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Breast Revision

There are various reasons why women who undergo a primary breast enhancement surgery may require an additional revision procedure. If you feel that you may benefit from a breast enhancement revision, Dr. Minniti can help you achieve your desired results. Our warm and welcoming staff makes every patient feel as if she is part of the family; patient care is our number one goal. Dr. Minniti performs all procedures in an outpatient surgery center that is accredited by both independent (AAASF) and Federal agencies (Medicare).

With board certification by the American Board of Plastic Surgery (ABPS) and membership in both the American Society of Plastic Surgeons (ASPS) and the American Society for Aesthetic Plastic Surgery (ASAPS), Dr. Minniti offers patients the opportunity to correct any unwanted problems that may have resulted from a previous breast enlargement surgery. Dr. Minniti has a special focus in breast augmentation and breast lift revision surgery, dedicating more than half his practice to these surgeries.

WHAT CONSTITUTES A BREAST REVISION?

A “corrective cosmetic enhancement,” breast augmentation revision is a procedure performed to correct problems from former breast enhancement surgeries including, but not limited to:

  • Rippling
  • Capsular contracture
  • Implant malposition
  • Breast Asymmetry
  • Wrong implant size
  • Suboptimal nipple position
  • Suboptimal breast shape

 

Capsular contracture is the most common complication that leads to revision surgery. Scientific evidence suggests that capsular contracture is triggered most commonly by bacterial contamination of the implant at the time of the original surgery. When replacing implants due to capsular contracture, Dr. Minniti treats the capsule and implant together to prevent re-contamination of the submuscular pocket. This can minimizes the risk capsular contraction a second time. Additional information regarding breast augmentation surgery (“augmentation mammoplasty”) revision can be obtained during a consultation.

Implant malposition is also a very common problem. The causes of implant malposition are many, and include capsular contracture, asymmetric pocket creation at the time of surgery, and unpredictable healing. There are two techniques that Dr. Minniti uses to correct this problem. Capsulorrhaphy is a technique that modifies the capsule by closing it down around the edges to constrict its size and limit the implant’s ability to settle into that unwanted space. This is occasionally done in conjunction with placement of a special product known as ‘acellular dermal matrix’ or ADM. These are sheets of woven collagen that help support the repair of the capsulorrhaphy as well as increasing the distance between the implant and the skin, limiting unwanted rippling.

Another technique that Dr. Minniti employs for malposition issues, especially a particular type of malposition known as ‘symmastia’, involves creating a ‘neo-subpectoral pocket’ for the implant to sit in. This is a novel way of getting the implant to sit in an optimized position without the need for sutures to hold the implant in place. This technique involves treating the implant from inside the capsule then separating the capsule from the undersurface of the muscle, but only where the new implant position is desired. Once released, this part of the capsule (top or ceiling) is sutured to the part of the capsule attached to the chest wall (bottom or floor). This closes the old capsule onto itself, forming the new floor for the implant to be placed on, and effectively repositioning the implant.

In addition to implant problems, some women would benefit from a revision surgery that would improve their breast shape or sagging. This involves some form of breast lift or mastopexy revision surgery. This is commonly done in conjunction with implant revision surgery, but sometimes done as a procedure by itself. Revision surgery involves reducing the excess skin and/or repositioning the nipple to improve the overall appearance of the breast. The most frequently performed breast lift revision surgery in Dr. Minniti’s practice is one that converts a vertical lift into an anchor type lift. Another revision breast lift surgery that Dr. Minniti performs converts a circumareolar type lift, also known as a Benelli or doughnut lift, into an anchor type lift.

By performing these revision breast surgeries, Dr. Minniti may be able to correct problems while possibly helping the patient achieve the new look she desires. During the consultation Dr. Minniti will examine your breasts and determine the best surgical treatment. In most cases, the implants are replaced with new ones, however there is a possibility that he may recommend no replacement. This is highly dependent on your individual anatomy and the extent of breast augmentation problems.

Making the decision to have plastic surgery again after a procedure that did not lead to a satisfactory result can be a big step in a patient’s life. Understanding the process that a patient goes through when choosing a revision breast procedure, Dr. Minniti is most compassionate and caring during this difficult period. Dr. Minniti believes that patient education of the nature of the problem and the best treatment options available is the most important first step in the process of obtaining a result that will lead to patient happiness.