Breast Implant Revision in Orlando, Florida
Have you had previous breast augmentation surgery and want to improve your result, because of size issues, tissue stretch, implant hardening or implant rupture? Dr. Fiala has a great deal of training and experience with breast implant revisionary surgery.
The most common reasons for breast implant revisions are:
- Size change: whether it’s switching to a larger size or a smaller one, or changing the shape and proportion of the current implants, size change is the most frequent secondary surgery for breast implants in the United States.
- Fixing implant hardness: Also known as capsular contracture, this hardening process of tissue around the implant can cause the breast to become more spherical in shape, more elevated or more painful. It can be fixed, and the breast shape made more symmetrical, more natural looking, and more comfortable.
- Implant Deflation or Rupture: Whether they are silicone or saline breast implants, all implants eventually wear out with time, and will need to be replaced. With a saline implant, a leak in the implant results in an obvious change in the breast size, as the saline is absorbed. With a silicone gel implant, it may be more difficult to tell – and some form of imaging, like an ultrasound or MRI of the breast may be needed to confirm whether or not a leak is present.
- Implant pocket issues: Are the implants too far apart? Do they go under your armpit area when you lie down? If so, then you may have a pocket problem. By re-opening the pocket where needed, or by closing the pocket where needed with an internal suture repair, these issues can be fixed. Sometimes a new implant, of a more proportional width, can help to optimize the cosmetic result.
- Ripples: Do you have ripples or wrinkles that show on the surface of your breast? If you have a “over-the-muscle” saline implant, these can often be significantly improved or eliminated by switching to a silicone gel implant placed “behind-the-muscle”. Sometimes, more advanced methods, like fat grafting or ADM placement, may be recommended.
- Desire for removal: Some women have changed their minds about having implants, and simply ask us to remove the implants.
“Dr. Fiala is an amazing physician, and did a wonderful job on my breast revision surgery. I would highly recommend him, and his wonderful staff to all my friends and family. They truly care about you!” Read more of Dr. Fiala’s Testimonials here »
How does Fiala Aesthetics figure out what my new implant size should be?
For women that wish to go to a larger size, we can place an air-filled sizer over the current breast, and the patient can preview the shape and size in a sports-bra & T-shirt. By knowing or estimating the size of the current implant, we can then determine the volume of the new implant by adding the volume of the implant and the sizer together, and picking an implant shape that will fit the patient’s frame. Often changing to a higher profile implant may give the fuller and curvier shape desired, without making the breast too wide for the patient’s frame. If you have your implant information, please bring it with you to the consultation.
For women that wish to “downsize”, and go to a smaller size, several options are available. For women that currently have a saline implant, sometimes a pre-operative deflation of the saline implant can be very helpful. This way the patient can “try on” the new implant just like a first time patient – and get the size selection “exactly right” prior to the second surgery. Many times, we see that the initial implant was too wide for the patient’s frame, and can look bulky or matronly. Switching to a more proportionally-sized one can help often the patient feel slimmer and better balanced in their figure.
For women that wish to continue with implants, the key steps in fixing implant hardness are:
- removing the scar tissue layer
- doing something to reduce the risk of a recurrence of the problem.
Removing the scar tissue layer is known as “capsulectomy”. Think of it like carefully peeling the orange peel off an orange. Your own normal breast tissue is left intact, and only the abnormal scar tissue, or “capsule”, is removed. Once the tight scar tissue is removed, the implant is no longer squeezed into a tight & unnatural shape, and the breast will feel soft again, and more comfortable for the patient. A drain is usually placed into the pocket when a capsulectomy has been performed. Most commonly, in this situation, we recommend that a new implant be used at the same time.
To reduce the risk of recurrent hardness, there are several options. If the old implant was “above the muscle”, it’s often wise to convert the implant to the sub-pectoral position. If the old implant was already “behind the muscle”, new advanced options like the use of Strattice may be considered.
Yes, that’s an option too. Implant removal without replacement can be done. For women that have had several episodes of breast hardness, this may be the best choice to minimize the number of future surgeries. If a capsulectomy is needed or is requested by the patient, we can perform that as well.
In many cases, a breast lift can be performed if there is obvious tissue laxity (loose skin) or a droopy shape. Alternatively, fat grafting to the breast can be done, to restore at least some of the volume of the breast. For those women who have a good breast shape and reasonable skin elasticity, sometimes simple implant removal without mastopexy (breast lift) can also work well.
Dr. Fiala is very familiar with this problem. The treatment is a surgical one – consisting of removing the old implant and free-floating silicone gel, and performing a capsulectomy to complete the “tidy up”. At that point, a new implant – either silicone gel or saline – can be placed, if desired by the patient.
ALCL is a rare, lymphoma-like reaction that can occur around an implant. It has been in the news recently, but is actually very uncommon. ALCL typically shows up as a significant fluid collection around a textured breast implant, about 8-10 years after surgery. The breast looks swollen externally. It can be easily ruled out by a breast ultrasound or MRI. If there is a fluid collection, the fluid needs to be sampled, and sent to the lab for testing, as many fluid collections are benign, and are not ALCL. The ALCL can typically be treated by implant removal with total capsulectomy. If you develop a swollen breast after having a normal result for many years, particularly on one side, please alert your surgeon, so that proper investigations can be done.
With a busy breast-implant related practice, Fiala Aesthetics has extensive experience in these breast implant revision surgeries, and a high success rate in these challenging revisional procedures.