Breast augmentation revisions
Breast enlargement surgery revisions are a tricky topic since its is a mixture of a number of factors which are all prickly to consider for plastic surgeons and patients. This patient came to me complaining of differences in breast size after surgery elsewhere. The previous plastic surgeon had placed two implants of markedly different sizes in her. I assume he had his reasons. She was unhappy with the difference in size and in the revision surgery I performed, I placed two implants of the same size for a great result. However, breast revision surgery can be a tricky surgery due to previous scarring and changes in blood supply and the results can sometimes be worse! A careful analysis of the risk benefits of the cosmetic breast surgery must be performed. Even here the difference may not be noticeable to the untrained eye!
Causes for breast augmentation revisions include
- Technical error by plastic surgeon
- Poor tissues and tissue healing of patient
- Lack of patient following directions post op
- Complications of surgery
- Perception of a bad result by patient
- Perception of a bad result by plastic surgeon
- perception of results by everybody else
- Bad luck
Problems arising from technical errors by the surgeon at surgery include
- rupture of breast implants
- mal-position of breast implants
- Inadequate hemostasis leading to bleeding
These problems arise from poor genetics on part of patients.
- Loose skin /poor elasticity
- Thin skin / lack of strength
- Reactive skin / skin which does not heal properly
Poor follow up
Specifically poor follow up of the plastic surgeon’s directions. After breast augmentation massage is essential. Lack of massage can lead to capsular contracture and breast hardening needing a revision surgery.
Complications of Breast surgery
- Nerve damage
- Implant deflation
- These are all known reasons for complications of surgery amongst many others
Perceptions of surgery result
Perceptions of defects ion the surgery results and the reason to change the surgical result with another procedure differ amongst
- Plastic surgeons- for whom minor defects in the surgical result are acceptable based on the patient’s anatomy and the naturalness of the result
- Patients – who may have expectations that are not real. Often patients forget that their two breasts are not exactly the same and never will be
- Friends and family of patients may say something regarding the surgery result which even the patient and plastic surgeon were unaware of .
Sometimes the reason is just bad luck and no known cause can be found and there is no one or anything to blame!
In summary- beware of revisions and listen to your plastic surgeon. Sometimes the risk is just not worth it.