Breast Augmentation Revision:

Breast augmentation, while usually a very satisfying procedure with beautiful results, can in rare instances result in suboptimal settling of the implants. On occasion, the breast surgery must be revised because of mal-position of the implant, or the desire for a different look or outcome. Because of his vast experience with breast augmentation, Dr. Zimmerman sees patients referred to him who are not pleased with the results they have obtained elsewhere, or desire a change in their breasts, or revision or replacement of an old implant. Each of these surgeries is unique, depending on the problem at hand. An old silicone implant may require removal of the implant and scar tissue surrounding it (capsulectomy), with replacement using either a saline or silicone implant. An implant may require re-positioning either above or below the pectoralis muscle.

Occasionally, all that is required is adjustment of the dimensions of the ‘pocket’ in which the implant is sitting, or change of the size of the implant. It is also possible to see an implant, which has migrated too low on the chest wall, resulting in ‘bottoming out’ of the breast and the nipple pointing upward. This may require a challenging revision called a capsulorrhaphy to close down the inferior aspect of the pocket. After childbearing, the implant may remain in place but the overlying breast tissue may droop, requiring a breast lift. There are also times when revision is not advised, such as when further enlargement would result in breast sagging or implant wrinkling from overly stretched skin, or when further improvement could not be guaranteed.

During consultation with Dr. Zimmerman, an extensive review of the findings, anatomy, and possibilites for revision are discussed. Time is spent reviewing photographs and reaching a mutual understanding of the desired appearance of the breasts. There are many variables to consider when performing an augmentation including the maximum size implant one can safely accommodate when a larger breast size is desired, and the placement, and anticipated settling of the implant. There will always be settling of the implant and resolution of the swelling (edema), which occurs over the first three months following the surgery.