About Breast Revision - Toronto Breast Revision Surgery

Facts and Statistics

For many years hardening around an implant (capsular contracture) was the leading cause of breast implant revision surgery. This number has now decreased dramatically due to improvements in implant technology and surgical technique.
The leading cause of revision surgery today is implant malposition — implants not sitting in their desired position under the breast tissue. The likelihood of malposition can be minimized with precise surgical technique, careful selection of implant sizes to match the measurements of the existing natural breast, and following a specified post-surgical routine during the important initial healing period.
Almost 50% of Dr. Brown’s breast procedures today are dedicated to aesthetic and reconstructive revision surgery. Dr. Brown performs over 150 revision breast surgeries per year.
Fat injection has become a very important and useful tool in revision breast surgery procedures. Dr. Brown incorporates fat injection in over 75% of his reconstructive breast surgeries and in a majority of his aesthetic revision procedures.

Important Messages About Breast Implants from Dr. Brown

Breast implants are not “once in a lifetime” devices. Although there is no “shelf life” and implants do not need to be replaced on a regular specified schedule, almost all women with implants will need to have them removed or replaced at some point in time.
Implants can be monitored for signs of rupture or fluid in the space around an implant with High Resolution Ultrasound (HRUS). This simple non-invasive procedure is offered through our office to all of our breast implant patients.
If there is a concern about an implant being broken, the best test to identify a rupture is an MRI.
Breast implants can have a smooth or a textured surface. Concerns have been raised about a connection between textured surface implants and a rare type of lymphoma called ALCL. If you have textured implants, you should discuss this with your original surgeon, or feel free to reach out to our office for advice.

Frequently Asked Questions

What is the recovery like from revision breast surgery?

The type and length of recovery will depend on the specific nature of your surgery. In general, revision procedures are more involved and may take longer than initial or primary breast surgery. Typically, patients are able to go home the same day, return to most normal non-physical activity within 7-10 days and are able to resume full physical activity within 4-6 weeks.

Is there any information that I can provide that would be helpful?

All revision breast surgery patients will have undergone at least one previous surgery on their breasts. In some circumstances, patients may have undergone multiple surgeries. Any information that you can provide to Dr. Brown about your previous procedures would be invaluable. If possible, please try to bring previous surgical records, breast implant information or photographs.

I have previously undergone a breast lift or a breast reduction. Can this type of surgery be repeated?

All women’s breasts will continue to change throughout life. Events such as pregnancy, breastfeeding, weight fluctuations, menopause or even just aging and gravity will impact both the size and the shape of the breasts. Previous surgery does not change this fact. There are some women who benefit from undergoing a second or third breast lift or reduction later in life. There are some important modifications that need to be considered in these circumstances. Dr. Brown will discuss this in detail with you at the time of your consultation.

I have heard about using external expansion for fat grafting. What is this?

When surgeons inject small volumes of fat as a graft (lip, cheek or facial injections), the fat typically survives by gaining a new blood supply from the tissues in the area that it was injected. When large volumes of fat are indicated (such as in some breast revision surgery procedures), it is important to maximize the blood supply to that area in order for the fat to survive. This can be achieved through a process known as pre expansion. Patients apply a suction dome to the breast for several hours a day in the weeks before surgery. The negative pressure from these domes stimulates the blood vessels, making fat injection more predictable. In cases where large volumes of fat are needed, Dr. Brown has found this preparation step to be invaluable.

How do I know if my breast implants need to be replaced?

Breast implants are well made devices however they are not intended to last a lifetime. Although there is no “shelf life” on a breast implant, on average breast implants are changed every 10-15 years. Indications that you may need to have your implants exchanged include a change in breast shape, hardening of the breast, new unexplained pain in the breast or dissatisfaction with your breast size or shape. If you are having no difficulties with your implants, it is wise to have them imaged every few years to look for signs of silent rupture. Our office offers high resolution ultrasound as an excellent screening tool to look at implant integrity.

Will I need drainage tubes?

Drainage tubes are very rarely used by Dr. Brown in initial or primary breast surgery. Revision procedures that involve either the removal or replacement of a breast implant often leave a space that is at risk for allowing the accumulation of fluid. As a result, it is often necessary to insert a drain in revision surgery. The drains are quite easy to manage and are usually ready to be removed in the office within the first week.

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