatment plan that addresses your anatomic
findings and achieves your aesthetic goals.

Lewis Albert Andres, MD · Answer

Thank you for your question!  The time will depend on how much work will need to be done.  Without an examination it will be difficult to give you my recommendations, but certainly re-lifting with pocket revision would be recommended at the least.  The procedure itself will result in less time off than your original procedure and likely be approximately one week off with restrictions carried on for approximately 3-4 weeks.  Hope that this helps!  Best wishes for a terrific result!

Larry S. Nichter, MD, MS, FACS · Answer

Breast Augmentation Revision surgery that you described varies from surgeon to surgeon but typically can be accomplished in a few hours. There is usually less pain than your original augmentation.
	Post-Operative Healing following Breast revision varies from patient to patient and recovery recommendations also vary among different plastic surgeons - Best advice is to ask your surgeon his recommendations.
	Below is what is typical for my practice.
	This is an outpatient surgery and you will  probably go home in a bra or with only light dressings over the incision lines.
	In my practice - Sutures are dissolvable but the ending knot is removed within 1-2 weeks.
	Initial discomfort is easily controlled with oral medication. Light activities may be started in 7-10 days and return to work for light duty 1-2 weeks following surgery

Richard Baxter, MD · Answer

There are usually two options for correcting what is called "bottoming out" which is where the implants drop. The simplest is to tighten up the scar capsule with a row of stitches, called a capsulorrhaphy. If that is all that is needed the recovery time is fairly quick. I suspect that in your case, you would get a more predictable and stable long-term result if support is added with a material called Strattice. Think of it as an internal bra, though it becomes living tissue and part of you. Recovery is a bit longer for this option but it may help prevent the need for additional revisions later.

Otto Joseph Placik, MD · Answer

Fortunately, breast implant revision is less down time than the original surgery. You may need a slight lift or some manipulations to the pocket. We suggest a week off work and you will be under weight lifting restrictions for up to 3 weeks and sometimes up to 3 months.

William Bruno, MD · Answer

Based on your photos I would recommend using a synthetic skin substitute (acellular dermal matrix-ADM) to act as a sling under your implants to give a higher appearance with more cleavage.  Some name brands are Strattice (derived from a pig) and Alloderm (derived from humans).  This is basically sewn in under the implants inside the breast pocket to control the space where the implant can move. It gives excellent support and can prevent your implants from migrating (moving down) as your age.

	Please consult with an experienced board certified plastic surgeon prior to having this type of procedure.

	Best wishes,

	Dr. Bruno

Steve Laverson, MD, FACS · Answer

While the position of the implants, in my opinion, cannot be substantially changed by revision, the shape of your breasts may be improved by tightening the lower pole (vertical portion of the breast lift closure beneath the areola), and this would be my approach. Recovery not bad at all, just requires lower pole support after the procedure by a good elastic support bra until the envelope is well healed, usually 8-12 weeks. Recovery to most normal activities several days, to athletic activity involving jumping up and down, my recommendation is to delay for a couple of months. This is surgeon dependent however. Scar matures and resolves over months.

Tom J. Pousti, MD · Answer

Thank you for the question. Assuming that the same breast implant "pockets” are utilized, revisionary breast surgery tends to be associated with minimal recovery time/discomfort, compared to first-time breast augmentation surgery. This is likely because the muscle/tissue stretch (and necessary dissection) has already occurred for the most part.Best wishes for an outcome that you will be very pleased with.

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