REVISIONAL BREAST SURGERY
INDICATIONS
Sometimes, despite the best efforts of the primary plastic surgeon, the outcome of a breast enlargement, lift or reduction may not be what the patient had expected. Dr. Salzman is often consulted in these situations to redo and improve upon the prior procedure. Examples of this include implant problems such as breast implant locations that are too close together, too far apart, too low, too high, tight in feel and with visible wrinkles. Also, breasts that are uneven, misshapen or lack a pleasing contour can be revised.
INTENDED RESULTS
A more natural appearance and feel to the breasts. Proper location of the breast and the implant on the chest wall. Symmetry of the nipple and areola. Less visibility of implant edge and/or wrinkles.
PROCEDURE DESCRIPTION
Dr. Salzman has developed several operations to improve the look of breast implants that have shifted in their pockets. Rather than just sew the scar tissue back together, Dr. Salzman has found that these simple methods do not hold up over time. He uses a flap of the scar and the underlying lining of the muscle to make a sling or hammock to support the implant. It can also be used to hold the implant closer to the cleavage or as a buffer to separate an implant that is touching the opposite side. He calls this a capsulofascial flap. If the integrity of this tissue flap is insufficient to give a long lasting result, he has pioneered the use of prolene mesh to add strength to the repair. For implants that may be broken, rock hard or severely tight, he will use a tumescent canula and dilute numbing medicine to aid in the complete removal of the scar encircling the implant.
The revision operations are done under a laryngeal mask general anesthetic in an outpatient facility in the Springs Medical Center or The Jewish East Ambulatory Facility. The patient returns home shortly after the procedure is done.
RECUPERATION AND HEALING
The patient goes home in a light dressing sometimes with a stretchy tape supporting the area of repair. All the sutures melt away on their own. Drains are infrequently used. Post operative instructions about type of bra and duration of limited activity vary tremendously depending on what is being revised. Explicit instructions are given at the time of pre operative teaching.
OTHER OPTIONS
Breast implants may be removed and not replaced or replaced with a different size or type of implant. Breast lifts may be done to even out the nipple location and/or elevate the breast to a more youthful chest wall position.
NOTES
The specific risks and the suitability of this procedure for a given individual can be determined only at the time of consultation. All surgical procedures have some degree of risk. Minor complications that do not affect the outcome occur occasionally. Major complications are unusual.