Breast replacement: when is revision mammoplasty necessary?

When to do it

First of all, the question of the need to re-correct the breasts arises with the desire to change the shape of the breasts or enlarge the breasts larger.

In this case, the indications for this type of operation are not always objective. Here the matter depends on the surgeon himself and his attitude towards his work.

If a specialist in this industry sees that the parameters are met, that is, the volume of the bust corresponds to the figure, the operation was performed correctly without any complications, the surgeon may refuse to perform repeated plastic surgery.

Further, it all depends on the patient - she can listen to the advice of a plastic surgeon, or she has the right to turn to another plastic surgeon for re-plasty.

Another question is due to the fact that the result of breast surgery really leaves much to be desired.

This is due to various factors, such as asymmetry, too much volume, sagging breasts, then a woman’s desire to undergo repeated plastic surgery is correct and quite logical.

If the question “When should repeat mammoplasty be done?” - includes time, then you should know that repeated breast correction should be done no earlier than six months after the first operation.

Repeated mammoplasty. Causes and risks of repeated breast surgery.

Over the past 10 years, the number of aesthetic operations performed on the mammary glands has tripled. Society's attitude towards such operations has become more tolerant, and in some countries, such as Brazil, it is strange to rather not have breast surgery if there are problems with aesthetics than to be the “owner” of silicone breasts... Oh times, oh morals...

However, these types of changes have their own reasons. Plastic surgery has become more reliable, techniques have become more mature, and the quality of implants has become almost perfect.

Indeed, today we (plastic surgeons - editor's note of the site) boldly talk about the high degree of satisfaction of patients after performing mammoplasty, for example, breast augmentation. Complications after breast surgery are very rare, and if they occur, they must be effectively corrected. Just imagine for a moment what would happen if there were complaints about the results of the operations performed one after another, if the quality of the implants did not meet the highest requirements. Simply, aesthetic surgery clinics would close, and plastic surgeons would change their occupation. Fortunately this does not happen. On the contrary, those patients who have previously undergone augmentation mammoplasty (as well as other types of breast surgery) recommend the clinic and the surgeon to their friends and acquaintances, share their positive emotions on the Internet and even decide to undergo other types of aesthetic surgeries...

Is it really possible to have breast surgery once and for the rest of your life? What is the risk of repeat breast augmentation surgery?

How serious is this?

Let's try to answer. In order to be completely objective, here we will only talk about augmentation mammoplasty, i.e. about those interventions when breast implants are used.

At almost every consultation, when answering a question about the reliability of implants, I talk about the lifetime warranty from the manufacturer. This is true - after all, just because 10-15-20 years have passed since augmentation mammoplasty, there is no need to change implants. If a woman is satisfied with the aesthetics of the shape of the mammary glands, and the breasts are soft to the touch, then there is no talk of any repeat surgery.

When does such a need arise?

A woman’s desire to change the shape or enlarge her mammary glands is not always associated with a poor result of primary mammoplasty. Often, the result of the operation is optimal, but the woman wants to increase the volume a little more or correct the shape even more. In this case, the indications for repeated mammoplasty are somewhat conditional and subjective. And here everything depends on the surgeon - if objectively the breasts turn out beautiful, the volume of the mammary glands is “adequate” to the patient’s physique, and there are no other complications, then the doctor may refuse the patient a repeat operation or, so to speak, not recommend doing mammoplasty again . Next is the patient’s attitude towards this opinion of her surgeon: she can agree with him, she can insist on surgery, or she can turn to another specialist (there will always be a surgeon who will be ready to perform such an operation...)

The situation is completely different when the result of the first operation really leaves much to be desired. This may be a suboptimal shape, too much volume, asymmetry, or some other reason. Such a patient may be dissatisfied with the result, and therefore her desire to change the situation is natural.

Capsular contracture

Capsular contracture is a complication of augmentation mammoplasty. Its essence lies in the formation of a dense fibrous capsule around breast implants, which can change the softness of the breast, and in some cases even deform the breast. The solution to the problem in most cases is a repeat operation, which consists of removing the capsule and replacing the implants. The risk of capsular contracture is about 5%. However, your surgeon can reduce this risk to 2-3%, if his experience allows, of course. Capsular contracture most often occurs if the primary operation was performed through the areola, because in this case, the glandular tissue itself is damaged and contamination of the implant cavity with its own microflora occurs.

Only in some cases, when the capsule is not very thick and the woman does not complain about breast compaction, is repeated surgery not indicated.

Hematoma

Hematoma after augmentation mammoplasty occurs extremely rarely. If the surgical technique is delicate in relation to tissues, and the surgeon has sufficient experience, then the risk of this complication is no more than 1%. If a hematoma is detected in the first hours or days after surgery, the situation can develop in two ways - observation or repeat surgery to remove the hematoma and stop the bleeding (extremely, extremely rarely!).

Distant hematomas that occur several months or years after the initial operation are extremely rare. In my practice, they have not been encountered, but are described in specialized literature. As a rule, they do not require surgical intervention.

Seroma

Seroma is an accumulation of serous or lymphatic fluid in the cavity of the pocket, or in the tissues near the implant. It is a consequence of aggressive surgical technique, when breast tissue is subject to rough influences from the surgeon. Indeed, mammoplasty can be done in different ways. Neglect of care in relation to tissues, performing an operation for 30-40 minutes, as well as refusal to adhere to the principles of high-quality surgery, create conditions for the formation of seromas. However, seromas are an extremely rare reason for reoperation (but are included here for completeness).

Implant rupture

An uncommon complication of augmentation mammoplasty. I repeat once again that modern breast implants are extremely reliable (we are talking about the implants that Alexey Yuryevich uses in his practice - these are 2 leading manufacturing companies - editor's note). However, there are many companies that make implants that are slightly more likely to rupture. It is these implants that I sometimes remove when performing repeat operations. At the same time, as a rule, I cannot know how correct the surgical technique was in these patients. I can only state the fact of rupture when such patients come to me with complaints of discomfort or abnormal shape of the mammary glands. In this case, I usually prescribe MRI (magnetic resonance imaging) as the #1 diagnostic tool.

The operation consists of removing damaged implants and installing new, better ones. In general, the problem of implant ruptures is also in the economic plane, because The desire of some patients to save money on a quality product (implants – editor’s note of the site) can lead to undesirable consequences.

The situations described above, however, are extremely rare. Surely, you will notice that most surgeons generally prefer not to talk about it loudly. My position is somewhat different. I usually make every effort to prevent complications from plastic surgery. My concept of “one-time mammoplasty” is to take into account factors that influence the result even before the first operation, as well as during the primary mammoplasty. Only in this case the risks of complications are reduced, and the probability of the desired result approaches 100%.

Note:

In June 2014, as part of the ALLERGAN discussion club, Alexey Anisimov gave a lecture “Single-time mammoplasty” to leading plastic surgeons, identifying during his speech all the most significant factors in the prevention of complications of augmentation mammoplasty, as well as in achieving the optimal result of the operation. The concept of “one-time mammoplasty” is new to the Russian surgical school, but following this rule allows you to perform the primary operation without complications, achieving a guaranteed result and high patient satisfaction. In this case, one condition is necessary - the duration of the operation increases by 20-30 minutes. This is logical, because additional time is needed to take into account all the necessary factors influencing the result. Practice shows that a 20-minute increase in the duration of the operation does not affect the patient’s health in any way.

Patients often turn to Alexey Yuryevich, as an expert in the field of mammoplasty, for repeated operations on the mammary glands. While working for Anisimov A.Yu. Several hundred cases of secondary mammoplasty have accumulated, and therefore we can say that to some extent this has become one of the narrow specializations of the surgeon.

As a rule, secondary mammoplasty is a more complex and expensive intervention. This is another reason why the work must be done efficiently the first time... Alexey Anisimov usually does not hide his passion for complex cases of mammoplasty, when skill and experience are most fully demonstrated.

Why is it needed?

Mostly women who have undergone breast augmentation seek revision breast surgery.

There is a list of factors why repeated mammary surgery is needed; let’s consider some of them:

• The endoprosthesis chosen is too large. With breast augmentation, the patient strives for very large sizes and is confident in her desire. Of course, the plastic surgeon will not refuse and will make the breasts large, but the larger the breasts, the higher the risk of postoperative complications and breast sagging. A large implant contributes to further tissue thinning and rupture, which can subsequently lead to implant loss.
• The plane for installing the implant is incorrectly selected. In this case, everything depends on the experience of the plastic surgeon. For the correct location of the implant, there are a number of small details that need to be taken into account when choosing, including the individual characteristics of each patient, body structure and skin structure. This operation is necessary and necessary in order to correctly place the implant.

Photo: Implants

How to avoid complications

In order for the breast to recover faster after mammoplasty, and dangerous consequences of breast enlargement do not occur, several rules of prevention should be followed:

1. Carefully choose a surgeon, since the results of mammoplasty depend on his professionalism and skills.
2. Strictly follow all the doctor’s instructions: avoid overheating and hypothermia of the chest, do not visit solariums, the beach, saunas and steam baths, limit physical activity, wear specialized compression garments at first, regularly visit a specialist for routine examinations.
3. Choose your bra carefully: it should match the size of your breasts, support them and not squeeze them.
4. To enlarge your bust, use implants of suitable sizes produced by well-known and well-established companies.

Breast pain after mammoplasty can be normal, but sometimes it is a sign of complications. Monitor your condition and consult a doctor in time if necessary.

Varying degrees and weakness.

If the recovery process proceeds normally, as well as if all basic conditions and doctor’s recommendations are met, the pain disappears on the second or third day after the operation.

But every woman’s body is special, so there are cases when the pain leaves patients only after a few weeks.

After mammoplasty, the skin becomes much more sensitive, and every touch is perceived with a special reaction from the body, sometimes this reaction is pain.

After mammoplasty, you should not create additional negative conditions for the breast, such as:

• using a washcloth;
• refusal of compression garments;
• too active lifestyle immediately after surgery;
• overwork;
• sleeping position on the chest;
• refusal of the recovery regimen drawn up by the doctor.

Usually, after mammoplasty, the patient remains in the hospital for a day, but there are exceptions when the patient can go home on the day of the operation. Physician supervision throughout the entire rehabilitation period is very important. In the first days, discomfort and pain appear due to disruption of the activity and integrity of the tissue, as well as due to the appearance of swelling.

In some cases, in addition to pain after mammoplasty, the following complications may appear:

• implant shifts;
• manifestation of breast asymmetry;
• introduction of infection;
• long-term healing of sutures;
• the occurrence of thrombosis of blood vessels.

All these risks arise depending on the individual characteristics of the patient and can be of varying degrees.

How long do breasts hurt after mammoplasty?

One of the common questions asked by mammoplasty surgeon patients is how long does the breast hurt after mammoplasty and how long does the recovery period last?

Therefore, it is important for patients to know what pain may occur and what should be done to eliminate it.

Rehabilitation for each woman after mammoplasty is different.

To eliminate the first pain, the doctor will prescribe painkillers. There are cases when, after mammoplasty, pain was completely absent. And, generally, painful sensations can last from one to three days.

Pain after mammoplasty occurs as a result of tissue stretching and muscle damage. Therefore, the doctor will also prescribe antibiotics and antiviral drugs to prevent complications and purulent deposits.

To avoid scarring and get rid of unnecessary pain as quickly as possible, it is very important to wear compression garments. The sutures after mammoplasty are removed after
7-10 days.
Sealing the seams with a special silicone patch for a month plays an important role. When the seam becomes barely noticeable, you can apply a absorbable cream.

After mammoplasty, pain may occur as a result of swelling. The following conditions will help to avoid swelling:

• avoiding hot baths;
• abstaining from steam rooms and saunas;
• eliminating exposure to sunlight;
• abstinence from intimacy and sports activities for about a month.

Indications

For re-operation the following indications:

• Capsular contracture is the formation of a dense scar around the implant. This deficiency can contribute to lumps in the breasts, which can lead to painful sensations in the breast area and deformed breasts. In the process of capsular contracture, the following are formed:

1. seroma;
2. purulent-inflammatory processes;
3. bleeding.

Seroma is an accumulation of lymphatic fluid in the tissues. It occurs when a plastic surgeon performs operations at double speed, without following the correct technique, and contributes to the formation of seromas.

• Leakage of solution from the saline implant. This most often occurs due to an incorrectly selected implant or an incompletely filled prosthesis, which results in thinning of the walls of the prosthesis and penetration of fluid into the tissue. This factor threatens the life and health of the patient.

There may also be indications for repeat breast surgery such as:

• implant displacement;
• loss of breast shape associated with changes in weight, weight loss or, conversely, weight gain;
• change in breast volume after pregnancy and breastfeeding.

What to do to relieve pain

Pain during the week after breast enlargement is normal, but this does not mean that you should endure it. If the sensations in the chest are sharp and strong, then, on the advice of a doctor, you can take painkillers, and non-steroidal anti-inflammatory drugs are most often recommended, which not only eliminate pain after mammoplasty, but also relieve swelling, and also stop inflammatory processes and minimize the risks of dangerous complications.

If your breasts hurt badly 2-3 weeks after mammoplasty surgery, you should consult a doctor and consult with him. He will conduct a thorough examination and evaluate the condition of the mammary glands to identify abnormalities.

In case of serious consequences, they will need to be eliminated as soon as possible. Thus, in case of suppuration and inflammation, removal of serous fluid or pus is indicated. Tissues are also disinfected in order to destroy pathogenic microorganisms whose activity triggered pathological processes.

Important: to relieve pain after mammoplasty at home, you should not use cold or warm compresses, massage, hot showers and other procedures, as they can lead to tissue damage and the spread of the inflammatory process.

Dangers of revision mammoplasty

For successful revision breast surgery, you need to choose an experienced specialist and listen to the recommendations.

When performing post-operative mammoplasty, it is worth knowing that all consultations and tests, visits to doctors, all these actions need to be done again, which affects the general physical condition and can lead to psychological breakdowns and nervous disorders of the woman.

Therefore, before re-correcting your breasts, think about it, maybe the first result is not so bad...

How to do it

The operation is carried out at the clinic with a further stay in the hospital. As a rule, it is performed under general anesthesia.

This operation has several stages:

1. removal of the prosthesis - the doctor makes an incision along the line of scar tissue and removes the implant;
2. capsulotomy partially or completely excises the entire scar membrane with the application of clearer, thin and neat sutures;
3. installation of a new prosthesis - if the implant is the same size as the previous one, it is installed in the old place, but if the new implant is larger or smaller, then the doctor forms a new location for such an implant.

It is also worth knowing about the incisions that will be made during the operation. The cuts depend on the number of changes made.

When replacing a prosthesis or capsular surgery, an incision may be made along an existing suture. If you need to tighten your breasts, incisions are made to tighten them.

The first incision is made around the areola, in the case of a minor breast lift. In the case of a large lift and tension, another incision is made, vertical, from the lower edge of the areola to the inframammary fold.

The third incision is made horizontally, along the lower semicircle, while the nipples and areola are not separated from the tissue and remain sensitive and capable of breastfeeding.

After plastic surgery is completed, the surgeon stitches the incisions and applies a sterile dressing. The operation lasts from one and a half to two and a half hours.

After the operation, the patient is transferred to a hospital, where she can stay from a day to several hours, depending on her general condition.

A few hours after the operation, you are allowed to walk. The bandage is removed a few days after the operation. You need to wear shapewear for several days.

The sutures are removed approximately ten days after surgery.

The recovery period lasts a little longer than after the first breast correction. It is important to follow all the doctor’s recommendations, maintain contact with him and go to all necessary consultations.

Pain

Often after mammoplasty, patients complain that their breasts hurt. Unpleasant sensations occur for 2-3 days after surgery, provided the healing process is normal and all doctor’s recommendations are followed. But you should know that the duration of the recovery period is individual in each case.

After mammoplasty, the nipples may hurt, which is also not a deviation, provided that the pain does not increase, but gradually disappears.

The causes of pain are injury to soft tissues during surgery and their stretching during the recovery period.

Complications

Complications after repeated breast surgery should be divided into two groups:

1. general surgical complications;
2. specific complications.

General surgical procedures include:

• wound infection;
• formation of hypertrophic scars;
• hematoma;
• increased temperature after repeated plastic surgery;

Specific complications include:

• implant rupture;
• deformation of the prosthesis;
• implant displacement:
• double fold;
• calcification;
• allergic reaction to the prosthesis;
• inability to perform mammography;
• symmastia;

Photo: Deformation of the prosthesis.
Implant rupture is a violation of the integrity of the prosthesis, resulting in deformation and sagging of the breast. The breast does not deform immediately, so implant rupture can be detected with magnetic resonance imaging.

Deformation of the prosthesis - looks like stretch marks on the chest and is a complication both during the first operation and during a repeat operation.

Double fold - occurs when the prosthesis is placed incorrectly, and is corrected again with the help of plastic surgery.

Calcification – characterized by the deposition of salts around the prosthesis and looks like lumps around the breast.

An allergic reaction to a prosthesis - does not appear very often and depends on the female body’s perception of the materials from which the prosthesis is made

Read when you can sleep on your side after mammoplasty. When can you drink alcohol after mammoplasty? The answer is in this article.

Inability to do mammography —Mammography is needed to identify new breast growths, such as lumps, that need to be removed.

Symmastia - looks like the fusion of two breasts; it can appear due to too close proximity of the mammary glands and a large volume of selected prostheses.

Approximate cost

Prices for repeated breast surgery, given that it is no less complex than the first plastic surgery, are also not cheap and depend on the methods and quality of the operation.

Conventionally, repeated breast correction should be divided into several types and then decide on the cost of the operation.

1. removal of breast implants – from RUB 100,000. up to 250,000 rubles;
2. replacement of breast prostheses – from 240,000 rubles. up to 350,000 rub.;
3. treatment of capsular contracture - from 200,000 rub. – up to 330,000 rub..

Answers to frequently asked questions

Why do women have to undergo breast surgery again after breast augmentation?

Answering this question, there is no clear answer to it. There are many factors that force a woman to seek revision surgery.

Many women, due to intensive weight loss and constant dieting, lose weight, and this contributes to a decrease in fatty tissue, displacement of the prosthesis and further sagging of the breasts.

Many women also undergo breast augmentation to reduce scarring after their first surgery.

Do scars actually disappear or not?

Unfortunately no, the scars remain. But sometimes they are completely invisible; it all depends on the technique the doctor uses and how the process of healing wounds on the woman’s body goes.

How is the rehabilitation period going and do you need to adhere to any restrictions after plastic surgery?

The rehabilitation period is the same as after the first operation. It is necessary to follow the doctor’s recommendations, monitor your diet, wear shapewear, bandages, and bandages.

Often, repeated plastic surgery is resorted to if the rules of rehabilitation after the first plastic surgery were not followed in the first one.

See how to massage after mammoplasty. What is vertical mammoplasty? Find out here. When can you sunbathe in a solarium after mammoplasty? Read on.

Can breast correction lead to cancer?

No, there can be no cancer as a result of breast surgery or repeated breast surgery.

Since this section of surgery is now widespread and the best specialists work in this industry, the risk of tumors in the breast is reduced to a minimum.

How often do dentures need to be replaced?

Manufacturers provide a lifetime guarantee for their product, but there are always a number of cases when implants do not meet the quality or prostheses are not suitable for a woman due to the individual characteristics of the female body.

To be sure of the quality of the prostheses you choose, consult with manufacturers and experts in the industry..

Does plastic surgery affect the ability to breastfeed?

You can breastfeed without any worries and you can plan a pregnancy two to three months after the second operation.

It is impossible to predict how the breasts will behave after breastfeeding.

For many women, the breasts sit back on the implant and no additional corrections are required, but for some, on the contrary, the breasts sag and require additional surgical intervention and a small breast lift.

How to choose the right plastic surgeon?

The question is very relevant, since there are many, many surgeons in this field. If, for example, you are not satisfied with the specialist who performed your first plastic surgery, you should turn to another one.

There are many good specialists and no less unscrupulous specialists.

Pay attention to the doctor’s practice, how many patients the specialist sees per year, and whether they are satisfied with the results of the operations performed.

Breast-feeding

With periareolar access, it is very important to preserve the integrity of the milk ducts for further lactation.

At the preliminary consultation, you should definitely tell the doctor your plans for having children.

For girls planning a future pregnancy, the plastic surgeon preserves the milk ducts as much as possible, which allows for unhindered lactation after the recovery period. Typically, at least a year must pass between mammoplasty and a planned pregnancy.

You can sign up for a free consultation now to be sure that your transformation will take place without unpleasant consequences!

If pain occurs after mammoplasty, this will certainly alert the woman who has undergone such an operation. But this symptom is not always alarming and dangerous, although in some cases it does signal problems.

Breast augmentation or mammoplasty is a fairly common plastic surgery that many women decide to undergo if they are not happy with the size or shape of their natural breasts. Surgical intervention is not the most difficult, and yet it involves violations of the integrity of tissues, so in any case it is associated with certain risks.

During mammoplasty surgery, a silicone implant is placed into each breast through an incision. It is placed under the soft tissue of the chest or under the muscles. But with either one or the other location option, the integrity of the skin and soft tissues is violated, which determines the rehabilitation after the operation. It includes such inevitable phenomena as:

• swelling
• hematomas
• hyperemia
• stretched skin can be itchy, sometimes very itchy

The breasts after mammoplasty will hurt in any case, and this is absolutely normal, because the body reacts to such an unnatural and crude intervention. The structure of the soft tissues is disrupted; they are forced to change their structure and become deformed, as they are pushed back and partially compressed by the installed implant. The skin is greatly stretched, which is also accompanied by pain. As they heal, some women experience itchy post-surgical scars.

If breast augmentation surgery was successful and the woman’s health is normal, the initial recovery usually takes about 2-4 weeks. Acute pain in the mammary glands that accompanies the patient in the first days after mammoplasty disappears within a week.

Next, slight pain is observed, and normally it persists for 2 weeks, after which all unpleasant sensations disappear. Severe swelling may occur within 1-2 months. But the final result is usually assessed only six months later, when each implant takes its final place in the chest, and the tissues recover after the intervention and acquire their natural structure.