Press/Media
Why can revisionary breast augmentation be necessary?
Breast augmentation is one of the commonest aesthetic procedures with the aims being to provide a natural long lasting result.
Over time both the skin/breast tissue and the implant can change and this can affect the overall result. Although this is uncommon and occurs infrequently the change can be devastating for the patient.
The aesthetic changes associated with the implant and its surrounding tissues are 1. Migration of the implant higher in relation to the nipple/areola/breast tissue, 2. Migration of the implant lower in relation to the nipple/areola/breast tissue or 3. Loss of integrity of the implant and its capsule leading to an unpredictable change in shape.
(In this article Mr Ross explains the approaches he uses to address these issues. In all cases the surgery was performed elsewhere and Mr Ross was not involved in any of the initial breast augmentations.)
In severe cases where there is associated capsular contracture the natural definition of the breast inframammary fold can be completely lost and redefining the fold requires recruitment of abdominal wall skin and a recreation of the fold. There may also be a requirement to change pocket placement and removal of the previous pocket.
Migration of the implant downwards can occur due to relaxation of the inframammary ligaments. This results in the unnatural appearance of the nipples/areola sitting too high in relation to the implant. This bottoming out affect can be corrected by manipulation of the implant pocket to raise both the fold and the implant. In cases where the skin has not been stretched excessively there is no need to remove any further skin and the original inframammary scar can be used for the procedure.
Capsular contracture is probably the commonest reason for change in shape and in severe cases can be associated with intracapsular and extracapular leak with seroma formation. The aesthetic sequelae are unpredictable and any revisionary surgery is extremely difficult. In almost all cases the capsule must be removed in its entirety and the pocket changed to accommodate the new implant. Due to excessive expansion of skin it may be necessary to not only re manipulate the inframammary fold but also to elevate the areola with a combination mastopexy.
The expectations of breast revisionary surgery are based on individual requirements
The main principals of breast surgery namely size, shape and symmetry still remain but the techniques to achieve an improved aesthetic outcome need to be altered to meet each individual requirement.
I aim to change and improve appearance by concentrating these expectations and needs. Preoperative consultations allow the development of the patient/surgeon relationship and a means to discuss any concerns and prioritize needs and expectations.
Advantages of Mr Ross’s Care
Optimising outcomes without compromising safety is paramount. By practising and operating aesthetically in one hospital Mr Ross is able to provide patients with a dedicated service. Preoperative consultations and all post operative visits are with Mr Ross and provision of 24 hour perioperative anaesthetic cover with dedicated intensive facilities ensures that every eventuality for all patients can be provided for on a single site.
To download this article as a PDF click here.
For information about Revisionary Breast Augmentation click here.
