Breast Revision

What is breast revision?

Breast revision is a surgical procedure our Specialist Plastic Surgeons perform in Perth to remove breast implants – this is known as explantation. This corrective surgery is primarily aimed at resolving breast implant issues and in some cases, it is possible to combine this procedure with the insertion of new implants.

This procedure can be performed for aesthetic (cosmetic) purposes or for medical/functional reasons, the latter being dependent on strict Medicare eligibility criteria.

What factors may influence the decision to have a breast revision?

This procedure is indicated if:

• One or both of your existing implants has ruptured (or deflated in the case of saline implants), or requires replacement due to age of the implants
• One or both of your existing implants has hardened due to capsular contracture
• You are no longer satisfied with your breast size or shape, especially following pregnancy or changes in weight
• You are no longer wishing to have breast implants.

Can I have breast revision surgery if I have had a breast augmentation with another surgeon or practice?

If you have had a breast augmentation performed in Australia or overseas by another accredited plastic surgeon within the past six months, and you are unhappy with the results, we strongly recommend seeking assistance from that original surgeon as they will be familiar with your operation, the implants used and the infection control employed. If you are experiencing a complication, infection or wound breakdown, please contact your original surgeon. If you cannot contact them, please visit your GP or present to your nearest hospital emergency department.

If you have had a breast augmentation performed in Australia or overseas by another accredited plastic surgeon or ‘cosmetic doctor’ over six months ago, you are unhappy with the results and you’ve either been unable to reach an agreed path forward with your original surgeon/doctor or you do not feel comfortable seeking further treatment from them, then we recommend the following steps:

1. Visit Your GP: Request a referral to a Specialist Plastic Surgeon. The referral can be general and does not need to be directed to a specific practitioner, allowing you the freedom to choose who you wish to see.

2. Contact Our Practice: Reach out to us to request our email address. We will ask for your referral, details of your previous surgical procedure(s), and the name of the practitioner who performed the surgery. We may also request photos of your results.

3. Review Process: Our team will review the referral and the information provided to determine if a consultation on breast revision surgery would be appropriate for you at our practice.

Is a breast revision right for me?

A consultation with your Specialist Plastic Surgeon is the first step when you are considering a breast surgery. During this consultation, it is important to openly communicate your goals and expectations regarding your appearance. During the consultation, your surgeon will conduct a thorough examination and attentively listen to and address your concerns prior to discussing the most suitable options for your individual circumstances.

How is a breast revision performed?

The technique used by your surgeon will depend on whether you are having your existing breast implant replaced or removed. If you are having your implant removed/replaced due to rupture or silicone leak, you may be required to undergo an ultrasound or mammogram prior to your surgery. Your referring GP can provide you with a radiology request form to have this imaging performed prior to seeing your surgeon.

Incisions are generally made using the scars of your previous surgery, the existing implant is removed and the internal structure of your breast, known as the breast pocket, is assessed. If your previous implant was inserted through incisions in the armpit though, your surgeon will in most cases remove them via an inframammary incision (in the fold where the lower part of the breast meets the chest wall) as this is a more preferred method.

If you are having your implant removed/replaced due to capsular contracture, a capsulectomy will be performed at the same time to remove the capsule of scar tissue around the implant.

If you are undergoing replacement of your breast implant, the new implant will usually be placed in the same position as your previous implant – behind the breast tissue either in front of or behind the pectoral muscle – depending on the reason why the implant is being replaced. Your surgeon may also reshape your breast pocket. Our surgeons use premium silicone implants provided by one of the world’s leading breast implant manufacturers, Mentor (Johnson & Johnson). They do not use, and have never used, Poly Implant Prothèse (PIP) implants. As part of the replacement, your new breast implants will be registered with the Australian Breast Device Registry – a nationwide Australian Government initiative established to monitor the safety and quality of procedures involving breast implants. Participation in the Registry is at no cost to the patient.

If you are undergoing a straight forward removal of your breast implant, you may be require a mastopexy to lift your breasts. This is because implants can stretch the skin and breast tissue over time, and once an implant is removed, patients may be left with breast ptosis (sagging of the breast) and downward pointing nipples and areolas.

Your plastic surgeon will determine which approach would be most appropriate for you. It is important to note that both breasts, nipples and areolas are never exactly the same size and shape.

The procedure is performed in Perth in a fully-accredited hospital under general anaesthesia. The surgery can be performed as a day procedure or alternatively with a short hospital stay under general anaesthesia, depending on your general health and the extent of the procedure. You should discuss the details of your recovery with your surgeon.

Are there any risks and complications of breast revision surgery?

All plastic, cosmetic and reconstructive surgical procedures come with risks and potential complications. To ensure successful surgery, it is crucial to understand and minimise these risks. Whilst all measures are taken to mitigate risks, some risks are unavoidable.

All information on this page is general in nature – your Specialist Plastic Surgeon will discuss the specific risks and complications pertinent to your individual surgical procedure during your consultation. General risks for surgery are listed here.

Specific risks related to breast revision surgery include, but are not limited to:

• Fluid accumulation: After the surgery, there is a possibility of fluid accumulating around the surgical site(s). This condition, known as seroma, may require additional procedures to drain the fluid. To prevent any fluid or blood accumulation, thin tubes called a drains may be temporarily placed under the skin while you’re in hospital.
• Fat necrosis: This is a rare complication that can occur when fatty tissue dies. It can cause hard lumps under the skin, but it is usually not a serious problem.
• Changes in breast and nipple sensation: Breast revision may lead to temporary or permanent changes in breast and nipple sensation. Some individuals may experience increased sensitivity, while others may notice reduced sensation.
• Numbness: Temporary or permanent areas of numbness in the breasts and surrounding areas can occur as a result of nerve damage during the surgery. It is important to discuss this possibility with your surgeon prior to the procedure.
• Breast asymmetry: Breast revision can sometimes result in unevenness or asymmetry of the breasts. This can occur due to variations in healing, tissue response, or implant placement.
• Breastfeeding difficulties: Breast revision may potentially affect breastfeeding, leading to reduced milk supply. It is important to discuss this concern with your surgeon before undergoing the procedure, especially if planning to have children in the future.

In addition to the above, these risks also relate to having new implants inserted:

• Skin wrinkling: In some cases, wrinkling of the skin over the breast implant may occur. This can be more common in individuals with thin skin or those who have chosen larger implants.
• Calcium deposits: In some cases, calcium deposits may develop in the scar capsule around the breast implant. These deposits are usually harmless but may require monitoring or treatment.
• Granulomas: Granulomas are lumps that can form in the local lymph node tissue due to leaking silicone. Although rare, they can occur and may require medical attention.
• Capsular contracture: Capsular contracture is a complication where scar tissue forms around the implant, causing it to become firm and lose its shape and softness. This can result in discomfort and may require additional surgery to correct.
• Implant-related issues: There are various implant-related risks, including inappropriate implant size, implant rupture, and deflation. These issues may necessitate revision surgery to replace or remove the implant.
• Breast cancer screening challenges: Breast implants may interfere with the effectiveness of mammograms in detecting breast tissue abnormalities, including tumors. It is crucial to inform healthcare providers about the presence of implants to ensure proper screening techniques are used.
• Implant movement: In some cases, breast implants may shift from their original position over time. This can result in asymmetry or discomfort and may require corrective surgery.
• Additional surgeries: In the event of complications or unsatisfactory outcomes, further surgeries may be necessary to address any issues. Breast implants are not lifetime devices and may need to be replaced after approximately 10 to 15 years.

In recent years, there have been claims suggesting a potential association between implants and the development of connective-tissue diseases such as rheumatoid arthritis, lupus erythematosus, scleroderma, and other autoimmune conditions. While some studies have indicated a slight increase in risk, many medical investigations have not established a definitive connection between implants and these health issues. It is important to note that a certain proportion of women in the general population may develop these diseases, whether they have implants or not. Therefore, while the possibility of developing connective-tissue and autoimmune diseases exists, it should be considered as a remote likelihood.

There are rare incidences of what is known as Breast Implant Associated-Anaplastic Large Cell Lymphoma (BIA-ALCL) – please click here for more information.

In rare cases, women with implants have reported experiencing general symptoms that include joint pain, overall body aches, swollen lymph glands, persistent fatigue, increased susceptibility to colds and flu, hair loss, skin rashes, headaches, memory issues, nausea, muscle weakness, irritable bowel syndrome, and sporadic fever. Although a correlation between these symptoms and autoimmune disorders has been suggested, it has not been definitively proven.

Will the breast revision procedure leave any scars?

Although scars are the inevitable result of any surgery, your surgeon will make every effort to keep your scars as inconspicuous as possible. The scars are usually just a few centimetres long and are located in such a way as to be less noticeable. Some patients have a tendency to develop keloid or hypertrophic scars and you should advise your surgeon if you are aware of this tendency in yourself.

What results can I expect from a breast revision?

Regardless of whether you are having your implant replaced or removed, the goal of your surgery is to resolve any current issues you are experiencing and leave you with breasts that are a size that is in better proportion with your physique. Your surgeon is the best person to determine whether your expectations are achievable.

When can I resume normal activities following a breast revision?

Recovery times differ depending on whether you have had a straight forward breast implant removal or whether you have had your breast implant replaced. You should be able to resume your normal routine though in 2-3 weeks however, you may wait a little longer before undertaking strenuous exercise. Returning to work or your normal activities is an individual matter and your surgeon will advise you. You will have to wear post-surgical compression garments for up to six weeks to reduce swelling and assist with the healing process.

It is important to note however, that each patient requires adequate time, support, and proper postoperative care to facilitate their recovery process. Due to individual variations in healing abilities and pain tolerance, the duration of recovery and ability to engage in various activities may differ among patients.

How much does this procedure cost?

Please contact us online or call us on (08) 9380 0333 and one of our medical secretaries can provide you with more information. Please note that pricing does vary from case to case.

Where can I find more information?

The Australian Society of Plastic Surgeons (ASPS) website is a helpful and reliable source of information online. Their website is an excellent place to research a range of surgical procedures and non-surgical treatments, and view video animations.

The Therapeutic Goods Administration (TGA) breast implant hub has several documents regarding breast implants, covering various subjects such as Breast Implant Associated-Anaplastic Large Cell Lymphoma (BIA-ALCL), consumer inquiries, and related matters. Utilising a search engine can also be beneficial in finding relevant information on these topics.