Breast augmentation isn’t a perfect science, and a patient may desire revision surgery. Whether she decided she would simply like larger implants or whether there has been some other issue, revision surgery is generally easier than the original surgery. Here are some reasons Dr. Hetzler has performed revision surgery, and the approach taken for each.
Besides possible rupturing of the implant, this is the main side effect of breast augmentation. When an implant (or any foreign object) is placed into the body, there is a reaction, as you would assume. This reaction is called the “capsule” and it is made up of calcified cells and scar tissue. If this capsule becomes very thick and causes the implant to shift or the breast to feel very firm, or if there is pain from the constricting scar tissue, this is called capsular contracture. When this occurs, surgery is usually required. If the capsule is very calcified, Dr. Hetzler will remove it along with the implant. If that hasn’t happened, he may leave the capsule. If there is a rupture of a silicone implant, the capsule may contain silicone shell fragments, silicone gel, and inflammatory cells that all need to be removed prior to placing new implants.
Changing the implant size
Sometimes a woman decides she would like a different size implant. This isn’t a decision that should be made soon after surgery, however. Dr. Hetzler advises patients to be, well, patient. He wants them to wait one full year before deciding to make a change. This will allow the implants to fully settle into their final position, and any residual swelling will have passed by then. If the patient still wants to change her implant size, Dr. Hetzler will enter through the original incision. If a larger implant is desired, he will increase the size of the pocket, the space in the breast to hold the implant. If the patient seeks smaller implants, the size of the pocket is reduced with sutures to fit the smaller implants. In cases of reduction, a breast lift may be done in conjunction with the implant revision to remove any sagging tissue and possibly relocate the nipples.
Sometimes a less experienced surgeon will place the implant pockets either too far away or too close together and the patient is not happy with the placement. In these cases, the scar tissue from the capsule can be used to reconstruct new pockets in better positions.
Implant rippling is usually a result of saline implants that have been placed atop the chest muscle. There isn’t enough skin and tissue to cover the implant, and rippling occurs. Sometimes the edge of the implant may even be able to be felt. Dr. Hetzler enters through the original incisions and replaces the implants with better muscle coverage. This may involve switching implant types and/or placing them in new breast pockets. Silicone gel implants have less occurrence of rippling, and gummy bear implants won’t ripple.
When a patient decides she no longer wants to have her implants, they are removed through the same incisions. Dr. Hetzler will also remove the capsule if it is calcified and thick. Many times, he will recommend a breast lift at the same time to remove excess sagging skin and breast tissue.
It’s important to remember that breast augmentation is major surgery. It’s not something to trust to a low-ball estimate or an inexperienced practitioner. Dr. Hetzler is a board-certified plastic surgeon with extensive experience. Do your research beforehand and the odds are you’ll be happy with your results.
If you have questions about possibly revision surgery, or anything to do with implants and augmentation, don’t hesitate to call Dr. Hetzler at (732) 219-0447.