Secondary Surgery after Implant Breast Reconstruction
Expander Implant Exchange and Revision
The process of breast reconstruction with implants is inherently staged in nature, usually requiring more than one operation to achieve a final breast shape. Breast revision procedures following implant reconstruction are typically done as outpatient procedures usually utilizing the healed mastectomy scar so that no new incisions are needed. In many cases, secondary breast revision can also be done at the time of nipple areola reconstruction.
In the setting of expander-implant reconstruction, the first stage involves the placement of the tissue expander while the second requires expander-implant exchange and revision. This second stage of the breast reconstruction allows for the creation of the final breast shape although additional revision surgery may also be necessary to achieve the best possible results. While direct-to-implant or “one-step” breast reconstruction with an implant avoids the use of a tissue expander, secondary revision procedure may still be desired in order to maximize the quality of the breast reconstruction outcome.
If you are considering secondary revision surgery to improve the outcome of implant breast reconstruction, please feel free to contact Aesthetic Plastic Surgery, PC today to arrange a consultation with our team of reconstructive surgeons.
Implant Exchange Procedure
Breast implant exchange is an outpatient procedure that is quick, straight-forward, and presents minimal risk. At the time of implant exchange, changes may be made to the implant pocket before the final implant is placed. Potential corrections to the implant pocket may include capsule repairs improving the inframammary fold, or other alterations of the capsule and surrounding breast skin that may allow improved positioning of the implant on the chest wall. In some cases, an acellular dermal matrix such as AlloDerm® may be placed to support areas of thin skin. After needed adjustments are made, the implant is placed into the pocket and the incisions are closed. If additional surgeries are required, such as surgery on the opposite breast or reconstruction of the nipple areola, it is recommended that the revised breast implant reconstruction fully heal before any further surgery.
Breast Implant Revisions
Following breast implant reconstruction, revision procedures may be desired to address contour problems that relate to the capsule and skin surrounding the breast implant. In addition, if there are problems that arise related to the implants, corrective surgery may be recommended. At Aesthetic Plastic Surgery, PC, our surgeons perform hundreds of implant breast reconstructions every year so that our team can help ensure that the results you desire are realized. Typical breast implant revision procedures include:
- Capsular Contracture Surgery - A capsule is the internal layer of scar tissue that occurs around the breast implant. This is normal and typically causes no complications; however, if the capsule scar tissue contracts, or shrinks, it can cause uncomfortable tightness and may even be visible. Should this occur, revision surgery can potentially allow release of thick or abnormal capsule. In some cases removal of a portion of capsule or removal of the entire capsule may be needed to alleviate the tightness and create a softer breast reconstruction.
- Contour/Symmetry Correction Surgery - If the contour or symmetry of the breasts is abnormal following implant reconstruction, revision surgery can frequently address the issue. An undesirable contour can be corrected by reshaping the skin envelope around the breast or through fat grafting using fat harvested with liposuction. Though fat transfer may not produce the desired results after the first procedure, a second session may be utilized if needed, as the procedure is minimally invasive and has the added benefit of shaping the harvest site where liposuction is done. Asymmetry of the breasts can be corrected through surgery on the opposite breast or by reshaping the reconstructed breast.
- Acellular Dermal Matrix Placement - Problems with implant malposition, capsular contracture and thin skin can frequently be improved with revision surgery utilizing the placement of an acellular dermal matrix such as AlloDerm®. When an implant capsule is repaired in order to help improve implant positioning, the acellular dermal matrix may help to reinforce the capsule. Similarly, when implant capsule is removed in order to address capsular contracture, the acellular dermal matrix may be used to reinforce thin skin that might otherwise allow implant irregularities to be visible. One common irregularity, particularly with the use of saline implants, is rippling of the skin overlying the implants. To reduce the appearance of skin rippling, revision surgery may include the placement of an acellular dermal matrix to bolster the strength and thickness of the skin around the breast implant.
Contact the Plastic Surgeons of the
New York Breast Reconstruction Associates at Aesthetic Plastic Surgery, PC
Don’t hesitate to contact our Long Island plastic surgery office today to arrange a consultation with our team – we would be happy to help. All of our surgeons are experts in breast reconstruction and can help you achieve quality outcomes at each stage of the breast reconstruction process.