Are the Breasts As Swollen After an Augmentation Revision As They Were the First Time?

Question

Having breast implant redo after 6 months to change style and size. I've heard it's an easier procedure and recovery. Is it? Would I be as swollen and would the implants be as high this time as they were the first time?

Jeffrey J. Roth, MD, FACS · Answer

It depends on what is being done. If it is straightforward removal and replacement in the same pocket, the swelling should be less. If there is a change of pocket, or extensive pocket dissection, then there may be swelling like you remember. Best to speak with your board certified plastic surgeon.

Ronald J. Edelson, MD · Answer

revision breast surgery may be less painful, assuming the implants are under the muscle, because the muscles have already been stretched. The amount of pain to expect does depend on what specifically will be done with the surgery. if it is a simple implant exchange, you should expect very little discomfort.

Michael E. Decherd, MD, FACS · Answer

If there is not a lot of pocket work the recovery ought to be pretty easy.  For example, if I just open an old scar and swap out implants there is little new raw areas and therefore your recovery is easy.

	On the other hand, if there is a capsulectomy, a plane change, or other stuff, it may be some recovery. 

	So it really depends on the circumstances about YOU.

Kenneth Hughes, MD · Answer

Provided that no substantial dissection is done with regard to the pocket or the capsule, the recovery is much easier than the first surgery. In the simplest of cases, this would involve making the incision, placing the implant, and closing the incision.

Craig S. Rock, MD, FACS · Answer

As long as the revision does not require significant removal of the scar capsule or change in breast implant pocket (site change), swelling after surgery should be minimal.  Implants being "high" after augmentation is related to implant size, style, location of implant pocket and time required for your tissues to relax and the implants to "settle".  Your appearance following the revision will depend upon each of these factors, as well as what is done surgically to the scar capsules already present.  Since you are having your second augmentation within six months of the first, I would strongly encourage you to be sure to spend enough time discussing your desires with your surgeon, so that the revision meets your goals.

	Good luck.

Jennifer Lauren Crawford, MD · Answer

Since your body has already developed a scar capsule (pocket) around the original breast implant, the exchange should be fairly easy. The only exceptions are when a lot of work has to be done to that scar capsule for shaping changes or when people are changing their implant position to above or below the muscle. That is much more involved when the pocket is manipulated and that can result in more pain and more swelling. If it is a simple exchange, then pain and swelling is generally minimal. Also, your implants will not undergo much settling since the pocket is already matured.

Joseph M. Perlman, MD · Answer

If you're going to a larger implant, the surgeon will probably have to enlarge the pocket by removing the scar tissue capsule around the implant. This is usually not very painful. If you are having a revision that requires placing an acellular dermal matrix (ADM) graft form a sling on the underside of the breast to keep it in a better position and decrease the chance of sagging, then you will be sore where the graft is sutured in place. Neither procedure should be as painful as the first, particularly if the first procedure was to place implants under the muscle

Steven Wallach, MD · Answer

Without knowing more and what needs to be specifically done makes it difficult to anser your question.  Usually a revision is easier and less painful if it is straighforward.

Jourdan Gottlieb, MD · Answer

Usually not.

	The second procedure, unless complicate by significant work on the capsule, can be expected to cause less swelling, less pain, and the high riding that occurs with primary operations is less common. What hurts most is making the pocket, and it is already done. 

	Thanks for your question, best wishes.

Tom J. Pousti, MD · Answer

Generally speaking, although dependant on exactly what procedure is performed, breast augmentation revisionary surgery is associated with an easier recovery time. Also, generally speaking there is less time associated with breast implant “settling” and/or swelling.  Pain/discomfort tends to be much less of an issue as well.

	 Your plastic surgeon will be able to advise you more precisely, depending on exactly what procedure is planned.

	 Best wishes.

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