Reasons for secondary breast surgery
Situations requiring secondary surgery occur in 7.5% of all mammary augmentation surgeries due to:
- Implant deflation or rupture – saline or silicone implant damaged
- Implant malposition – implant moves out of normal placement
- Surgery complications – bleeding, infection
- Abnormal breast scarring – capsular contracture, hypertrophic scars
Breast implant deflation or rupture
Like all man-made products, both saline and silicone implants can fail as medical devices.
- Saline implants can deflate due to either a failure of the valve used to fill the implant or a “fold failure,” in which the implant’s silicone shell develops a crack from repeated folding. The saline in the implant will leak out and be absorbed by the body and a new implant will need to be placed. Failure of implants typically occurs between 10 and 15 years after implantation.
- Silicone implants can also rupture due to fold failure. In this case, the silicone gel will leak into the breast pocket and will need surgery to be removed and a new implant.
Breast implant malposition
Sometimes, due to the weight of the implant and its effect on weak tissues in your body, the breast implant can move to a lower or more lateral position than desired. In these cases a second surgery may be needed to make the pocket smaller by placing sutures. A new implant may be necessary in these types of surgeries.
- Infection is an unfortunate complication that occurs in 2% of cosmetic breast surgeries. Even though patients are treated with antibiotics during and after the surgery, infections still occur! In these cases, the implant needs to be removed. The patient will then have to wait at least three months before a new device can be placed.
- Bleeding occurs in 2% of cosmetic breast surgeries. The device will need to be removed in most cases along with the blood. The device may need to be replaced, depending on whether it has been exposed to the air or not.
Abnormal scarring/capsular contracture
Scarring that forms around the breast implant is normal. This is called a breast capsule and is usually a thin scar. In some patients, for unknown reasons, the capsule will become much thicker and contract around the breast implant, causing a hardening of the breast. In these cases the implant will have to be removed along with the scar tissue and replaced.
In some patients, the scars will become thick and unsightly. They may also be itchy, red and painful. In most cases, these scars need to be revised under local anesthesia in the office, though they can be injected with steroids to help calm the inflammation.
Secondary surgeries are sometimes necessary for cosmetic breast augmentation patients. Though rare, these situations require patience and understanding on the part of the cosmetic patient and the cosmetic plastic surgeon’s empathy and help.
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