Revision Breast Surgery
NYC Revision Breast Surgery
At Neinstein Plastic Surgery we believe in surgical mastery. Dr. Anna Steve has joined the team and she brings subspecialty training in breast cancer reconstruction to the team. This hyper-specialized training brings the latest tool kit of surgical techniques for our patients seeking aesthetic breast surgery revision.
Common Scenarios for Revision Breast Surgery
- “I don’t like the size of my breast implants”
- “ I don’t like the look of my breast implants”
- “ I got big implants when I was young and now I don’t like the way they look at my age”
- “I feel like my breasts are sagging over my implants”
- “I have pain in my breasts and I think I have capsular contracture”
- “My body does not seem to agree with my breast implants and I would like them out”
- “I had breast cancer reconstruction surgery and I would like to improve the look of my breasts”
- “My implants look weird when I flex my pec muscles”
- “I have rippling and can see the edges of my breast implants”
- “I think I have a double bubble deformity”
- “My implants seem to have dropped too low”
- “My right and left side look different”
- “I feel like my implants are in my armpit”
- “My nipple position is different on each side”
- “I can feel a hard ridge on my breast flap reconstruction”
- “I can see a ridge between my normal skin and the skin of the breast flap”
What operations can be done for Revision Breast Surgery
- Removal and replacement of breast implants with a different size
- Changing the breast implants from below the muscle to above the muscle (or the other way)
- Fixing the implant position with an internal bra
- Removing the breast implants and replacing with fat
- Placing fat above the implants to camouflage the implant rippling
- Placing fat for custom cleave over an implant
- Placing fat to fill in dents or contour deformities
- Any combination of changing your breast implants with a donut shaped, vertical or anchor pattern breast lift
- Performing a change to the breast implant capsule
- Performing a release of the breast implant capsule
- Removing the breast implant capsule
- Altering the shape of your breast cancer reconstruction flap
- Reconstruction of the breast fold
- Correction in nipple asymmetry
Revision Breast Surgery Case Gallery
Click Case to See Details
34 year old Florida patient came to see us with concerns over her implants.
Her Concerns
- She exercises a lot and does not like the feel of them anymore
- She has had multiple surgeries over the years for capsular contractures
- She stated, “I am tired of these implants”
We were able to remove her implants, most of her capsule, and we used a combination of structural and finesse fat grafting to give her an elegant and natural look
46 year old mother of 3. She had 450cc implants placed when she was 20 years old. After breast feeding she had a lift performed. Her main concern for coming to see us was the “animation deformity” which is an akward look of the implants with movement and she felt at this stage of her life her breasts were simply too large and inappropriate
Surgical Plan
- Remove Breast Implants
- Anchor Pattern Breast Lift
- Custom cleavage with fat grafting
46 year old mother of 3. She felt that her breast was falling off of her implants. She wanted a
smaller more elegant lifted look
Surgical Plan
- Remove Implants
- Replace Implants
- Vertical Breast Lift
- Fat graft for custom cleavage to give an in bra look without the bra
- Internal bra
- Capsule change
36 year old mother of four came to see us for a mommy makeover. She had 360cc smooth round silicone implants placed under the muscle before her kids. After four kids and four rounds of breast feeding her concerns were the following:
- My implant has bottomed out
- When I lay on my back my implant falls into my armpit
- My tissue is thinner our from breast feeding and I look Deflated
Surgical Plan
- Remove old breast implants
- Tighten lateral capsule so implant does not fall into armpit
- Release capsule closer to the sternum
- Put in new implant
- Secure position of new implant with internal bra
- Lift the fold and lock it down to the chest wall with internal bra to prevent bottoming out
- Put purified fat over implant under skin to fill in areas lost from breast feeding
This 37 year old mother of 3 had 375cc implants placed under the muscle when she was in her early 20’s. She had no pain or concerns about the implants placement, with weight changes and breast feeding from pregnancy she asked if we could lift her breast over her existing implants while we do a tummy tuck.
58 year old mother of 3 had 390cc textured implants placed below the muscle 6 years ago in Europe. This was done to address what she felt like was breast droop.
Her Main Concerns
- My breasts are too large
- My breasts are too wide
- My implants fall into my armpit when I lay down
- My breasts feel droopy
- I look big and the fashion I like is more slim and elegant
Surgical Plan
- Remove old implants
- Custom pocket creation
- Long acting numbing- Exparel
- New more elegant shaped implant
- Breast lift to reshape and restyle the breast
38 year old mother of two. Had the recalled style 410 allergan implants placed under the muscle about 10 years ago. The recall does not mean all women with these implants should have them removed. The FDA says the surgery is not worth the risk unless a woman is having symptoms. Signs and symptoms of rare lymphomas may include lumps, pain, swelling, and asymmetry (breasts look different from each other). This patient felt the breasts were painful and appeared odd. On examination she had firm capsular contracture (Baker Grade 3)
Her Concerns
- They are hard
- They are high
- I like the volume
Surgical Plan
- Remove old implants and send for pathology
- Remove capsule and send for pathology
- Switch from below to above muscle
- Replace textured implant with smooth implant
- Add structural and purified fat “like butter on toast” to improve the finesse appearance of the breast
Before Photos
After Video
48 year old mother of two. She originally when she was 20 had 600cc implants placed. She later went on to switch them to 375cc. However she was getting recurrent capsular contracture and this was causing pain. After her fourth operation elsewhere she came to see us. She is a busy executive and exercise is very important to her. Her breast implants were significantly impacting her enjoyment of exercise daily and she also felt her breasts were too large at this stage in her life
Surgical Plan
- Remove the breast implants and capsule as needed
- Replace the volume with fat
- Lift the breast with a breast lift
40 year old mom of 3 came to see us complaining of painful irregular breasts 6 years after breast augmentation. She noticed the implants became hard and had an irregular appearance.
Surgical Plan
- Implant removal
- Capsule removal
- Move new implants from under to above muscle
- Post-op aspen system for capsule control
This patient came to see Dr. Anna after having multiple breast augmentations in the past. She had obvious concerns over asymmetry and irregularities in look and feel.
Surgical Plan
- Implant removal
- Capsule change by selective release otherwise known as capsulotomy
- New gummy bear silicone implant customized to desired shape
- Structural and finesse fat grafting to correct tissue deformities and asymmetries from previous surgery
Click Case to See Details
37 year old mother of 2 with 240cc implants placed through the areola came to see us complaining that her implants were falling into her armpits when she lies down and in her abdomen when she stands up.
Surgical Plan
- Change to infra mammary incision
- Remove implant
- Lateral popcorn capsulorraphy
- New implant -335cc smooth round silicone gel
- Insertion of galaflex internal bra
- Fat grafting for cleavage
Here is an example of implant malposition
Showing the internal bra holding the implant where we want.
Old implants removed
Internal bra vs. no internal bra
Fat grafting to cleavage
Preparing the internal bra
35 year old mother of 3 who had breast augmentation before her
children. After breastfeeding she felt as though her breasts became
droopy and lost there youthful look and feel. She also had congenital
sternum and rib irregularities
Surgical Plan
- Remove old implants.
- Close pocket laterally with popcorn technqiue.
- Place new implants.
- Insert internal bra to hold the implant up the slope of the rib deformity.
- Fat graft the the sternum and cleavage.
- The breast was falling off the implant
- The implants were too high and too big
- She did not like the shape
Surgical Plan
- Take out the old implant
- Release the capsule
- Insert internal bra
- Insert new 190cc low profile implant
- Modified anchor pattern lift
- Micro fat for custom cleavage
- Nano fat for chest sun damage
43 year old patient had her textured implants removed. She decided she wanted to add volume so we used 275cc saline implants and fat grafting to reconstruct the breast.
This 43 year old woman came to see us for complex breast, reconstruction and revision surgery. She had multiple breast augmentations with silicone implants. In the past. Her main concern was that her breasts were hanging off of her implants, and that the implants or falling into her armpits, and that when she flex her muscles, the implants will go up into her shoulders.
We took her to the operating room. We remove the old implants. The left implant had ruptured, and there was silicone within the capsule. The right implant was completely intact. We found a new home for the new implant by dissecting a New subglandular plane and obliterating the old plane and capsule. We downsized her implants to a more age-appropriate and elegant size, which was approximately 250 cc from 450 with then inserted an internal bra and performed an anchor pattern Breast Lift to treat contour deformities and deficient cleavage we injected purified fat into the breast.
49 year old mother of two complaining of pain and abnormal movement of the breast.
We moved the implant from below the muscle to above the muscle and fat grafted the cleavage for roundness.
Before
After
This 52 year old women came to us with breast implant bottoming out and asymmetry following previous surgery elsewhere. We performed an explant, new implant, 3D internal bra , lift and fat graft to restyle the breasts
Before
After
This 64 year old came to us unhappy with her animation deformity (muscle moving her implant causing an awkward look).
We removed her implant and did a lift with some fat grafting – she had plenty of volume and did not feel as though she needed an implant anymore.
This 50 year old hated her animation deformity, we took out her old implants sewed her pec muscle back down, put new implants above the muscle with an internal bra and smooth out contour irregularities with fat transfer.
Click Case to See Details
This 52-year-old. Patient came to see us because her breast implants had moved out of the breast pocket.
We removed the large old implants and replaced them with smaller ones. We secured the new location of the implants with an internal bra, and performed a breast restyling with an anchor pattern, Breast Lift and Fat transfer.
This 44-year-old mom came to see us with concerns over asymmetry of her breast.
She had developed a significant capsular contracture on the left side.
Surgical plan
- Remove implants
- Perform capsulectomy
- Place new implants above the muscle and sew the muscle down to the chest wall to obliterate the old space
- Secure the new implants with an internal bra
- Perform an anchor pattern lift
- Fat graft to the cleavage
REAL RESULTS
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