About Breast Revision Surgery
Breast augmentation using implants is one of the most popular cosmetic procedures in the United States, and in most cases allows for beautiful and natural outcomes. Unfortunately, sometimes a woman with implants can be dissatisfied with the appearance of her breasts. Keep in mind not all revision surgeries are because of surgeon error. While few breast augmentations do end with a poor outcome, there are some who desire a larger or smaller implant, while others have a medical problem and ask to have the implant corrected or removed altogether. Los Angeles, CA double board-certified plastic surgeon Dr. Geoffrey Keyes provides breast revision after giving an in-depth assessment for women who have had a previous augmentation. Learn more at the practice of Geoffrey R. Keyes, M.D., F.A.C.S. in a private consultation.
"I chose Dr. Keyes after looking for the best plastic surgeon in California for my daughter’s rhinoplasty. From the very first appointment, I felt she was in the right hands. He showed us exactly what he was going to do and what we could expect and sure enough, that’s what he delivered. She had very little pain and her nose looks amazing. I’m so glad we selected Dr. Keyes and Kimberley to care for my daughter. I highly recommend Dr. Keyes and staff!"- M.G. / Google / Jun 14, 2019
"Finding Dr. Keyes was fate. After having one of the worst rhinoplasty consultations from a top plastic surgeon in Beverly Hills (that quoted me an obscene amount),I was kind of unmotivated and scared to keep looking. Out of nowhere, Dr. Keyes showed up at my workplace. I remember thinking how kind and welcoming he was in our interaction. When I found out he was a plastic surgeon specializing in rhinoplasty I knew this was meant to be! He answered all my questions right then and there and told me to call his surgical assistant and manager, Kimberley, and let me tell you...Kimberley is AMAZING!!! Not only did Kimberley answer the phone immediately with the most comforting voice but she scheduled a consultation based on what worked best for my schedule. The consultation was so easy. I didn't even have to wait. They brought me in the room, took photos of my nose and next thing I know Dr. Keyes was in the room showing me what my nose could look like. He listened to what I had to say, what I was self conscious about, and really incorporated me into the treatment and what I could get out of it. Dr. Keyes and Kimberley made me feel welcome, comfortable, excited, and confident about my decision on getting my nose done. Scheduling my surgery was crazy because of my schedule at school and work. Kimberley always answered my calls and answered my concerns about rescheduling my surgery which made it very convenient for me. Surgery day was nerve wracking but exciting. The anesthesiology nurse even called me a few days before to make sure I was aware of the process and what would happen, addressed my concerns about surgery, and eased my nerves. Dr. Keyes, Kimberley, and all the nurses made sure I was okay, talked me through the process, and kept me updated on what was happening next. Next thing I know, I was waking up with Dr. Keyes and Kimberley by my side. They called that night to make sure I was okay and scheduled a time for me to come in the next day.From the time I woke up from surgery, I had barely any pain! Besides the swelling and bruising(which is expected), recover was so easy. I was up and about within a few days. The bruising and swelling went down within 5 to 7 days but that's patient specific.When I finally got my cast off, I couldn't believe how amazing my nose looked! I couldn't help but cry my eyes out. It was just what I wanted for sooo long. To this day, I still look at myself in the mirror and get all giddy inside. The best part is how NATURAL it turned out. I still look like ME and I LOVE it. People that knew me before the surgery just look at me and tell me something as changed but they can't pinpoint it. If you are looking for a natural looking nose that compliments your face and who you are as a person then Dr. Keyes is your guy!I have never felt so confident and beautiful in my life. I owe it all to Dr. Keyes and Kimberley!!!"- L.F. / Google / Jun 14, 2019
"Dr. Keyes and Kimberley are amazing! They treated me with respect and provided incredible care before and after surgery. I am 3 weeks post op from rhinoplasty surgery. The swelling has gone down tremendously and will continue to do so. I am thrilled with how it looks so far and I know it’ll only get better!"- A.W. / Google / May 22, 2019
"I have been a patient of Dr Keyes for over 17 years now and I highly recommend Dr Keyes. Over that period of time I have had breast augmentation, brow and lid lifts, nose job, lipo and botox treatments. I have been completely satisfied with the results and have always received professional and caring service from Dr Keyes, Kimberly, and staff. I recommended Dr Keyes to a college friend of mine years ago and she is also very happy with her breast augmentation from Dr Keyes. Unlike some cosmetic surgery offices, Dr Keyes will not comment on a body part unless YOU ask first. Check out his impressive credentials and go visit him for a consultation !"- I.G. / Google / May 22, 2019
"After interviewing three other Doctors for my girlfriends augmentation, we decided to go with Dr.Keyes. From his office, to his staff, Kimberley is amazing, we felt comfortable from the get go. We always felt he cared about us as people and the surgery was a marvelous success, he is a talented sculpture and he had had us following up with visits for months now just to make sure the healing is going along as it should. I would recommend him in a heartbeat!"- D.S. / Yelp / Feb 26, 2019
Should you have any worries (either cosmetic or medical) after breast augmentation surgery, please make an appointment for a consultation. Talk with Dr. Keyes if you suspect something is wrong or if you feel like your breast implants have changed over time. Poor outcomes in a breast augmentation may be seen immediately or develop over time in just one or both breasts. Whether it is scar tissue, breast sag, ripples under the skin, or uneven breasts, revision surgery can help repair the deformity and create a more appealing and properly functioning outcome. Breast implant revision may also be appropriate if you would like to replace older implants, alter the implant style, size, or address another aspect of your breasts.
Common Reasons for Revision
Secondary breast augmentation either removes an implant that is not functioning properly or is no longer desired. Breast revision surgery may also be performed to change implant size or go from silicone to saline (or vice versa). There are other common situations where a breast revision is needed, such as:
This condition occurs when the breast implants look out of balance. This may be due to an incorrect size implant, or lack of tissue on one side, or a different condition that can possibly cause asymmetry. An assessment and diagnosis would need to take place to determine what is causing the asymmetry, then a revision surgery would be implemented to resolve the condition, and finally a new set of breast implants would be inserted to attain a proportionate appearance.
Bottoming out is a problem that may happen if one or both implants "bottom out" or drop too low. Sometimes this is a positioning and placement error from the original surgical procedure. To fix this, a different placement method may be recommended. For some patients, tissue grafting will be needed, in addition to a surgically produced pocket to stabilize the new implant. For many patients, switching to a silicone breast implant will resolve this issue.
Sometimes revision surgery is as straightforward as getting a larger or smaller-sized breast implant. During the first surgery, you may have chosen to go too small or big. A different implant size can be switched with the original to attain the desired aesthetic goal.
When your breasts develop an area of hardening after having a breast augmentation, you may have a capsular contracture. If the smooth tissue that surrounds a breast implant becomes thick and hard, then this is called capsular contracture. While breast implants do create some internal hardening, most women will never realize this. It is when the hardening tissue changes the implant function and placement, that it creates an undesirable outcome. The scar tissue will have to be removed as well.
Rippling occurs when you see noticeable lines and ripples under the skin around the edge of the implant. Many times, this issue can be repaired by switching to a silicone breast implant.
Although this rarely happens, a breast implant rupture can occur. When a saline breast implant ruptures, the implant will deflate rather quickly and deflation will be noticeable. Meanwhile, if an implant made of silicone ruptures, it is usually seen only through an MRI. In either case, when a rupture occurs, a secondary breast augmentation will be needed.
Symmastia of the breasts may occur if the initial breast implants are positioned too closely together. Most often, this is because the breast implant selected was the incorrect shape, size, and/or width. Dr. Keyes would replace your implants with new ones that are acceptable to your frame and proportions.
Dr. Keyes has several options to improve the appearance of your bust line with breast revision. Usually, he can reopen your original incision to minimize scarring. In an outpatient setting, he can perform a breast revision in several different ways.
Replacing your implants
Implants that are leaking, damaged, or deflated, Dr. Keyes will remove the old implants and insert a new set. If the skin has stretched with large implants, Dr. Keyes may recommend a breast lift as well. It is important to keep in mind a lift may involve additional incisions. If you are not having new implants placed, then he will likely remove the lining of the implant pocket, which will help speed healing.
Removing your scar tissue
This is done by performing a breast capsulectomy, a surgical procedure that removes all the thickened capsule surrounding your breast implant. The implant will be reinserted after the tissue excision into the existing pocket or replaced with new implants.
Repositioning your implants
If your implant has migrated or shifted out of place, Dr. Keyes can remove your old implants and reconstruct the pocket will hold new ones. He can achieve the right implant position with suturing techniques. He may also utilize tissue grafts or supportive mesh to enhance the result and prevent the implant from moving in the future.
What to Expect
Following your procedure and a brief observation period, you will be sent home to begin your recovery. The overall recovery varies depending on what is involved in your surgery. Any type of revision that requires grafting or complex reconstruction will incur a longer recovery that may last 6 – 8 weeks. You should slowly start to see your surgical results when the bruising and swelling fades. You should attend follow-up visits as often as directed so Dr. Keyes can monitor your healing and results.
Frequently Asked Questions
How much does breast revision surgery cost?
Your cost for breast revision surgery will vary based on the complexity of your procedure. In your consultation, Dr. Keyes will listen carefully to your needs and goals and perform a physical examination of your breast and implants. After this, he will explain your choices before creating your treatment plan. The total cost of revision surgery will be based on the extent of the procedure, plus your new implants. At Geoffrey R. Keyes, M.D., F.A.C.S., we accept several payment options and we will give you information on low-interest financing.
What if Dr. Keyes wasn't my original surgeon?
Dr. Keyes can perform your revision surgery even if he was not the surgeon who performed your first breast augmentation. Revision surgery is sometimes more difficult compared to augmentation surgery especially if you want significant changes or have problems like scar tissue. This is why it is better to choose a plastic surgeon like Dr. Keyes who has advanced training and experience in breast surgery. Dr. Keyes also invites his patients to come back to Geoffrey R. Keyes, M.D., F.A.C.S. for revision surgery after their implant surgery if they notice an issue or would like new implants.
What about loose skin?
When your implants are exchanged or removed, you may want to have excess, sagging skin removed as well. After hearing your goals and evaluating your current implants, Dr. Keyes can discuss adding a breast lift. If you lose a lot of weight, get pregnant, or breastfeed after augmentation surgery, a revision with a lift gives you better results.
Will there be new scars?
If possible, Dr. Keyes will make incisions for revision surgery in the original augmentation incisions. If this is not possible, he will place the revision incisions where they are least visible. Revision surgery may use a transaxillary incision (in the armpit), a periareolar incision (along the lower border of the areola), an inframammary incision (beneath the breast fold), or TUBA incision (through the belly button). Dr. Keyes or a member of his team will explain scar care instruction so your incisions heal properly and blend well with your skin.
Select The Right Surgeon
Breast implant revision surgery is a specialized procedure tailored for your individual problem by Dr. Keyes. If you're displeased with your breast augmentation results or want a different result, we invite you to contact our Los Angeles, CA office to book your appointment at Geoffrey R. Keyes, M.D., F.A.C.S. There are many factors to consider and Dr. Keyes will provide you with a full physical examination, create your revision recommendations, and discuss realistic goals and expectations. Schedule today.