Dr. Boyd

Breast Revision Surgery in Palos Verdes, CA

What Is Breast Revision Surgery?


Sometimes breast surgery does not go the way one would like. While a good plastic surgeon will strive to ensure that everything goes smoothly, surgical complications may still arise or you may be unhappy with the results. Occasionally, even good results may be undone by childbirth, breast feeding, sagging skin or even oncological breast surgery such as biopsy or lumpectomy. If this occurs, you may wish to undergo breast revision surgery. Breast revision surgery corrects surgical complications or dissatisfying results from procedures such as breast augmentation, breast reduction, breast lift, partial mastectomy, and breast reconstruction.

What Are the Benefits of Breast Revision

  • Improves the symmetry of your breasts
  • Corrects surgical as well as postoperative complications and their resulting deformities
  • Creates more natural-looking breasts

What Should I Expect From Breast Revision?

Your original surgeon is undoubtedly the best person with whom to discuss your concerns, as he or she is primarily responsible for correcting unforeseen complications and achieving the best results possible. (After all, the initial surgeon should know exactly what was done the first time around!) However, if this is not feasible because of location, financial concerns, retirement of your surgeon, or even a lack of comfort working with him or her, Dr. Boyd would be delighted to consult with you and, if necessary, perform your breast revision procedure. Dr. Boyd will review your records, meticulously evaluate the aesthetics and symmetry of your breasts, and discuss with you the best options to achieve your goals. The procedural details will depend on your particular deformity as well as your desired result, and these details will be discussed in greater detail when you meet Dr. Boyd in person.

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Bottoming Out

  • The breast implant slides below the inframammary fold, causing the nipple and areola to point upwards and the upper pole of the breast to collapse.
  • Dr. Boyd may recreate the inframammary fold at its normal level and may also replace both implants with smaller ones, as larger implants are more likely to bottom out. It might even be necessary to excise skin to tighten the lower pole of the breast.
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Anatomical Implants

  • Anatomical (shaped) breast implants may be malpositioned or may shift or rotate after insertion, causing the breasts to appear misshapen and often leading to other complications such as double bubble deformity or bottoming out.
  • Dr. Boyd will most likely exchange both implants with round ones to eliminate the effects of implant rotation.
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Capsular Contracture

  • The scar capsule that forms around the implant may become hardened, causing painful scar tissue, noticeable distortion of the breast, and coldness or hardness to the touch.
  • Depending on the grade of capsular contracture, Dr. Boyd will remove the scar tissue and will usually either replace the implant with a new one or completely remove both implants and perform a breast lift, according to the patient’s wishes.
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Double Bubble Deformity

  • The breast implant may be pushed upwards by muscle action, causing the skin to appear loose at the lower pole of the breast. This is often associated with a capsular contracture, which may become painful.
  • Dr. Boyd will loosen the breast pocket, surgically remove the scar tissue, replace the implant, and tighten the breast. Optimal positioning and tightening of breast skin will minimize the risk of future implant shifting.
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Positioning Issues

  • If a breast implant was malpositioned during the previous procedure, bottoming out, double bubble deformity, or inadequate cleavage can develop.
  • Depending on the issue, Dr. Boyd may reshape and tighten the breast pocket, remove scar tissue, and/or replace the implant with a new one in a more favorable position. The pectoral muscle may need to be repaired or released.
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Ruptured Implants

  • The breast implant shell loses its integrity and ruptures, causing potentially noticeable asymmetry and pain as well as capsular contracture.
  • With silicone implants, Dr. Boyd may require an MRI to confirm implant rupture, and in either case, he will remove the scar tissue together with all loose silicone. The patient has the option of breast lift, re-augmentation, a combination of both, or doing nothing more.
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Implants Size Change

  • The breast implants are either too large or too small.
  • Dr. Boyd will replace the implants with new implants of a more favorable size and possibly of a different material, shape, or profile to achieve your desired results, sometimes with a concurrent breast lift.
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Symmastia

  • Here, the breast prosthesis shifts toward the center of the chest, crossing the sternum and causing painful scar tissue, lack of cleavage, and possible visibility of the implant.
  • Dr. Boyd may use an acellular dermal matrix to contain and support the breast implant, and he may also replace the implants with higher profile, narrow-based implants to minimize the risk of recurrence.
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How Is Breast Revision Performed?


Implant Removal (Without Replacement)

Dr. Boyd will make an incision on the breast (usually in the same location as your breast augmentation incision) to remove the breast implant. This incision may be slightly longer than the original but should not result in significant additional scarring.

The implant is removed, and the breast capsule is excised.

This technique is not appropriate for women experiencing complications with the scar tissue as it does not involve removing the tissue.

Implant Removal (With Replacement)

Much like implant removal without replacement, an incision is made on the breast (usually in the inframammary fold), and the damaged or unwanted implant is removed. When the capsule is thickened it is excised (capsulectomy).

A new implant is then inserted into the breast pocket. This implant may be identical to the one removed or may have a different size, shape, or filling material.

Capsulectomy

A capsulectomy is performed when the scar tissue (the capsule) that surrounds the implant is thickened and has tightened causing the breast to feel hard. This technique removes both the implant and the surrounding scar tissue. A new breast implant may be inserted at the same time if desired.

  • A partial capsulectomy removes the implant and some of the scar tissue (while leaving some behind).
  • A total capsulectomy removes the implant and all of the scar tissue. The scar tissue is often removed in pieces.

En Bloc Capsulectomy

An en bloc capsulectomy is a variation of a total capsulectomy; however, with this technique, the implant and scar tissue are removed in one piece. This is ideal for patients with ruptured implants or other complications as it does not allow for any of the capsule contents to escape into the body.

Because the capsule is removed in entirety, an en bloc capsulectomy usually requires a longer incision with extended downtime.

Implant Removal and Breast Lift

Often, women who choose to remove their breast implants (with or without a capsulectomy) experience sagging afterward. A breast lift is commonly performed as part of the breast revision to lift and tighten sagging breasts.

What Should I Consider Before Choosing Breast Revision


Breast revisionary surgery involves an operation often on the same scale as your original procedure, and therefore you should prepare yourself as you did the first time around. Patients who experience any of the above issues should schedule their consultation with Dr. Boyd for possible breast revision surgery. Remember that Dr. Boyd always puts the patient’s wishes first and is flexible in his recommendations with regard to how the patient would like her breasts to look.

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Frequently Asked Questions

If you are experiencing pain, if you are dissatisfied with your surgical results, if there are noticeable asymmetries between your breasts, or if you are uncertain whether or not your breasts may have developed one of the above issues, schedule your consultation with Dr. Boyd. He will be able to determine whether you are a candidate for breast revision surgery.

Breast revision surgery will correct your current issues, but it won’t necessarily prevent future complications. For example, capsular contracture can be recurrent. It is recommended that you continue to follow up with your surgeon regularly to ensure that your breasts and breast implants remain complication-free.

There are many other reasons to undergo breast revision surgery, such as excessive scarring, nipple loss, and breast sagging. If you think you may need breast revision for any reason, schedule a consultation with Dr. Boyd.

Results from breast revision surgery are long lasting, though the breasts will continue to age normally. Breast implants may need to be replaced at some point in the future. Dr. Boyd will happily provide ‘maintenance’ for your new breasts over the years.

As much as 15 percent of women may need to undergo breast revision to change the size of their implants, especially as they age and their preferences change. Approximately 10 to 15 percent of women with silicone implants may experience capsular contracture or positioning issues, and slightly fewer may experience implant rupture. Other complications are even rarer. Overall, most women are very satisfied and experience no complications with the results of their breast procedures.

Breast revision may cost as much as your original breast procedure. Depending on your reason for undergoing breast revision, you may be able to get a portion of the procedure covered by your insurance or even the breast implant manufacturer.

Not always. Some lifts, fat grafting, and nipple repositioning may be done without entering the implant pocket. If breast implants need to be removed during breast revision surgery, brand new implants are usually inserted. However, they do not have to be replaced at all if you no longer wish to have breast implants! Dr. Boyd can remove the implants and perform a concurrent breast lift to improve the appearance of your breasts after breast revision surgery.

Ten years is the average length of time after the original breast augmentation that women tend to have their breast implants replaced due to preference changes, breast changes, or complications. However, replacing your implants every ten years is not medically necessary. As long as the breasts remain soft and attractive without any of the complications outlined above, Dr. Boyd would urge you to leave them alone.

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Our Location

Dr. Boyd's office is located in Palos Verdes (Rolling Hills Estates)

550 Deep Valley Drive, Suite 283
Rolling Hills Estates, CA 90274

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