Breast Revision Surgery
Doctor Ballieux has advanced training to deal with the issues of breast revision surgery such as breast augmentation or a breast lift.
To avoid complications such as double bubble or bottoming out, she takes several measurements and determines the ‘footprint of your breast”.
In addition, she assesses the clinical characteristics of the inframammary fold (the native fold of your breast) and determines its utility in the prevention of double bubble deformity.
The technical aspects of this breast revision surgery are generally more complex than the primary (or initial) breast augmentation.
Get in touch with Dr Ballieux
Types of Breast Revision Surgery
Women choose revision surgery for a variety of reasons such as:
- Repositioning implants that have dropped and caused a bottoming out.
- Exchanging breast implants for a different size or type.
- Correcting a complication such as capsular contracture, double bubble or bottoming out.
- Repositioning nipples: if the nipples are pointing down or sits too low on the implant.
- Revising scars.
- Removing breast implants without replacing them.
Capsular Contracture
All implants are encapsulated. These capsules, which are made by the body to wall-off the implant, normally remain soft and pliable. For various reasons, however, in some patients, they can become firm over time making the breasts feel harder.
To correct this problem a surgical capsulectomy is often required in which the old implant capsule is removed prior to the insertion of the new implant. Another technique is the use of a ‘neo-pocket’, whereby the old capsule is isolated and the new implant is placed into a completely new pocket. This technique provides better implant stability.
Excessively Wide Cleavage
Breasts that are too far apart may be due to poor implant choice and inadequate release of the pectoral muscles.
Symmastia or ‘kissing implants’
Symmastia is present when one or both implants are positioned too close to the midline over the sternum. The breasts have joined together so that there is no cleavage. This means that the pockets, or capsules, surrounding the implants are too medially placed.
It requires several surgeries to adjust the pocket and the use of narrower implants.
Double-Bubble Deformity
The double contour is when the implant and the native breast fold sit at different anatomical levels. Double Bubble is caused by a lack of vertical planning. This is the reason why Dr Ballieux takes into consideration the position and grade of your infra-mammary fold.
The type 3 fold is the most at risk of remaining visible following breast augmentation.
Correction is complex and may require implant exchange, pocket adjustments, “Internal Bra procedure“, parenchymal modifications or lipofilling.
Implant Rippling
The edge of the implants wrinkle or creates ripples. These ripples may in turn be visible on the breast skin. This can be very difficult to correct when the patient is very thin as there is little tissue available to cover the implants surface. Lipofilling is an option.
Breast Lift
If the sagginess has not been absorbed by the implant (usually anatomic implant), the patient will need a mastopexy or breast lift.
Breast Revision Surgery : Bottoming Out
The term “bottoming out” is used when a breast implant slips to a lower position on the chest wall below the bottom fold (inframammary crease) of the breasts.
Most patients report that they have a hanging or heavy sensation because of lack of support for the implant. Bottoming out can be caused by choosing too large implants and/or weak breast tissue.
An experienced plastic surgeon should be able to diagnose bottoming out from photos alone. When diagnosing yourself, in addition to the heavy or uncomfortable feeling, you may also notice a worsening of your implant position in relation to your nipple position.
To correct a bottoming out deformity caused by tissue laxity, Dr. Ballieux uses the “Internal Bra procedure”. We can remodel the breast tissue like an ” Internal bra” on the inside and secure that breast tissue onto the ribs. Sometimes we use a material called “Strattice” which is inserted between the patient’s skin and breast tissue. This membrane become incorporated into the person’s own body; our blood supply grows into the material and create internal support of the breast tissue.
Breast Implant Associated-Anaplastic Large Cell Lymphoma
BIA- ALCL is a T-cell lymphoma that can develop near breast implants. It is not breast cancer but a rare form of non-Hodgkin lymphoma (cancer of the immune system). Women with breast implants are at a risk assessed at 1 / 86,000 to develop a BIA-ALCL. Although the etiology of BIA-ALCL is not yet fully understood, it is likely to be multifactorial.
Bacterial contamination (at the time of surgery or later), particles on the surface of the implant (biofilm) and genetic predispositions are the factors that are implicated in the development of this disease.
Dr Ballieux uses the 14 step antibacterial strategy that reduces the risk of developing capsular contracture and BI-ALCL.
Frequently asked questions about breast revision surgery
Before surgery, Dr Ballieux will give you specific recovery instructions.
These instructions will be very detailed, including everything from the type of bra to be worn to when to return to work and how soon normal activities can be resumed.
While patient experiences vary, you can expect recovery to follow this general timeline:
First 1 to 2 Days
You will need a friend or family member to drive you home after surgery, to stay with you for the first 24 hours, and possibly a day or so longer.
Sleeping in a recliner or propped up with pillows will help minimize swelling. You can expect to be up and about the day after surgery.
Some temporary bruising, swelling, and numbness of the breasts can be expected. You can use medication prescribed by your plastic surgeon to control discomfort, if needed.
It is recommended to keep your surgical bra for the next three months after the surgery.
Follow-up Appointment
You will have a follow-up appointment approximately 5 days after surgery.
Return to Work
Most patients are ready to return to their everyday activities within 1 to 2 weeks, and physical activities are limited for one month or more.
Any surgical procedure carries some risk of infection, bruising, bleeding swelling or reaction to anaesthesia.
All of these potential risks will be discussed with you during your pre-surgical consultation and you will be given a comprehensive list of pre- and post-operative instructions.
Following these instructions carefully will reduce the chances of complication and improve your chances of a successful surgery.
Certain over the counter products and prescription medicines can cause complications before and after surgery. Do not take any medication containing or related to aspirin two weeks prior to your procedure. This includes NSAID’S, anti-Inflammatory medications, blood thinning medication. Please see your doctor regarding if and when to cease medication. This is not an all-inclusive list.
Also avoid Vitamin E supplements and red wine. Stop all herbal medications before surgery. The most common herbs used are Echinacea, Ephedra, Garlic, Ginseng, Ginkgo, Kava, St. John’s Wort, and Valerian. They may adversely affect anaesthetic drugs, prolong bleeding and impair healing after surgery.
The cost for a revision procedure depends on the complexity of the procedure, whether it’s combined with other procedures and if we have to change the implant.
Before and after photos
An iPad with before & after pictures to illustrate the results will be available.
Follow @dr.fannyballieux on Instagram to see results photos that our patients send in!
