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- Breast Implant Revision Benefits
- Breast Implant Revision Consultation
- Breast Implant Revision Procedure
- Hospitalisation for Breast Revision
- Breast Implant Revision Recovery
- Breast Implant Revision Results
- Resuming Activities After Breast Implant Revision
- Breast Implant Revision Complications
- Breast Implant Revision Scars
- Breast Implant Revision Before & After Pictures
- Breast Implant Revision Surgical Animation Video
- Breast Implant Revision Cost
Meet your Surgeon
Dr Steve Merten
Meet your Surgeon
Education and Training:
- Bachelor of Medicine, Bachelor of Surgery from Sydney University in 1991
- Fellow of the Royal Australasian College of Surgeons (FRACS) in 2001
- Fellowships in Aesthetic (Cosmetic) Surgery at the Melbourne Institute of Plastic Surgery and Monash University
- Fellowship in Breast Reconstruction at the University of British Columbia, Canada
- Clinical Senior Lecturer in Cosmetic Plastic Surgery and Plastic Surgery Fellowship Program Director at Macquarie University, Sydney
- Consultant Plastic Surgeon Concord Hospital, Sydney
- Supervisor of Plastic Surgery Training, Concord Hospital
- Consultant Plastic Surgeon at numerous top Sydney private hospitals, including:
- Macquarie University Hospital
- Hunters Hill Private Hospital
- North Shore Specialist Day Hospital
- Plastic Surgery Representative NSW Members Advisory Committee Avant Mutual
- Fellow, Royal Australasian College of Surgeons (RACS)
- Member, Australian Society of Plastic Surgeons (ASPS)
- Member, Australian Society of Aesthetic Plastic Surgeons (ASAPS)
- Member, Australian Medical Association
- Member, ANZPATH (Australia and New Zealand Professional Association for Transgender Health)
- Member, WPATH (World Professional Association for Transgender Health)
What Is Breast Implant Revision?
Breast Implant Revision is usually only necessary many years after having initial breast implant surgery. However revision may be needed for those who have developed problems, or are unhappy with their results from previous surgery.
Breast Enlargement is one of the most commonly performed cosmetic plastic surgery procedures in Australia, with most patients getting excellent results and happy with their outcome for many years. Unfortunately, all breast implants have a limited lifespan of around 15-20 years and eventually need to be replaced. This is one of the single largest reasons that women opt for breast implant revision.
Aside from this, the reasons for breast implant revision vary. Some problems and issues can be avoided through careful planning before initially having your implants inserted. Others issues are inevitable with the passage of time and eventual weakening of the implant. While revision surgery typically involves a breast implant exchange, some patients may wish to remove their implants altogether, known as an explant procedure.
It should be noted that breast implant revision surgery is generally more complicated than the initial insertion surgery, and it needs to be handled by an experienced plastic surgeon who can advise you on the best course of action to best meet your needs.
What Are the Benefits of Breast Implant Revision?
Breast Implant Revision is for those who have had past Breast Enlargement and have either developed problems or are unhappy with their final result. This procedure will benefit you if you have previously had implants and:
- The implant has moved out of position, or is rippled or wrinkled
- Are disappointed with implant size, usually undersized
- Are disappointed with the appearance of your breast enlargement
- Complications with contracture or infection have developed
- Are having problems with the implant, such as hardening, leakage, deflation or rupture
- Start to experience systemic problems caused by the implant material
- Decide you no longer want implants
Breast implant revision can also improve the cosmetic appearance of the breasts by removing scar tissue or repositioning the implant. The previous implant is usually replaced with a new one that may be a different size, shape, or texture.
What Can I Expect in the Breast Revision Consultation?
The consultation process allows open conversation between you and your plastic surgeon about what you hope to achieve with surgery. It is important to remember that the purpose of breast revision surgery is to improve the results from a past Breast Enlargement, not to achieve perfection. To better understand your expectations and determine your candidacy, your surgeon will ask about your aesthetic goals as well as your medical history. Be prepared to share details about any medications you are currently taking, if you have any allergies, and any past medical procedures you have had. Please bring any details about your previous breast surgery with you to this consultation as well.
During this first consultation, it is important that you fully explain what your concerns are from the results of your initial Breast Enlargement and how you would like your breasts to look, including size and shape. To help your surgeon get an idea of what you are desiring, it can be helpful to bring in pictures of examples you would like to obtain.
To begin planning for your procedure, your surgeon will take a variety of measurements. A successful Breast Enlargement goes beyond just increasing breast size. Your surgeon will consider several aspects of your ideal look, including the slope of the upper breast, the curve of the breast below the nipple, and the location of the nipple. In addition to examining your body proportions, your surgeon will go through photographs of previous patients with you, asking what you like or want to avoid. You will also have the opportunity to see how different implants may look on your frame by inserting implant samples into your bra.
The entire consultation process typically takes about 45 minutes. After discussing your goals, going over your medical history, and performing a physical examination, your surgeon will give their recommendations. They will also inform you on what the recovery entails and risks associated with your procedure. Please feel free to ask questions at any point during your consultation.
As your procedure gets closer, a second consultation is scheduled to go over your surgical plan to ensure you are happy with your decisions.
What Does the Breast Implant Revision Procedure Involve?
The exact procedure for breast implant revision depends on the issue being corrected. We handle a wide variety of issues including improvements in size or shape, high-riding or malpositioned implants, hardening of implants (capsular contracture), ruptured implants and other concerns.
The specific methods used during your breast explant procedure will be determined by your plastic surgeon, and it will be based on the facts and circumstances in your individual case. To remove the original breast implants, one of three main methods will be used:
- Breast Implant-Only Removal
- Breast Implant Removal with Capsulectomy
- En-bloc Implant Removal and Capsulectomy
In general, the incision is made through the existing scar, and the implant and the surrounding “capsule” are removed. If the breast implants are being replaced with new ones, a new pocket is created and new implants are inserted. The skin is closed with internal dissolvable stitches to minimise scarring.
In some patients, an additional breast lift or breast lift with implants may be needed if the skin is loose, or the breast and nipples have dropped. This would require additional scars.
Breast Implant-Only Removal
This is the fastest and easiest of the three breast implant removal methods that may be used by a plastic surgeon. The capsule that formed around your breast implant is dissected and is not kept intact during the removal.
It is normally possible to use the original Breast Enlargement scar with this plastic surgery method, and drains are not usually required because there is little new raw surface area that could produce fluid accumulation. Muscle repair is usually not performed and recovery is quick after this procedure.
Breast Implant Removal with Capsulectomy
This type of breast implant removal surgery is more complicated than an implant-only procedure. The plastic surgeon will leave your breast implant in place while they remove the lower ¾ portion of the capsule surrounding the implant. The implant will be removed once it is no longer possible to keep the capsule intact, and the remainder of the capsule will also be taken out.
The upper quarter of the breast implant capsule can be thin and filmy, making it difficult to keep intact while still minimizing the incision and scar length. This explant procedure allows your plastic surgeon to balance between minimizing any leakage and keeping your incision and scar as small as possible.
En-bloc Implant Removal and Capsulectomy
En-bloc breast implant removal with capsulectomy means that your breast implant and the entire surrounding capsule will be removed in a single piece. If en-bloc removal is possible it can prevent any of the breast implant contents from leaking into the tissues in the area. This is the most complicated explant procedure that a plastic surgeon can perform, and it usually requires a significantly longer incision and scar than the first two breast implant removal methods.
An en-bloc with capsulectomy may be recommended by a plastic surgeon if you have been experiencing any systemic symptoms caused by breast implant leakage or rupture, or if you have been having an adverse reaction in some way to your breast implants.
There are some situations where breast implant removal en-bloc may not be the best option, such as:
- A large capsule has formed which cannot fit through the incision without being broken up further.
- Capsule removal would cause significant risk. This can be the case when the capsule is tightly adhered to the surrounding tissue or the skin over the capsule is very thin and would die off if the capsule is removed.
Special Considerations with Breast Implant Removal
If you want breast implant removal then you need to realize that capsulectomy and en-bloc procedures have some important limitations and restrictions. It is impossible for any plastic surgeon to guarantee a complete capsulectomy, because at times removing some of the capsule could cause the overlying breast tissue and skin to die off.
Will I Need to Be Hospitalised for My Breast Revision Surgery?
Breast implant revision surgery is performed in a fully accredited facility, under general anaesthesia. The procedure typically takes 3 hours to complete. After the surgery, most patients can go home after a few hours. Drains are not routinely used for revision.
What Is Recovery Like After Breast Revision Surgery?
Following breast implant revision surgery, anaesthesia will begin to wear off, typically with minimal post-operative sedation and nausea. It is normal to feel sore and tired, as well as experience swelling and discomfort; these symptoms are usually well-controlled.
If a capsulectomy is performed you will normally have drains, and these will have to stay in place for a specific period of time. This procedure leaves open areas and raw tissue which will result in fluid production in your body. If this fluid accumulates faster than your body can absorb it then the fluid can puddle and cause a seroma, a condition that is difficult to treat and is best avoided if at all possible. Drains can prevent a seroma from forming.
Dissolving sutures are typically used, preventing the need for removal; in rare cases, non-dissolving stitches may be utilised, which are removed at about two weeks into recovery.
Surgical tape is used for the first week after surgery. Then you will wear a special bra during the day and at night for about 3 to 6 weeks. To maintain your results and reduce sagging long-term, it is beneficial to wear a supportive bra.
You will generally have restrictions on your physical activity for about 6 weeks after a breast implant removal or revision. You may have some discomfort during this period. Your surgeon will advise you on any incision care and the specific restrictions that you have.
In addition to pain medication your plastic surgeon may also provide antibiotics or an antifungal medication if a bacterial or fungal infection is suspected. During the breast implant removal your surgeon may take cultures which will be analysed in a lab to determine whether these medications are necessary.
When Will I See My Breast Revision Results?
Most patients can see how their final breast implant revision results will look at approximately 8 weeks. Post-operative swelling, though minimal, can cause fullness for the first 4 to 6 weeks. The body will continue to heal for several months, and the implants typically settle around 3 months.
When Can I Resume Day-to-Day Activities After Breast Revision?
Since every patient heals at a different rate, resuming one’s normal routine may begin earlier or later for certain individuals. In general, breast surgery patients should avoid strenuous exercise for about 6 weeks, at which point they can begin incorporating more activity.
What Complications Can Arise from Breast Implant Revision?
Surgery always comes with some degree of risk and potential complications. These can include:
- Bruising, bleeding, haematoma
- Issues with anaesthesia
- Allergic reaction
- Deep vein thrombosis
Risks and complications specific to breast implant revision include:
- Ongoing dissatisfaction with the appearance of your breasts
- Capsular contracture (hardening of the layer around implants)
- Reduced nipple sensation
- Seroma (fluid around the implant)
- Wound Breakdown
More details about the risks and possible complications will be explained to you during your consultation process.
Will Breast Revision Surgery Leave Scars?
Since the incision for breast implant revision surgery is usually made through the existing scar, there should be no additional scarring, unless skin tightening (“mastopexy”) is required. Any scarring should gradually fade and are in areas that become less noticeable over time.
Breast Implant Revision Before & After Pictures
Breast Implant Revision Surgical Animation Video
How Much Does Breast Implant Revision Cost?
Breast implant revision surgery attracts Medicare and health insurance rebates under special circumstances, where surgery is undertaken for medical reasons or for certain complications from implants, such as rupture or capsular contracture.
Size dissatisfaction is not covered under Medicare or Health Insurance.
Costs include your surgeon, anaesthetist, hospital fees and implant costs (private health insurance may cover the last two, if your level of cover is appropriate).
You will need to contact your insurance provider to learn about your coverage for hospital and associated fees. A personalised quote will be provided during your consultation.
What Else Should I Consider Before My Breast Revision?
Maintaining realistic expectations about your surgical outcome is one of the most important factors for achieving a successful procedure. Results from breast implant revision are intended to improve a previous outcome from Breast Enlargement; they are not a guarantee of an enhanced life. However, patients often feel a boost in self-confidence after the procedure.
Prior to your surgery, it can help to plan for your recovery by arranging for help from others as you heal. You may also want to familiarise yourself with how to identify and respond to complications should they occur.
With careful treatment planning, repeat breast implant surgery should not be necessary.
Any More Questions About Breast Implant Revision?
If you have any other questions or concerns about breast implant revision surgery, please feel free to contact our office. Our knowledgeable staff will be happy to assist you.