General Comments

Although fully trained in all aspects of Plastic Surgery Dr. Edwards has chosen to specialize in breast and body procedures and he sees patients from many parts of the world that are unhappy with their breasts and desire a change.

Breast augmentation is a procedure that is assumed by many to be so simple that almost anyone can perform it. The procedure is actually complex in nature in that every woman, in fact every breast must be considered individually and proper planning and execution are critical to a good outcome. We tell all of our patients that they really have one opportunity to have their first breast augmentation. By this we mean that the patient should be as discriminating in who they pick to perform their breast surgery. In the arena of cosmetic surgery there are dentists, Family Practitioners, OB/GYN, General Surgeons, Ear Nose and Throat Surgeons and even Dermatologists who advertise and perform breast surgery. It is often not until we have met breast revision patient that they realize they did not have a plastic surgeon as their doctor. A cosmetic surgeon is not the same as a board-certified plastic surgeon; they have not had the same rigorous training. This is a topic for another article.

The common reasons for revision breast surgery are implant deflation, changing implant size, capsular contracture, implant malposition, a double-bubble deformity and the more complicated revisions usually result from poor decision making in the part of the first surgical procedure. Many women are not good candidates for a breast augmentation alone at their first surgery and should have had a breast lift as well. A common example of this is a patient who has breast laxity or sagginess after having had children or losing weight. Some surgeons will stage these procedures either performing the lift first, followed by the breast augmentation or visa versa. Every patient is an individual and should be evaluated and treated as such.

We will review the issues that often bring patients in to see us for revision surgery. They can occur individually or in combination as you will see.

Implant Deflation

Saline implants can leak or “rupture” leading to a distressing situation for the patient. Although it is helpful to evaluate and treat these patients as soon as possible, Most implants placed in the US now come with an implant warranty where the implant manufacturer will replace the implant. The same is true of silicone implants except you would not know if your silicone implant had a structural defect, aka crack. It would take either a surgery or an MRI to tell you that there was a chance that the implant was defective. Treatment may be as simple as removing the deflated implant and replacing with the same size or you may have decided that you would like to change your implant size. As stated before, each case is different and the starting point is different. If you have a capsular contracture or thin tissues covering your implants, there may be good options to improve on your breast aesthetics (see the complicated cases at the end of this article). If it has been awhile since your primary surgery, your breasts may have changed from changes in your weight or with pregnancy. If this is the case you may need to entertain having a breast lift in addition to tighten your breast tissue and move your nipple to a position more at the apex of your breast.