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
"So happy with rhinoplasty results - two weeks post op! - I'm only two weeks post op from my nose surgery so technically I should wait to write this review until the final result, but I can't wait. I am so happy with my results. Dr. Keyes is an expert rhinoplasty surgeon, and he did a remarkable job on me. I was classified as "a hard nose" because I already had a nice nose, but I was always self conscious because it was slightly crooked and pinched in the center which also gave me breathing issues. He knew exactly what I needed from the moment he saw my nose, and he delivered. My nose is so natural and beautiful now, I can't believe it's only going to get better. Hard to imagine! Not to mention my breathing is amazing. Feels like I have an invisible breathe right strip on. It's an incredible feeling.Kimberly, his partner is also lovely. Like all the other reviewers say, she is there every step of the way answering questions and concerns. Both of them couldn't be easier to reach. Kimberly is warm and friendly and makes you feel totally comfortable. All in all I feel lucky to have found them, and I am so thankful. Will report back with an update a couple months from now. Thank you Dr. Keyes and Kimberly!"- P. / RealSelf / Nov 11, 2019
"Dr. Keyes and Kimberley, his surgical assistant, are the best in the business. These days it is tough to find a surgeon especially because you can find a lot of flashy pictures on social media that might make you interested in visiting a surgeon, but when it comes down to it it's all about skill. Dr. Keyes has been president of the rhinoplasty society and speaks around the world on surgical techniques. Kimberley is SO kind and caring, you will certainly be in great hands with these two. When it comes down to picking a surgeon, it is key to find a surgeon that has the credentials, bedside manner, and experience and that is Dr. Keyes and Kimberley! I'm only 4 months post-op and I can't wait until my final results. This is the place to go for your next procedure, 100%. Wish I could give more than 5 stars!"- J.S. / Yelp / Oct 29, 2019
"Kimberely and Dr. Keyes are the best! - Prior to Dr. Keyes I had seen three different ENT’s; two scoped my nose, one wanted a CT scan and I had a couple of surgeries that were of no help.My primary care physician suggested I go see Dr. Keyes, because he was able to help one of her other patients.I was NOT thrilled on the idea to go see a "plastic surgeon".I called and talked to Kimberley, Dr. Keyes Director of Patient Services. She is absolutely AMAZING! She answered all of my many questions and I called more than once!I met with Dr. Keyes and told him about the issues with my nasal passages. He listened, asked a few questions and then examined my nose.After a little prodding, he said there were three items wrong with my nose. He described the details of the nose functions and then explained what needed to be done to mine.I was impressed. It made sense and I went through with the surgery.I wish I would have gone to him FIRST!THANK YOU Dr. Keys and Kimberley! You two are the best!"- N. / RealSelf / Oct 14, 2019
"3 months post-op and loving so far! - Dr. Keyes and Kimberley are literally the BEST of the best. I've been waiting to write my formal review (and will be doing so when I have more time to rave about them) but honestly I've been getting a ton of compliments and couldn't wait! They are the dream team! More formal review to come :)"- R. / RealSelf / Oct 13, 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.