In-person news gathering is a highlight of what we do at Costhetics. Recently, our team was onsite for the 38th Annual Australasian Society of Aesthetic Plastic Surgery Conference in Sydney. This year’s gathering focused on body-contouring and breast enhancement.

We were in the room for a talk offered by Dr Nimrod Friedman on the challenges and rewards of revision breast augmentation. Dr Friedman is a board certified plastic surgeon and a member of IPRAS, ISPS & ISAPS. His private clinic is based in Tel Aviv, where he specialises in aesthetic and reconstructive breast surgery.

What we learned was too enlightening not to share…

What Women Want After Breast Augmentation: Revision Surgery

According to the International Society of Aesthetic Plastic Surgery (ISAPS) more than 1.3 million breast augmentation procedures were performed in 2014 worldwide. The figure that raised our eyebrows, however, was this:

11-18% of breast augmentation patients have revision surgery

It is true that breast implants are not lifetime devices.Some patients will require a secondary surgery to have them replaced within ten to twenty years. Implant rupture and deflation can also trigger a need for breast revision surgery.

Other common reasons for the surgery include:

  • Switching implants – going from saline to silicone or changing size
  • Capsular contraction – scar tissue that must be removed surgically

“Capsular contraction is the number one reason for breast revision surgery,” reported Dr Friedman. “More often than not, however, it’s an aesthetic, not a medical problem that leads to breast revision surgery.” The same poor implant placement or substandard surgical technique that can cause the problems above can also lead to patient dissatisfaction with:

  • Asymmetry – a surgical outcome in which the breasts do not match.
  • Double-bubble – a surgical outcome in which the breast fails to take on the shape of the implant, making the implant visible along the bottom edge of the breast.
  • Bottoming out – an outcome in which the implant drops over time, settling into a position that is too low in relation to the nipple.
  • Symmastia – an outcome in which lifting the skin from the chest wall creates the appearance of a “uniboob”.

4 Things a Doctor Must Know Before Performing Breast Revision Surgery

Dr Friedman spoke at length about the steps surgeons must take in order to ensure optimal outcomes and reduce the need for further procedures.”It’s imperative that the right implant is chosen for each patient,” he remarked, noting that only a trained and experienced cosmetic plastic surgeon is truly qualified to make that recommendation.

“Women should look for surgeons who have an extensive background in breast enhancement and who can offer a wide range of implants to their patients… This way they can work collaboratively to select the right implant to suit a woman’s frame and goals.” He urged colleagues to focus on understanding:

  • The dreams and expectations of the patient
  • The unique anatomy of the patient
  • The differences among implants (gel, envelope, shape)
  • How the implant will change the 3D shape of the breast

No patient should have to suffer from capsular contracture, hardened breasts, mal-positioned implants, or an unsightly appearance after breast augmentation surgery.  Costhetics salutes professionals like Dr Friedman who have dedicated themselves to make breast enhancement surgery outcomes more successful.

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