Revision Breast Augmentation
Mr Awf Quaba has extensive experience in revision breast augmentation having operated on hundred’s of women over the last 3-4 years with PIP breast implants. Revision or secondary breast augmentation can range from being a simple procedure to being a very complex one. There are a multitude of factors involved, and we explore some of these in the text below.
How often do breast implants need to be changed?
Breast augmentation is the most common cosmetic surgical procedure, and it is inevitable that some women will require revision breast augmentation at some point. Data from the FDA (the regulator in the USA) suggests that one in five cosmetic implants are explanted (removed and not replaced) or replaced within ten years.
Why do breast implants have to be replaced/ revised?
A. One of the most common reasons for revision is up-sizing – patient requesting larger breast implants.
B. Capsular contracture (abnormal scar tissue around an implant) resulting in hardening of the breasts and adverse changes in their shape.
C. Being able to feel/ see the edge of an implant, visible ripples, folds or creases (seen or felt) can all be indications for revision.
D. A shift in the position of implants from their original location (implant malposition) resulting in a wide gap/ poor cleavage, high riding implants or bottoming out (abnormal low lying position) with lack of support.
E. Droopiness of the native breast tissue resulting in the so-called “double-bubble” appearance.
F. Breast asymmetry (noticeable difference in size, shape or position)
G. Other indications for revision may include, unsatisfactory scars and/ or disproportionately large nipples.
The above indications for revision breast surgery may be related to the implant, the initial surgical technique or to problems with the breast tissue surrounding the implant. These might include a change in the volume of the breast tissue and/ or loss of skin elasticity. Factors contributing to this include ageing, pregnancy, breastfeeding, weight variation, sun damage and smoking.
Do breast implants need to be replaced every 10 years?
The answer is no as long as women are satisfied with the long term cosmetic result and there are no concerns about the integrity of the implant and the safety of the filler material.
What would breast implant revision involve?
Depending on the patient, revision surgery may involve one or a combination of the following procedures:
A. Removal of the old implants and replacement with “like-for-like” or different size, type or shape implant.
B. Removal of thickened contracted scar tissue lining the implant pocket (capsulectomy).
C. Modification of the existing implant pocket to allow for the insertion of a much larger implant and/ or reducing the gap between the implants (capsulotomy).
D. Modification of the existing implant pocket to correct bottoming out which results from a descent of the breast crease and lack of support.
E. Breast implant pocket switch from above to below the muscle to address rippling and recurrent capsular contracture.
F. Breast uplift/ reshaping (mastopexy) to correct droopiness.
How does recovery compare with that of the first operation?
Women contemplating revisional surgery will have some idea of what the procedure is like (having had a previous breast augmentation). There are many similarities to the original procedure, but there can also be some significant differences depending on the complexity of the revision procedure. A simple exchange of implants for implants of comparable shape/ size can be quite straightforward as no major work is required on existing implant pockets. The surgical procedure can be fairly quick. On the other hand, if the surgery is complex, the procedure will take longer, and the recovery would be more involved. Examples of complex revisional surgery include correction of capsular contracture, implant malposition and breast uplift.
What are the risks?
Revision breast implant surgery is an operation of varying complexity, and a has a degree of unpredictability. There is no guarantee of a satisfactory outcome, and further surgery may sometimes be necessary. All operations carry associated risks including those of the anaesthetic and infection. All complications and long term problems that follow the primary breast implant procedure can happen following revisional surgery.
What are the costs?
Revisional surgery usually costs more than the initial implant procedure and varies depending on the complexity of the revision. Further information may be obtained from the customer services department of the Spire Murrayfield Hospital.
We cannot give a firm price until full assessment due to the potential complexity of revision breast augmentation.
Breast augmentation with Exchange of implants £4700
Revision Breast augmentation combined with Breast lift (minor lift) £6400 (full lift) £7500
Removal of breast implants £3500
All inclusive costs for one year following surgery
Finance is available (subject to application and vetting) through a company working with the Spire Hospital. They offer interest-free loans up to a particular value. They can usually provide a decision online within 15 minutes.