There are many types of breast revision surgery (capsulorrhaphy, implant exchange, capsulectomy, capsulotomy, and mastopexy revision) that Dr. Tsujimura of Scottsdale Plastic Surgeons performs to correct unsatisfactory results of a previous breast surgery or to fix an implant problem. Many patients are referred from other plastic surgeons across the country since Dr. Tsujimura has earned a reputation as a breast revision surgery expert. From old, hardened, misshapen, bubbled or malpositioned implants, our board-certified plastic surgeon utilize his artistic surgical techniques to correct, remove or replace existing implants to achieve beautiful results. He also incorporates different styles/ profiles of implants and uses biologic materials (SERI, Alloderm, Strattice) if needed. He is also able to customize lifts to existing or new implants. With his extensive experience in cosmetic and reconstructive techniques, he is able to accomplish results that others could not.
"Rhinoplasty - Scottsdale, AZ - I couldn't be happier with my new nose.I hated my nose for as long as I can remember, when I looked in the mirror or at pictures of myself that's all I saw. The first time I met with Dr.Holden he pin pointed my exact issues with my nose with out my having to tell him. He was very kind and patient and answered all of my questions. While talking to him it was obvious he knew what he was talking about and was an expert in his field. I felt so comfortable and confident with him that I canceled my other consultes (with another surgon I used in the past) and scheduled by surgery for the next week. Dr.Holden also saw me at every one of my follow up appointments, not some nurse, which was very important to me and helped with my post surgery anxiety. With being 34 years old and a mother of 3 it was very important to me for my new nose to look natural. It does. I am thrilled when I look in the mirror and the people close to me have all remarked how wonderful it looks. While people that I haven't shared my surgery haven't noticed or at least not enough to say "oh my gosh you got a nose job!" I still look like me. :)"- S. / RealSelf / Jul 30, 2015
"Restylane Lyft Gave Me the Lift I Needed. - Dr. Holden was very knowledgeable and he took time to discuss all options available to me."- L. / RealSelf / Dec 04, 2016
"After many consultations with several surgeons I'm happy to say I found Dr. Holden. He is hands down the best of the best when it comes to trusting someone for facial plastic surgery. Dr. Holden performed a revision rhinoplasty and chin augmentation on me. After doing extensive research, Dr. Holden was more than qualified for the job. He had the same vision I had when it came to creating the masterpiece that he did. He turned my imperfection into perfection. I'm a person who worries about every little thing, and not only did Dr. Holden answer all my questions but he never rushed me and always made me feel comfortable. Behind every phenomenal doctor is great staff. Everyone was positive, smiled and was happy to assist. Andrea provided me with step by step instructions and explained everything to me. The customer service was beyond my expectations. Dr. Holden will be the only doctor to perform any future facial plastic surgery that I may need as I age."- K.A. / Yelp / Oct 28, 2016
"Chin Implant, Lower Facelift, Fat Grafting- 42 Year Old Female- Best Decision - Scottsdale, AZ - Dr Holden was amazing- start to finish. He was very honest with me, and we discussed the best plan for my multiple issues. This was not a quick conversation and I was so impressed with the way he explained everything to me. He spent considerable time going over what the surgery itself would entail, what to expect after surgery, and my questions about recovery. He understands that this is both exciting and a bit terrifying as well- because it is my face after all. I wanted to look like myself, but with a better profile and jawline. He explained that a lower facelift, custom chin implant, as well as a touch of fat grafting under the eyes, at the temples, and at the lips would give me the results I desired.Interestingly enough, I was planning on having a different surgery for this problem, where my jaw would be broken and moved forward (orthagnathic surgery) and we spent considerable time weighing the pros and cons of both. Since my braces had largely corrected my teeth crowding and overbite, there would only be a few millimeters added with orthagnathic surgery. This would not be enough to change my profile in a noticeable way, and I would still need soft tissue reconstruction to get my desired effect. Not to mention, I would NOT need my jaw wired shut for 6 weeks with a facelift, and the pain would be remarkably less as well.Dr Holden made me feel very confident in my decision, and his advice was so valuable to me. His expertise was obvious as well. Not once did he pressure me or rush my decision, and we decided to proceed.After surgery, he was just as interested in my recovery and had frequent follow up visits. I felt he genuinely cared about my well being and outcome. I really could not be happier! I feel so grateful to Dr Holden for all the time he spent walking me through this complicated decision, and the results speak for themselves. When my friends see me now a week out, even though I'm still a little bruised and swollen, the typical reaction is tears of joy. I have several friends who are plastic surgeons, and they were impressed with my results right away as well. I am so grateful that Dr Holden was my surgeon- I have never felt so beautiful."- S. / RealSelf / Sep 11, 2016
"42 Yr Old - Amazing Breast Augmentation Experience - Scottsdale, AZ - Dr Tsujimura was the perfect choice for my breast augmentation. I trusted him immediately. He was kind, respectful, and gave me very honest feedback to my questions. I wanted silicone implants, somewhere in the 250-300cc range, under the muscle, with transaxillary placement. He discussed the pros and cons of implant types, incision location, implant placement, and implant size/profile. We agreed on a plan, and I couldn't be happier with the results. Even though I am only a week out from surgery, they look natural, symmetric, and appropriately sized for my small frame. I did not have any numbness on my inner arm or chest wall, which can happen with the transaxillary approach. I had almost no bruising either, just a little around the incisions. Pain was very minimal. He was very caring and involved during my postop visits as well, and made me feel very comfortable during my recovery. I am so grateful that Dr Tsujimura was my surgeon! I would recommend him to anyone!Also, his office staff and surgery staff are amazing- they make you feel appreciated, important, and they are all so kind and helpful! They made the experience even that much better!"- S. / RealSelf / Sep 11, 2016
Patients who wish to have their implants replaced will undergo a procedure where an exchange of one or both implants may occur. These revision surgeries are generally straightforward. If scar tissue does exist around the implant, an additional step will be taken to remove or release this. Some patients may require a breast lift or lift revision during this surgery. In addition some patients require a tissue matrix device known as (Strattice , SERI, Alloderm) for added support. Still others may need their implants adjusted and the pocket repaired or released. Dr. Tsujimura is confident that the customized surgery will address and correct the issues presented. The goal of the revision process is to resolve or overcome issues in a way that satisfies the patient’s aesthetic goals. Revision surgery is magnitudes greater in complexity than primary surgery. It is critical to know that your plastic surgeon has the visualization and skill to address and correct the problem.
Breast revision surgery is performed under monitored anesthesia care (MAC) sedation as an outpatient procedure in our surgical facility. The ease of recovery will depend on exactly what was being done during the revision process. Most women are able to resume their normal work activities after a full week of rest. Exercise will be a gradual process. It may take up to a full year for the scars to begin to fade and for the newly revised breast or chest area to look and feel natural.
The cost for a breast revision procedure will vary greatly, but on average, the range is between $5,000-$11,000. The final cost will depend on numerous factors including:
- If the breast implants are being removed or replaced
- If breast replacement is occurring with a silicone or saline breast implant
- If any additional surgical technique will be needed (i.e. a capsulectomy or a breast lift)
- If the implants were covered by a manufacturer warranty
Plan Your Procedure
Reasons for Revision Surgery
There are various circumstances as to why a woman may decide to undergo breast revision surgery. The most common reasons are listed below:
If a saline implant ruptures, the implant device will deflate due to the leakage of saline. This will result in an obvious deflating of the breasts. Silicone implants will not deflate visibly, however a break in the shell may still occur and may cause a deformity. The only true way to detect a shell break is through an MRI, which is why routine check-ups are recommended throughout the years. The majority of implants are guaranteed for life and the manufacturer will replace them. Scottsdale Plastic Surgeons can assist in getting them replaced.
Breast rippling and/or wrinkling can occur along the side of the breast, or underneath it. This occurs within saline implants resulting in an unnatural appearance under the skin. This is most common in women who are extremely thin. Rippling is less common with silicone implants but can occur. There are other implants or procedures that can correct or minimize rippling.
Double Bubble Implants
“Double bubble” is a rare complication with women who have breast implants. This occurs when the implant drops down behind or below the natural breast crease, or it has risen and now breast tissue drapes (double folds) over the implant. When this occurs, an unnatural indention will result in a “double” breast appearance. This is usually caused by improper breast implant placement from the original surgery, capsular contracture, which shifts the implant from is position or movement of the implant out of position “bottoming out”. One of the most common causes of this deformity is not performing a lift at the original surgery when it was needed.
Breast Implant Removal
Some women may decide later in life they no longer wish to have breast implants in place. Breast implant removal is a procedure that removes the implants and tightens the skin around the breasts to create a natural look. In the majority of cases a breast lift (mastopexy) is necessary.
Some women will be unhappy with their breast size following breast augmentation surgery. They may desire a secondary surgery to replace the implant with one of a different size, texture or shape. Some women may want to go from saline to silicone, or vice versa to achieve the results they desire.
Scar tissue that has formed around the implant may create a capsular contracture. When this occurs, excessive tightening of the capsule will result in a hard feel of the breast. This can lead to distortion and pain. Sometimes, in order to correct this, a capsulectomy must occur. This is the removal of scar tissue from around the implant. In other situations release of the capsule, capsulotomy, is all that is needed. In general, silicone implants have a higher incidence of capsular contracture (approximately 10-15% chances) than saline implants (5% chance).
Implant Bottoming Out
This can occur post-surgery when an implant shifts or moves from its original location to an inferior position. This can occur with aging, gravity, trauma to the chest, or not utilizing proper support. The most common cause is not wearing enough support with high impact activities (running) or working out the chest muscles. This deformity will need to be repaired (capsulorrhaphy) primarily or with an internal sling (SERI, Alloderm, Strattice).
Some women will need their breast lift revised. Either the nipples/areolas are too low or too high. A breast implant may also be added. Some issues are more complex than others. Experience and planning are critical in correction.
Experience of the surgeon reduces this risk. Some women are not good candidates for breast augmentation surgery alone. Women who have sagging breasts and undergo breast augmentation will have suboptimal results. The breasts will continue to sag, and the implant will either drop low or the breast tissue will droop over the implant. It is crucial to recognize when a lift and what type of lift is necessary to produce the desired outcome. Also choosing the right implant is important as well.