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.
"This review may be a little early as I just got my cast off my nose today...but I am over the moon. I don't know how Dr. Keyes does it, and I'll admit I was skeptical while the cast was on as the cast and tape can distort things. I was actually a nervous wreck. But when that cast came off today, it reduced me to happy tears. He did everything I wanted and more. My nose is now straight, and it looks amazing. Even swollen I love it! I can breathe through my left nostril for the first time and it feels so good. I seriously feel like a new person. I'm so excited to see how it progresses over the next year. Dr. Keyes was the only consultation I had, and for a second it crossed my mind, did I jump the gun on this? Do I need a second opinion? Something in my gut trusted him. And I'm so glad my gut was right. His reviews and his before and after photos on his website speak for themselves. I am so thankful to Dr. Keyes and Kimberly. They're so easy to reach and they care about you just as much before the surgery as they do after. They are wonderful. Couldn't recommend them more. I am so happy. Thank you Dr. Keyes and Kimberly. From the bottom of my heart!"- S.B. / Yelp / Nov 05, 2019
"I started considering rhinoplasty when I was 16, I am 28. I hated my nose, the shape and the size. I tried for many many years to love as it was. But to be honest, I always knew one day I would take the step. Los Angeles has a big offer of plastic surgeons, and is hard to know who is good and who is the best. After some months of research, I narrowed my options and had two consultations with two different surgeons. From the very first second I knew Dr.keyes would be my surgeon. I am a really hypochondriac person, and Dr.keyes and Kimberly made me feel confident, safe and comfortable during the whole process. The day of the surgery I was really nervous and everyone made it really easy for me. Post op is painless, just uncomfortable. Dr Keyes and Kim were available for me 24/7in case I had any question or concern. That really makes a difference. I am one month post op and even swollen, I looooove my nose, it changes your life. It is natural, fits my face and I could not be any happier. If you are thinking about having a rhinoplasty, Dr.Keyes and Kimberly are the team you are looking for, thank you both!!"- S.R. / Yelp / Feb 04, 2020
"I am in love with my new nose - I started considering rhinoplasty when I was 16, I am 28. I hated my nose, the shape and the size. I tried for many many years to love as it was. But to be honest, I always knew one day I would take the step. Los Angeles has a big offer of plastic surgeons, and is hard to know who is good and who is the best. After some months of research, I narrowed my options and had two consultations with two different surgeons. From the very first second I knew Dr. Keyes would be my surgeon. I am a really hypochondriac person, and Dr. Keyes and Kimberly made me feel confident, safe and comfortable during the whole process. The day of the surgery I was really nervous and everyone made it really easy for me. Post op is painless, just uncomfortable. Dr Keyes and Kim were available for me 24/7in case I had any question or concern. That really makes a difference. I am one month post op and even swollen, I looooove my nose, it changes your life. It is natural, fits my face and I could not be any happier. If you are thinking about having a rhinoplasty, Dr.Keyes and Kimberly are the team you are looking for."- S. / RealSelf / Feb 04, 2020
"Rhinoplasty - I'm scheduled to have rhinoplasty with dr Geoffrey Keyes in LA. I had my consultation and I had my pictures taken and then photoshopped by the dr to show me what he can do with my nose. He is nice and very straight forward and gives his honest opinion on what realistically can be done. I told him I want a really small Barbie nose . He said he can give me that but it also all depends on what happens in the OR , but I told him to go as small as my body will allow. I'm also interested in lip lift and fillers so I'm going to call tomorrow to see if that can be done as well."- M. / RealSelf / Feb 02, 2020
"In November 2019 I had rhinoplasty revision surgery & a facelift with Dr. Keyes and Kimberly. I had consultations with other very experienced & highly regarded surgeons but did not feel the connection that you need to have with the surgeon and staff.Dr. Keyes is very well regarded and President of the Rhinoplasty Society so I trusted him completely and listened to his guidance, he does what is best for his patient and will not try to "sell you" which is very common with a lot of Los Angeles surgeons. He also officially sets the Standard for Safety in Plastic Surgery. You are putting your life and looks in a surgeon's hands it's important to feel safe and confident! Dr. Keyes and Kimberly were patient, caring and went beyond the call of duty at every step of the way. I received a call from Dr. Keyes the night before the surgery and he and Kimberly his surgical assistant were both available and in contact all the way through. They are the best in the business and have been working together for decades and it shows!It has been two months since my surgery and I feel and look better than at any point in my life I am absolutely in awe of Dr. Keyes' aesthetic, surgical, safety and communication skills. I am thrilled with my decision! So much so that I have booked a breast augmentation in a couple of months and I will not be nervous. Dr. Keyes and Kimberly are so talented and caring I am so lucky to have found them. Truly a life changing experience. I cannot recommend and thank them both of them enough!"- L.M. / Google / Jan 18, 2020
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.