Implant Revision: Maintain Your Youthful Profile

What is an implant revision?

An implant revision is the replacement or removal of your original breast implants. Through a breast revision, you can change your breast size, correct any complications that have arisen, and restore your youthful shape.

When is an implant revision necessary?

Not everyone who has had an augmentation will need an implant revision. With the passing of time, though, you may find that any one of these reasons spurs you to consider doing a revision.

• The original implant has deflated or is leaking.
• You want to do a change in size, either increasing your breast size or decreasing it.
• Scar tissue is tightening around the implant creating “capsular contracture.”
• The implant has shifted from its original position creating asymmetry in your appearance.
• Subsequent pregnancies and breastfeeding or substantial changes in weight have changed the breast tissue and stretched the skin.
• Asymmetry has occurred for some reason.
• You want to permanently remove your original implants.

Certified by the American Board of Plastic Surgeons and a member of the American Society for Plastic Surgeons and the American Society for Aesthetic Plastic Surgery, Dr. Tolson can address any of these issues, restoring aesthetically pleasing, reasonable results.

Can anyone have an implant revision?

Just like with the original augmentation, those who are in good health, both mentally and physically, can undergo an implant revision. Individuals should have realistic cosmetic goals. At your initial consultation, Dr. Tolson will evaluate your overall health and the condition of your breast tissue and skin quality to determine if an implant revision is right for you.

What goes into the implant revision procedure?

Consultation

The initial consultation will be rather lengthy as Dr. Tolson will use this time to evaluate your overall health and the condition of your current implants and breast tissue. You will need to be prepared to discuss your medical history including

• Current medical conditions.
• Any allergies you may have.
• All medications, vitamins, and supplements you are currently taking.
• Any previous cosmetic treatments you have had.
• Any breast biopsy results.
• Your family’s breast cancer history.
• Your current mammogram results, if you have them.

Dr. Tolson goes beyond just looking at the medical side to considering cosmetic issues as well. In order to design the appropriate procedure, he will

• Examine, measure, and photograph your breasts for your medical record.
• Consider the current size and shape of your breasts.
• Ask about the size and shape of your current implants.
• Ask about the size and shape you desire to be.
• Examine the quality and quantity of your existing breast tissue.
• Examine the quality and elasticity of your skin.
• Consider the nipple and areola placement.
• Discuss whether you may need just an implant revision or a combination of procedures to give you the outcome you desire.

Preparation

In order for the best possible outcome for your implant revision, you will need to take care to follow Dr. Tolson’s pre-operative list for you. Some general things that you will need to do for the procedure are

• Avoid taking aspirin, anti-inflammatories (NSAIDs), and any herbs that may thin the blood, increasing the risk of bleeding.
• Stop smoking six weeks prior to your implant revision.
• Drink plenty of water before and after your procedure.
• Wear soft, comfortable clothing to the office on the day of your implant revision. You will want to wear a top that opens in the front and slip-on shoes so that you do not have to bend over to get dressed.
• Arrange for someone to drive you home after the surgery and stay with you the first night.

Procedure

Implant revisions are performed as outpatient procedures in Dr. Tolson’s state-of-the-art, AAAASF-certified operating room in Cumming, Georgia. Either general anesthesia or intravenous sedation will be used to keep you comfortable throughout the procedure. Regardless of the type of implant revision being done, the original incision will be used to help minimize scarring. If a breast lift is being performed at the same time as the revision, additional incisions may be made. One of six basic procedure will be used.

• Size change/structural replacement – The old implant is removed, and the pocket adjusted for the new implant. If a larger implant is being put in, the pocket will be enlarged before the implant is put in place. For a smaller implant, the pocket will be reduced in size and a lift may be done at the same time to keep the contour youthful. The same procedure is used if an implant is being replaced because of leakage or deflation.
• Capsular contracture – The body automatically creates scar tissue around the implant, creating a “capsule.” For some people, the scar tissue constricts around the implant causing the implant to feel firm or hard. Dr. Tolson will go in and remove both the original implant and the capsule surrounding it. The new implant will then be inserted usually along with a sheet of acellular dermal matrix.
• Implant rippling – If a saline implant has shifted, the edges of the implant might be able to be seen or felt on the breast. Dr. Tolson will go in and remove the implant and replace it with a different type if that is what is desired. If you are keeping the saline, he will reposition the implant, possibly creating a new pocket where more muscle or thicker tissue can cover the implant edge.
• Implant malposition – Over time, implants can shift. To correct this, a new pocket will be created in the correct place for the implant. Tissue will be moved around to help support the implant’s new position, and, if necessary, an acellular dermal matrix may be used to help support the new pocket, keeping the new implant in place.
• Implant removal – Both the capsule and implant are removed. Implant removals often heal faster than implant replacements or implant movings. A lift may be done at the same time the removal is performed.
• Implant and nipple elevation – If the nipple and areola need to be lifted along with the implant revision, additional incisions will need to be made. For a slight lift, the incision will be around the areola only. If a vertical lift is necessary, the incision will go all the way around the areola and extend down the bottom of the breast to the breast crease.

Recovery

After your implant revision is complete, you will be taken to recovery and observed before being released to go home. You may be wearing gauze and an elastic bandage or a surgical bra when you leave. If you have a drain in place, one of Dr. Tolson’s staff will go over how to care for that before you leave.

During the first week you can expect to have swelling, discomfort, and some discoloration. This should subside with time. The swelling and discomfort may limit your range of motion until it begins to dissipate. You will want to prepare ahead of time to have someone help you with housework and drive you places for the first two weeks. You should not drive, lift, or clean during that time. To minimize the swelling, sleep on your back at a 25- to 45-degree angle. You may want to invest in some extra pillows to keep you from rolling over. Plan on wearing comfortable clothing that opens in the front and doesn’t require bending over to get into and out of. You should avoid hot showers, baths, hot tubs, and saunas for two to three weeks.

Your results won’t be seen immediately as the swelling often distorts what has been done. You may notice that the skin around your implants feels tight. This will subside over time along with the swelling. Your implants may take several weeks to several months to settle into their final position. Any numbness or tingling that you may experience around the incisions should dissipate after several months.

What are the long-term results of an implant revision?

Implant revisions generally last a lifetime. Significant weight changes and pregnancies can create changes in the breasts, so be sure to speak with Dr. Tolson if you are planning on having more children or losing significant weight in the future. You may want to wait to do the implant revision until after these events have taken place. Unfortunately, the pull of gravity and the aging process cannot be stopped by anyone or any process. These will continue to occur, but your profile should continue to appear natural and appropriate to your age throughout it all.