It’s unfortunate but true… nothing lasts forever, and the same can be said for a breast augmentation, even when it’s done to perfection. While Dr. Lowenstein’s re-operation rate on his own breast implant patients is less than 5% for any reason, the average rate of re-operation in the United States approaches 15%. There are several reasons that a woman might want her breast implants replaced. Women from all over seek out Dr. Lowenstein for his experience in breast implant revision surgery because while it one thing to create a beautiful breast, it is another all together to improve the look or feel of a breast that has undergone capsular contracture, deflation, malposition, or drooping. Breast implants can be subjected to several factors that can cause capsular contracture or rupture of an implant over time. Except for diamonds, everything in the world is subjected to wear and tear, and Dr. Lowenstein thinks it is the responsibility of every plastic surgeon to explain that any woman who gets a breast augmentation may require further surgery down the road. Conveniently located in Santa Barbara, Dr. Lowenstein commonly cares for many breast implant revision surgery patients from Santa Maria, Bakersfield, Ventura, and Thousand Oaks. For more information on Breast Implant Revision Surgery, Contact Us Today
The normal tissue around the breast implant is usually soft and supple. When capsular contracture occurs, this tissue surrounding the implant becomes tight, firm, and sometimes thick. The breast can then become firm or hard, and capsular contracture patients can often see ripples or deformity in their breast. Sometimes the only sign of contracture is that the implant on one side seems higher than the other side. Capsular contracture can manifest in many ways, and although it is not completely understood, there are some particular maneuvers Dr. Lowenstein uses to achieve his low contracture rate. Often patients who have had surgery elsewhere will present to Dr. Lowenstein for his help in rectifying their situation. Capsular contracture surgery has historically meant that the entire capsule or scar tissue surrounding the breast implant had to be removed, but new techniques have found a high success rate by manipulating the capsule rather than removing it all together. To see if this less invasive operation is right for you, a consultation with Dr. Lowenstein can inform you of the best way to achieve a soft, natural appearing breast once again.

Breast Implant Rupture

Breast implants can rupture over time, and this can mean different things to different women. Breast implants filled with saline, when leaking, will deflate causing one breast to become smaller than the other. Because your body is mostly salt water to begin with, the saline from the inside of the breast implant simply gets absorbed by your body while the volume of the implant decreases. If left alone, the tissue surrounding the implant will slowly contract, collapsing on the pocket which originally held your implant. It is important to try to have a leaking saline breast implant evaluated sooner rather than later, as achieving excellent symmetry with the opposite breast becomes more difficult once the tissue around a leaking saline breast implant begins to significantly contract. Dr. Lowenstein tries to operate on patients with leaking saline breast implants within 2-3 weeks of noticing the problem in order to maintain the best opportunity for a fantastic outcome.
Silicone breast implants are different from saline implants in several ways. One of the main factors is that the silicone in these implants is NOT absorbed by the body, and so it may be more difficult to detect a rupture or leak in a silicone implant. This is the principle reason that the FDA recommends MRI evaluation of silicone breast implants after 3 years and every other year thereafter. While newer breast implants have silicone gel in them that is highly cohesive, older breast implants used a more liquid type of silicone that often leaked throughout and sometimes outside of the pocket where the breast implant was placed. In Dr. Lowenstein’s extensive experience in secondary breast surgery, the leakage of liquid silicone from these older implants is the most significant factor contributing to the development of capsular contracture and excessive scar tissue. Women with leaking old silicone implants can present with hard, deformed breasts which require not only removal of the old ruptured implant, but significant amounts of scar tissue which often contains hard calcium deposits surrounding collections of free silicone. Dr. Lowenstein’s advanced techniques allows for removal of both free silicone and problematic scar tissue to restore a soft and natural appearing breast shape in these cases as well. Newer cohesive breast implants are thought to have less problematic complications as compared to the older liquid silicone implants, and current breast augmentation patients can be much less concerned about such problems.

FAQs: Breast Revision

  • Will breast revision surgery be able to correct my capsular contracture?

    Capsular contracture is perhaps the most common reason Dr. Lowenstein sees breast implant revision patients from other surgeons. Removal of the capsule and exchange of the breast implant is the usual course of action for these patients, and in patients who have a sub-optimal breast implant pocket, the pocket for the breast implant may be changed at this operation to provide a more natural postoperative outcome.

  • How can I tell if my implants need to be replaced?

    Breast implants usually do not need to be replaced unless there is a problem with them. If your breast implants are saline, you might notice a deflation if one breast becomes smaller than the other. If your breast implants are silicone, you may need an MRI to tell if they are still intact. The FDA recommends patients with silicone implants get an MRI of their breast implants three years after they are placed and every other year after that to make sure they remain intact. Other reasons that patients replace their implants are to get smaller or larger implants or for capsular contracture. If your implants don’t look as natural as you would like, Dr. Lowenstein may be able to revise your breast augmentation to create a more attractive appearance.

  • Do you reuse my old implants?

    In most cases, breast implants are replaced during breast revision surgery. That is not absolutely necessary if your implants are in good shape, but most women ask for a new set of implants to maximize the length of time that the new implants will last, rather than use implants that have some wear and tear on them.

  • Am I too old for a revision of my breast surgery?

    Many women are concerned that having their breast implant surgery revised is something only for “younger” women, but this is not the case. In Santa Barbara, Dr. Lowenstein performs breast augmentation revision and breast lift revision on women into their seventies. Your health at any age is more of a concern than your age itself, and a 30 year old woman with multiple medical problems is less likely to be a candidate for breast surgery revision than is a healthy 70 year old.

  • Should I remove my implants completely?

    Complete removal of your breast implants is certainly possible, but often comes with some aesthetic trade off. Most often when patients want their implants removed breast lift or a sometimes smaller implant is used to maintain an attractive breast form. Since each patient’s anatomy and goals are different, discussing your wishes with Dr. Lowenstein will allow him to provide you with an optimal education for expectations and outcomes.

  • Can breast implant revision fix asymmetry between breasts?

    Some breast asymmetry is normal with or without implants, but sometimes Dr. Lowenstein sees patients from other surgeons where the implants themselves have made things worse rather than better. Improvement of asymmetry is a very reasonable goal of breast augmentation revision as well as revision of breast lift procedures. Different surgical techniques may be used depending on the particular issue, and Dr. Lowenstein is well versed and experienced in improving breast symmetry with breast augmentation, breast lift, and revision of breast surgery as well.

  • Can I change my implant size or type with implant revision surgery?

    Changing the size of your implants is another excellent reason to have breast revision. If your breasts are too large or too small, a change of implant can help fix this with or without other surgical techniques such as manipulation of the breast implant pocket, lifting or resecting extra sagging skin, or changing the capsule around the breast implant to create a more pleasing breast mound.

  • What if you just don’t like the way your breast implants look?

    Perhaps the most frequent reason Dr. Lowenstein performs secondary breast enhancement procedures is because of breast ptosis, or drooping of the breast- nobody escapes the effects of father time. Surgery to rejuvenate breasts such as these may or may not require new implants, and may or may not require changing the pocket in which the original breast implant was placed. Additionally, a breast lift or mastopexy might be recommended to reposition the breast tissue to it’s proper position and create an aesthetic and proportional breast shape. These patients are so often thrilled by their renewed breasts as many of them had not realized the opportunity for such significant improvement until their consultation with Dr. Lowenstein.

    As a women ages, your breasts can grow with changes in your body associated with pregnancy or weight fluctuations. Previously small breasted women who have undergone breast augmentation may then find that their breasts are now larger than they wish. Such patients may ask for smaller implants, or for their previous implants to be removed and their breasts rejuvenated utilizing their own breast tissue alone. Here again breast lifting may be helpful in conjunction with revision or removal of the breast implant itself.

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