Breast augmentation and breast enhancement are some of the most common cosmetic procedures performed in the country. Breast implants, both silicone, and saline can be placed over and under the chest muscle through multiple incisions. Breast augmentation appears to be relatively straightforward and in most instances is; though breast implants can lead to long term problems, including scarring around the implant (capsular contracture); implant malposition, implant rupture and rippling around the implant. Fortunately, these long term problems are relatively rare and occur approximately 10 percent over a 10 year period. When these problems do occur, the patient is left with feeling scarred and self-conscious about the appearance of their breasts. As well, scarring around the implants can be painful and uncomfortable with activity. The most common question I get asked when discussing breast augmentation and breast implants with my cosmetic patients is do I need to have my implants changed or removed after 10 years? The answer is “no”, breast implants need to be changed when the aforementioned problems occur, and there is likely no benefit from prophylactically changing implants. The most common reason why breast implants are revised, are secondary to size issues, either increasing or decreasing size.
Fortunately, when revision breast augmentation is required this is a fairly straightforward experience for the patient with a short recovery. Revision breast augmentation can be a technically challenging operation for the plastic surgeon and the each surgery should be individualized to the patient’s complaint and breast implant problem. The actual operations can be increasingly complex, and vary between just changing the implants out (implant exchange), versus removing scar tissue around the implants to performing a breast lift (mastopexy) with an implant exchange and or implant transposition to a new implant position.
If a patient has questions pertaining to their pre-existing implants or would like to discuss the improvement of the breast augmentation results, it is always helpful to have the original operative report and implant size. I would encourage revision breast augmentation patients to seek out a board certified plastic surgery who is experienced in cosmetic breast surgery to discuss and plan the revision breast procedure. Most procedures are performed as out-patient surgeries not needing over-night care, and cost of the breast procedures are highly variable depending on what components and implants are used.
