Surgical Cases Related to Revisional Breast Surgery

Dr. Belsley's Philosophy of Breast Revision

I apply the same criteria to patients who have had their surgery elsewhere as I do to my own patients.  I am typically reluctant to re-operate on a breast augmentation patient for minor issues, because each time one undergoes revision, many of the risks of surgery tend to be multiplied.  This is why I spend a great deal of time discussing size preferences and the likely outcome of surgery with my patients pre-operatively.  It is said frequently that the most common reason for re-operation of the breasts in women who have had breast augmentation surgery is that they wish to “go bigger.”  Ultimately, I feel that this is a poor reason to undergo repeated surgical procedures that can only result in more scar tissue, which is unpredictable, and thinning of the native tissues, which are necessary to cover the implant and provide a natural looking result.  I encourage patients to think carefully about the risks of revision in cases where there is not a major problem.

Revisional breast surgery implies a repeat operation

The surgical use of the word “revision” implies more than repeat; it means going back to the site of a previous operation and performing another one, similar perhaps but not necessarily the same. The reasons are multiple – there may have been an anticipated or unanticipated complication, the patient may not be satisfied with a cosmetic result although there is no other issue, the procedure may need to be repeated because the implant has become worn or damaged (not only breasts, applies to pacemakers and eye lens implants).

In terms of revision of breast surgery, the patient may be dissatisfied with a poor result, or perfectly satisfied but now wants the breasts made larger or smaller; something may have happened to the prosthesis and it needs to be replaced; the prosthesis may not have changed but the patient wants a different type (switch from saline to gel); there may have been post-augmentation changes due to pregnancy, weight gain or loss, or advancing age.