Treatment Options

The options that are available to you will be dictated by your specific concerns, your goals for surgery and by the changes that have occurred within the breasts since your previous surgery.

Breast Implant Replacement

Breast implants are medical devices and are not intended to last a lifetime. On average, a breast implant will need to be replaced every 10-15 years. Complications with implants can include hardening (capsular contracture), rupture, or malposition (implant moving out of position under the breast). Occasionally these problems may result in pain. Aesthetic concerns may include stretching of the breast tissue, asymmetry or dissatisfaction with breast size.

The specific revision procedure will be guided by the underlying problem but will involve removal of the old implants, correction of the problem, followed by replacement with new implants. These implants may be saline or silicone gel filled and may vary in size from the original implants based on your particular goals. Sometimes, implant removal and replacement is combined with procedures to address breast shape including breast lifting or fat grafting.

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Breast Implant Removal

Some women may wish to opt for a solution that involves the removal of their breast implants without replacement. This may be related to problems with the implants themselves. Alternatively, as women age they may actually develop larger breasts through weight fluctuation or hormonal change and feel that they are large enough in size without the need for implants.

Implant removal can be performed in a variety of ways. Some patients elect to only remove their implants with no further modification of the breast. Alternatively, women can undergo a breast lift or reshaping to create an improved appearance using only the remaining natural breast tissue and skin. Additionally, Dr. Brown has developed an expertise in the use of large volume fat grafting for restoring volume to the breast.  The procedure known as SIEF (Simultaneous Implant Exchange with Fat) involves controlled liposuction of fat from other areas of the body and injection of that fat into and around the breast following removal of the implant. Although this procedure will not give the same volume or appearance that is achieved with an implant, it does provide an option for maximizing volume using nothing more than your own natural tissue

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Breast Mound Repair

There are times when revision surgery does not require either removal or replacement of the breast implant. The underlying problems are more related to the breast tissue itself. This may include situations where there has been an increase or decrease in breast volume, thinning of the breast tissue resulting in visibility or rippling at the edges of the implant itself or asymmetries that have developed over the years.

Revision procedures may include reshaping or lifting of the breast tissue, removal or reduction of breast tissue, or addition of volume with fat. Sometimes it is necessary to add internal support structures such as mesh or dermal matrices to support the implants in an improved position. This may be combined with the repositioning of your breast implants in to a new pocket or location under the breast to maximize coverage of the implant and produce more natural overall results.

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Dr. Mitchell Brown, Toronto Plastic Surgery and Toronto Brest Revision Surgery