Breast Revision in Scottsdale, AZ

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.

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. 

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” 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.

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).

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.