Breast Augmentation Revision in Fairfield & Hartford County, CT

A. Dr. Restifo may discuss the following options with you:

• What type and size of implant would achieve the desired results (saline or silicone)
• Whether the implant will be placed above or below the muscle
• Whether you would also benefit from a breast lift or reshaping of the breast
• Whether you’d like to remove the implants without replacing them

A. Your reasons for breast revision will determine the best treatment plan. Whenever possible, Dr. Restifo will use your original incisions to remove and/or replace implants. He may need to either enlarge the size of the pocket to accommodate larger implants or surgically reduce the pocket to accommodate smaller implants. If your original implant pockets were originally placed too far apart or too close together, Dr. Restifo will use sutures to reconstruct the pocket in the desired location. Finally, if your original implants were placed above the muscle, he may recommend placing them below the muscle for better results. A breast lift may also be helpful to achieving the desired results, in which case your incisions may be different than for your initial breast augmentation.

A. Issues following breast revision surgery are uncommon and usually minimal, however they may include:

• Capsular contracture (with silicone implants)
• Swelling and pain
• Scarring
• Changes in sensation
• Milk production
• Change to the implant as a result of injury, activity, or the normal passage of time

Implants do require monitoring and will eventually need to be replaced.  If a saline implant ruptures, the implant will simply deflate in a few hours and your body will absorb the salt water.  Regular monitoring of breast implants after breast augmentation is recommended to ensure continued breast and implant health.

A. Prior to your consultation, you will be asked to fill out a complete medical history, which includes information about:

• Medical conditions, both past and present
• Current medications and supplements
• Previous surgeries and medical treatments
• Allergies
• Pregnancies
• Mammogram results from within the past year (for patients over 40)
• Family history of breast cancer
• Current use of alcohol, tobacco and recreational drugs
• Weight fluctuations

During your initial consultation, Dr. Restifo will listen to your cosmetic goals, needs, and any medical concerns. He will evaluate whether you’re a good candidate for breast revision based on your anatomy and physical health, and will determine a treatment plan based on your expectations. He will also be candid about whether he can achieve the outcome you desire.

After you’ve discussed the size and shape of breasts that you desire, Dr. Restifo will work with his assistant to measure and photograph your breasts for your medical record. He will also evaluate the following:

• Current size and shape of your breasts.
• State of your skin’s elasticity.
• State of existing breast tissue.
• Type and size of current implant.
• Current size and location of your nipples and areolas.
• Desired breast size after surgery.

If your breasts are drooping significantly, Dr. Restifo may also recommend a breast lift (mastopexy) in conjunction with breast revision to achieve the best overall outcome. See Dr. Restifo’s video “Implant, Lift or Both?” for more information.

If you are planning to lose a significant amount of weight, be sure to mention this in the initial consultation.  Also be sure to mention any plans to get pregnant, in either the near or distant future. It is ideal to stabilize your weight before undergoing surgery to get the best possible results.

A. Dr. Restifo is committed to each patient’s safety and satisfaction, and he stays well-informed regarding breast implant options and surgical techniques for breast revision. Recently, a lot of press has been given to BIA-ALCL and unfortunately there is significant misinformation on blogs and social media. Accordingly, Dr. Restifo recommends the following round-table VIDEO discussions by esteemed colleagues and board-certified plastic surgeons for patient education: Improving Patient Safety Part 1 & Part 2. Dr. Restifo only uses smooth implants. It is important for women who have had breast augmentation to have periodic examination by a board-certified plastic surgeon to monitor their implants. Saline, silicone gel−filled breast implants and the IDEAL IMPLANT have all been approved by the FDA. The FDA reported finding no link between silicone gel breast implants and connective tissue disease, breast cancer or reproductive problems.  More information can be found on the FDA breast implant page on their website. Although breast augmentation is safe and all implants come with a limited manufacturer’s warranty, it’s important to understand that sometimes issues can arise, like implant deflation, rupture, or capsular contracture. If revision is necessary for a covered reason, having an extended warranty can offset revision costs.  We recommend purchasing this coverage for $200-$300 based on your specific implant choice.  Here are the warranty links to the most commonly used implants by Dr. Restifo: Mentor®, Natrelle®, and IDEAL Implant®.

A. Whenever possible, Dr. Restifo will use your original incisions to remove and/or replace implants, however if you have a breast lift to change the position of your nipples or the shape of your breasts, additional incisions may be necessary. Scars from breast surgery incisions will begin to fade in a few months and will continue to fade for months or years. Our postoperative instructions include information about scar therapy.

A. Breast revision is typically long-lasting if you maintain a healthy body weight, however lifestyle and life-stage both play a role in how long the results of your surgery will last.  Your breasts can change due to a number of factors, including:

• Pregnancy
• Hormonal fluctuations
• Time and gravity

In general, implants do not need to be changed until they demonstrate deflation (saline) or internal disruption (silicone).

A. Prior to your surgery, Dr. Restifo will ask you to:

• Stop smoking at least six weeks before undergoing surgery to better promote healing.
• Contact your primary care physician to schedule a preoperative physical for the following tests required for your surgery:
  • A recent complete history and physical with medical clearance for surgery and general anesthesia
  • Labs complete with CBC, PT, PTT
  • Current EKG and report of the reading for patients over the age of 50 or those with a cardiac history
  • A mammography report completed within the last year (for patients over 40)
  • Any other exam that you or your physician feel is indicated
• Avoid taking aspirin and certain anti-inflammatory drugs (e.g. ibuprofen, naproxen) that can increase bleeding.
• Fill any prescriptions he provided prior to surgery (though you won’t need them until afterwards).
• Hydrate well both before and after the surgery for safe recovery.
• Purchase a front-closure sports bra.
• Arrange for a ride home after surgery.
• Plan to have someone to stay with you for at least the first 24 hours following surgery.

Full preoperative instructions can be found under Patient Resources.

A. Most patients feel tired and sore after breast revision surgery for the first day or two. Some discoloration and swelling may occur, but this usually passes relatively quickly. Some patients feel an increased tightness and sensitivity in the breasts, and skin may feel warm or itchy. Dr. Restifo will prescribe specific medications that will increase your safety and comfort during healing. If you’ve had a breast lift in addition to implants, your recovery time may be a little longer.

Many patients return to work within one week, although we recommend that patients wait a minimum of two weeks before driving. Patients should walk as early as the day of surgery, but should also refrain from lifting, pulling or pushing anything greater than five pounds for one month. We also recommend avoiding high impact aerobic exercise or upper body workouts for six weeks.

Any post-operative pain, swelling and sensitivity will diminish over the first few weeks. It may take several weeks for your breasts to fully “settle” into place.