Breast Revision Surgery in Toronto
Breast revision surgery is the umbrella term for any breast procedure that is done following prior breast surgery. Within the area of cosmetic breast enhancement surgery, this term encompasses:
- Patients who may be dissatisfied or have a problem with their original result
- Patients who want or need to have their implants replaced
Considered one of the top plastic surgeons in Toronto, Dr. Lawrence Tong has the training and expertise to safely and effectively perform breast revision surgery with beautiful results that look natural.
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Optimal Timing of Breast Revision Surgery
In general, breast revision surgery should be performed at least 6 months after the initial surgery, although there are exceptions. The basis for waiting has to do with scar tissue maturation and breast tissue settling following surgery.
Scar Tissue
With any type of surgery, scar tissue will form in the area of the procedure. This includes scars on the skin’s surface or internally within the breast. Scar tissue in the first 6 months after surgery tends to be dense and unyielding, making any further surgery in that area more difficult. Additionally, the area tends to bleed more when the scar is at this immature stage. After 6 months, the scar tends to become softer, and surgical procedures tend to become easier to accomplish and have less blood loss.
Breast Settling
During the first year after any breast surgery, there are changes that occur as a part of the natural healing process. This includes the effects of gravity, plus the skin and soft tissues relaxing over time. As healing progresses, a breast will settle, changing its overall shape and position. This settling tends to result in the breast looking much more natural. Performing revision breast surgery prior to full settling can result in performing surgery unnecessarily, or be akin to trying to hit ‘a moving target.’
Reasons for Breast Revision Surgery
There are a number of issues that may prompt a woman to seek breast revision surgery. Some women pursue breast revision surgery for cosmetic reasons, while others seek to rectify breast implant complications.1,2
Deflation of Breast Implants
Deflation or leakage of a breast implant usually occurs when the shell of the breast implant is compromised (usually many years after they are placed). This should be considered an anticipated outcome of breast implants, as they are not expected to last a lifetime. Breast implants on average last between 10-20 years. When deflation occurs, patients have 3 choices:
- Do nothing (not recommended)
- Remove and replace the affected implant/both implants
- Remove the implants all together
Breast implant manufacturers currently warrant their implants for a lifetime, and most patients will be able to receive one or both implant replacements at no charge from the manufacturer.
If you have a deflated implant or suspect you may have a deflated implant, Dr. Tong will evaluate your case and carefully discuss your options. Surgery to replace or remove implants usually involves going through the original incision; the old implant is removed and a new one is placed.
Capsular Contracture
Capsular contracture occurs when scar tissue around a breast implant becomes thick. A patient may notice that the breast feels firmer or looks less natural. Capsular contracture is more commonly found in patients with implants placed over the muscle. This is one reason why Dr. Tong recommends his patients have their implants placed under the muscle. Leakage of silicone implants can also result in capsular contracture. This is especially true with patients who have older generation silicone implants. The current generation of highly cohesive silicone gel (gummy bear) implants ostensibly do not leak silicone when the shell is compromised.
Capsular contracture is treated by removing the scar and/or replacing the implant under the muscle as needed.3
Breast Ptosis (sagging)
As patients age, undergo weight changes, or become pregnant, the breasts may become ptotic (sag). The development of ptosis can also occur in patients who have had previous breast enhancement surgery, due to the same factors.
A Breast Lift (Mastopexy) can be carried out to correct breast drooping after prior breast enhancement surgery. Special consideration must be made in these patients as there are certain pitfalls that are not present with non-operated breasts. Make sure that your surgeon has experience in dealing with these types of issues. Dr. Tong can evaluate your situation prior to surgery and formulate a plan to correct the issue(s) at hand.
Scar Revision
Scars on the skin from breast surgery may occasionally be wide, thick, or dark. Scar revision is a surgical procedure to correct these unsightly scars. The procedure involves cutting out the old scar and re-sewing the incision. In some cases it may be performed under a local anesthetic, without the need for sedation or general anesthesia. Timing for breast scar revision generally is after a minimum of 6 months, or when the scar is no longer changing. Waiting longer (1 year or more) will usually result in a better overall outcome.
Breast Asymmetry
Asymmetry following breast enhancement surgery may occur over a period time, or it may be present initially. There is a wide range of presentations and each case must be evaluated individually. Options that may be used to correct breast asymmetry include any combination of implant removal, exchange, repositioning, pocket exchange, scar removal, breast lift or breast reduction. Dr. Tong can make recommendations about your particular case.
Replacement to a Different Size
Dr. Tong puts a great deal of effort into ensuring the implants chosen for a primary Breast Augmentation will be the ideal one for that patient. It is very rare that a patient will want a different implant size shortly after their initial Breast Augmentation.
More commonly, the choice to replace implants to a different size occurs when there is a deflation, or some other basis for breast implant revision. These situations present an opportunity for patients to change both implants. Replacement may either be a larger or smaller size. Depending on the situation at hand, the incision used for the original surgery can be used for the replacement procedure. Some adjustments to the pocket, such as expanding its size, are required if a larger new implant is being placed.
Your Breast Revision Surgery Consultation in Toronto
There may be much information to absorb during your initial breast revision consultation, and Dr. Tong will make sure that you are informed every step of the way. He will take his time to answer all of your questions. You will never be rushed. You will never be pressured into making a decision. Our goal is to have you become an educated patient. We know that an educated patient will make smarter choices about their surgery and their surgeon.
To learn more about how Toronto Breast Revision surgeon Lawrence Tong, MD can help with breast revision surgery, set up a consultation with Dr. Tong by giving us a call at (647) 931-1287, or let us give you a call. Just fill out our contact form and we will call you on the same or the next business day. No physician’s referral is needed.
See Dr. Tong’s work in our Breast Revision before and after photos.
1 American Society of Plastic Surgeons. What is breast implant revision surgery? Available: https://www.plasticsurgery.org/cosmetic-procedures/breast-implant-revision. Accessed September 2, 2020.
2 U.S. Food & Drug Administration. Risks and Complications of Breast Implants. Available: https://www.fda.gov/medical-devices/breast-implants/risks-and-complications-breast-implants#Implant_Complications. Accessed September 2, 2020.
3 American Society of Plastic Surgeons. What is capsular contracture and how can it be treated? Available: https://www.plasticsurgery.org/news/blog/what-is-capsular-contracture-and-how-can-it-be-treated. Accessed September 2, 2020.
Dr. Lawrence Tong has either authored or reviewed and approved this content.