Dr. Leonard W. Gray

450 Sutter Street Suite 2303, San Francisco, CA 94108
Contact Us Now 415-434-8858

Breast Revision/Implant Removal Surgery – San Francisco, CA

39 Procedures ( View All )

Overview

Revision of a previous breast augmentation is a specialty of board-certified plastic surgeon, Dr. Leonard Gray. Based on statistics from the American Society of Plastic Surgeons, nearly 300,000 breast augmentations are performed a year. With such a large number of procedures, there are a number of patients who have concerns with their results and seek a correction, improvement, or even removal. Dr. Gray and the team at Bay Area Plastic Surgery in San Francisco, CA, see a large number of these patients and support them in finding solutions for their problems. Dr. Gray welcomes discussion of difficult cases with his peers, and offers his recommendations and advice when other surgeons consult him.

Breast Augmentation Revision is generally requested for these reasons:

  1. To change from saline to silicone
  2. To change from sub-glandular to sub-muscular
  3. To improve rippling and palpability
  4. To change size
  5. To correct asymmetry in shape, volume, or both
  6. To treat capsular contracture

Reasons for Revision Surgery

1.) To change from saline to silicone

Changing from saline to silicone has been common in Dr. Gray’s practice since silicone breast implants became more available in 2007. This is because silicone implants create a result that looks and feels more natural than the saline result. Switching to silicone will decrease the rippling and palpability associated with saline implants. The breasts are considerably softer with silicone implants as well. In general, the silicone gel result is less artificial in appearance than the saline implant. In addition, this preferred look tends to be retained better and persist longer over time than the saline result.

2.) To change from subglandular to submuscular

When patients have a subglandular breast implant placement (over the muscle), there is frequently a round shape with more rippling on the upper part of the breast. Capsular contracture (breast hardening) rates are also higher with over the muscle implant compared to under the muscle. This hardening with capsular contracture is 30% less when placement is under the muscle. Patients will often ask to change to the submuscular position in order to achieve a more natural tear drop shape with less rippling and palpability, and less chance of hardening.

3.) To improve rippling and palpability

Rippling and palpability are the result of feeling and seeing the breast implant under the breast tissues. This effect is much higher with saline implants, and when implants are placed on top of the muscle. Generally, there are two ways to improve rippling and palpability. The first is to change the position, placing the breast implants under the muscle. This especially helps in the area of the upper and inner parts of the breast. Changing to silicone gel also improves the rippling and palpability as silicone is more viscous than salt water filled implants and does not have nearly as much rippling or palpability. Textured implants, in general, have more rippling and palpability than smooth implants, so they are best avoided if rippling is a concern.

4.) To change size:

Patients sometimes want to change their breast implant size. Some patients want to be larger, while others want to be smaller and more conservative. Dr. Gray works with these patients whether they are already in his practice or if they had their original surgery performed elsewhere. A thorough discussion reviewing all the available implants is performed to make sure that the patient can get the look that she wants. Changes in size, profile, and width are explored until the patient’s best option is found.

5.) To correct asymmetry in shape, volume, or both

Some women have breasts of different sizes, shapes, or both. Not only do these patients want breast augmentation, they want their breast asymmetry improved at the time of their procedure. Women can have breast asymmetry that is congenital or it can be noticed after previous breast augmentation surgery.

6.) To treat capsular contracture

Scar tissue always forms when a breast implant is placed in the body. Capsular contracture is a hardness of the breast that develops when this scar tissue collapses and squeezes the breast implant. Mild contractures can be improved with increased massage and the use of medication. Preoperative planning to place the implant under the muscle also helps. Placing the implant under the muscle lowers the risk of capsular contracture by 30%. However, when the conservative measures fail, the recommendation most often is to return to surgery to remove the capsule and replace the implant.

 

Surgical Technique

Revision surgery is tailored according to the cosmetic issue the patient is addressing. With this treatment, a major correction is done to the augmented breast in conjunction to scar tissue removal, if applicable, or a breast lift if there is sagging. There are instances when a strattice (a tissue matrix device) will be needed to act as an internal underwire if additional support is required. Ultimately, the correction aims to fix the issue that’s the source of the patient’s dissatisfaction.

During/After Surgery

Breast revision surgery is performed with general anesthesia in an accredited surgical facility. The patient may be sent home after treatment depending on the severity of the case. It is recommended to have someone who can drive the patient home and who can provide support within 48 hours. Patients can resume to their normal routine on the second week. It will take a few more months for the effects of the revision to become noticeable and the breast to develop a natural feel and look.

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Average Cost  
$9,000 - $16,000
Recovery Time  
6 Weeks
Average Procedure Time  
4-8 Hours
Post-op Follow-up  
4 Months
Procedure Recovery Location  
Out-Patient
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* All information subject to change. Images may contain models. Individual results are not guaranteed and may vary.