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6 Revision or Reconstruction Options after Removing Breast Implants

Breast reconstruction is a surgery that typically gets associated with lumpectomy and mastectomy, the surgery to remove breasts on a patient to prevent or treat breast cancer. But breast reconstruction or – what might be better referred to as “revision” of breast augmentation in many cases – may also be done for a patient who is simply looking to remove their breast implants. In fact, there are actually more and more women opting for the removal of their implants. In 2018, The American Society of Plastic Surgeons estimates there were a total of about 48,000 breast implant removal procedures performed – and that number has since been on the rise.

Why? There’s a handful of reasons why breast implant removals are performed, but some often are a result of these cases:

• Lifestyle Change – Just like your personal preferences change as you age, there’s often a desire to go smaller or bigger or return to your natural state of having no implant at all. And as the style of implants change, patients may find themselves wanting to try a new type of material (maybe switching from saline or silicone to what’s known as “gummy bear” or teardrop-shaped gel-based implants).
• Capsular Contracture – Once a breast implant is in place, fibrous scar tissue forms around it, creating a tissue capsule that holds the implant in place. While not usually noticeable, sometimes, over time, the capsule can become unusually hard and dense (a condition known as capsular contracture), which can lead to distortion in the shape of the breast, and it can make the breast rise higher on the chest.
• Animation Deformity – This condition occurs when only a portion of the pectoralis muscle covers the implant, causing the implant to move or take on a rippling appearance anytime the patient flexes or moves that part of the body.
• Pain or Discomfort – Breast pain, breast discomfort, nipple sensitivity, and soreness are not uncommon complaints from patients with breast implants.
• Breast Implant Illness (BII) – While BII is not currently recognized as an official medical diagnosis, it is used to describe the instance when patients believe their implants are making them sick, including joint and muscle pain, chronic fatigue, memory and concentration problems, sleep disturbance, headache, depression and anxiety, hair loss, and more.

If you’re dealing with one of the above cases and looking to remove your implants but also revise and rejuvenate your breasts after the surgery, you have options. In fact, breast revision is something board-certified plastic surgeon Dr. Anthony Wilson of Portsmouth’s AW Plastic Surgery specializes in. Here are six of revision/reconstruction options.

Implant Replacement

If you had to remove breast implants due to a medical condition, or if you’re removing breast implants to replace them with a newer material or ones that may be a different size, your top option will likely be reconstructing your breasts with a new set of implants. 

If you had implants removed because of a mastectomy, you may expect to have more than one reconstructive surgery to allow time for skin to stretch as you prepare your body for new implants. You should also consult with your medical team following surgery to ensure that an implant replacement won’t interfere with any possible future treatments.

Breast Reduction

You may choose to have a breast reduction after removing your implants for medical reasons or to go the opposite direction and change the appearance of your breasts so they’re smaller in shape or size. 

A breast reduction is performed under IV sedation or general anesthesia, depending on your comfort level. An incision is made around the areola and sometimes down the breast. Excessive breast tissue is removed and reshaped, giving your figure more harmonious proportions overall.

Fat Grafting

Some patients may change their minds about implants or choose to have them removed instead of replaced when it’s time. If you find yourself facing this scenario, you may choose to have a more natural increase in bust size using fat grafting, or lipoaugmentation.

After implants have been removed, excess fat cells can be transferred from areas such as the belly, hips, or waist using a traditional liposuction technique, and then they are injected into breasts. The end result is a small increase in overall size and a more natural look than some types of implants.

Tissue/Flap Reconstruction

This type of breast reconstruction may be chosen if you want to naturally restore the appearance of your breasts or correct an issue of asymmetry after the removal of breast implants. During tissue reconstruction, tissue is taken from parts of the body including the abdomen, buttocks, or thighs to help reconstruct the chest. 

Scarring from the donor site is usually minimal during a tissue reconstruction and it gives a plastic surgeon the ability to enhance the appearance of the breasts without using materials foreign to your body.

Breast Lift

A mastopexy, or breast lift, is often used to address sagging breasts caused by pregnancy, weight fluctuations, age, and other natural causes. Typically, when you have breast implants removed most of the area and tissues around the breast will look similar to the way everything looked pre-augmentation. But like the abdomen after pregnancy, sometimes the skin is stretched out and permanent damage is done to the body. 

If you’re not satisfied with the appearance of your chest after your implants have been removed for about four to six months, ask your plastic surgeon about the benefits of a breast lift. A breast list can also be combined with implants.

Internal Bra Technique

No, it’s not an actual bra, but this surgical technique certainly mimics the support of a bra – just internally – in order to really control breast position, shape, or implants. The internal bra technique can be a great way to correct implant complications, such as symmastia, “double bubble,” and “bottoming-out,” which result from implant pocket instability created by poor dissection and the use of an inappropriate sized implant. It can also be used in conjunction with a breast reduction or lift procedure in order to support the newly lifted tissues and ensure longevity in the final result.

RELATED READING

• Why Are Women Electing Smaller Breast Implants?
• “How Soon After Breast Augmentation Can I . . . ”: 20 of Your Questions Answered
• The 3 Breast Augmentation Surgical Techniques That Reduce Capsular Contracture Risk