Revisional Surgery

If you have previously had cosmetic breast surgery and the result has deteriorated over time, then you might be a good candidate for a revisional procedure. The commonest complaints that patients have are, hardening of breast implants, possible implant ruptures and change in the shape of their breasts. Factors such as aging, large weight fluctuations and pregnancy, all play a role in the way breast evolve over time. Silicone in implants, is not a dangerous substance and even if implants rupture, there is no urgency in replacing or removing them. This needs to be carefully planned and the treatment tailored to you and your needs. Sometimes a mastopexy is also required upon replacing the implants, to remove excess skin and improve the shape of the breasts. Some patients decide that they do not want to continue with implants and the volume can be replaced with fat. Other procedures that might require eventual revision, include old breast lifts or reductions, augmentation mastopexies or any other such intervention.

This can be challenging surgery and I always say that although revisions can produce some wonderful results, the risk of not getting it ‘perfect’, is much higher than first time surgery. With careful surgical planning however, the results should be long lasting. Factors such as aging, weight fluctuations, large implants and pregnancy can deteriorate a result, so the timing needs to be considered carefully.

This really depends on the surgery required, but it can range from two hours to four hours for the more complex cases.

There is always an element of discomfort with any surgery. Local anaesthesia is additionally given during the surgery and combined with post-operative oral analgesia, should keep you very comfortable during your recovery.

Recovery time varies between two to three weeks. Incisions are generally healed within a week to ten days. As a general rule, you should avoid any heavy lifting or vigorous exercise for six weeks after surgery. You are of course encouraged to move as normal, to minimise the risk of chest infections and leg clots. The final result including scar appearance is usually evident once all the swelling has subsided and this can take up to 12 months. Using a single layer of the provided micropore tape on the scars for 6 – 12 weeks, will give the best results possible. If this is not tolerated, scar surgical massage is a good alternative, starting after the first 3 weeks when all the wounds have healed. Scars should not be exposed to direct sunlight without the application of a high SPF cream for about a year and products such as Cicaplast contain both silicone and SPF block. There are however other alternatives. A post-operative surgical or sports bra (depending on the surgery), should be worn at all times for 6 weeks.

A surgical bra will be required, as it provides support and comfort and depending where your surgery takes place, this will either be provided for you (Spire Clare Park), or one will be recommended to you for purchase. It is recommended that this is worn day and night for six weeks following surgery.

Although I rarely use drains in routine breast surgery, these might be necessary for revisional work. I will assess every person individually and we can plan this together.

Some of the general risks include discomfort, risk of poor scarring, risk of infection (1%), altered nipple sensation or loss, risk of bleeding, bottoming out, need for revisional surgery, degrees of asymmetry, loss of the ability to breast feed and delayed wound healing. Your nipple sensation may decrease, increase (hypersensitivity), or lost completely (including erotic sensation) and this might be different between the two sides. This can improve over time as the nerves recover, but it is difficult to predict and it is not guaranteed. Depending on the individual procedure performed, there are certain specific risks and these can be found in the augmentation, mastopexy and lipofilling pages. I will generally not perform a revision procedure or any other breast cosmetic procedures on active smokers. This is because the risks to smokers are far greater, including infections, fat necrosis, seroma and poor scarring. There is always the risk of stretching of the scars and development of poor-quality thick scars, such as hypertrophic or keloid scars. Lastly like in all surgery, there are no guarantees for a perfect outcome.