Expertise in plastic & cosmetic surgery - Lloyd D Landsman MD FACS

Revisional Breast Reconstruction Surgery in Smithtown, Long Island

Re-Operative Implant Replacement Surgery (RIRS) in Suffolk County

Before & after breast reconstruction patient

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Revisional Breast Reconstruction in Smithtown, Long Island

Removing old saline or silicone gel implants and replacing them with state-of-the-art modern implants (a procedure known as “Re-Operative Implant Replacement Surgery,” or RIRS) requires careful assessment, planning and use of the full complement of materials and techniques available.

Re-operative implant replacement surgery is necessary when a woman develops a problem with her implants or decides she no longer likes the look of her augmented breasts.

After 10 years, the rate of deflation for saline implants and the rate of rupture for silicone gel implants rises significantly. Also, there are many conditions that arise following long-term use of both types of implants that alter the appearance of the breast, including capsular contracture.

Capsular Contracture

Capsular contracture is the formation of unusually hard, thick scar tissue that contracts around a breast implant. This causes varying degrees of cosmetic deformity and pain.

Scientific literature shows that capsular contracture is more common in breast reconstruction cases as compared to cosmetic breast augmentation cases. However, the reasons why some women develop capsular contracture while others do not are not widely known. Radiation therapy (particularly following breast reconstruction surgery) is linked with a higher risk of capsular contracture. Implants placed in front of the chest muscle (as opposed to under it) are also slightly more likely to develop capsular contracture.

Preparing for RIRS

Recognition, diagnosis and ultimately a precise operative plan to correct these alterations will result in outstanding outcomes.

Revisional Breast Reconstruction Assessment

Assessment includes:

  1. Are either or both the implants deflated or ruptured? Neither condition represents a health hazard and can therefore be addressed without haste.
  2. Are the breasts even in appearance? (asymmetry)
  3. Is there displacement of the breasts to the side? (lateral displacement)
  4. Are the implants sitting too low causing the nipple to sit too high? (bottoming out or lower pole stretch deformity)
  5. Is the nipple position low? (ptosis)
  6. Is there hardening of either breast from scar tissue around the implant? (capsular contracture)
  7. Do you want to be bigger or smaller?
  8. What type of implant would you prefer going forward?
  9. Do you no longer want implants?

Many of these conditions may exist simultaneously and in one or both breasts.

Following the assessment, a customized plan is put into place. Some of the above-mentioned conditions require additional materials and techniques. Capsular contracture and positional displacements require use of biological and biocompatible tissue sheets and special meshes in addition to new implants. Lifts (mastopexy), reduction of existing breast tissue and liposuction of the side wall adjacent to the breast are among the other techniques often used in this multiplatform approach.

Preoperative Breast Implant Deflation or Removal

Another technique used to prepare for implant replacement is to deflate (saline) or remove (silicone) implants to allow the skin, breast tissue and the pocket where the implant is placed to shrink down prior to definitive surgery (usually for a minimum of two weeks). This may seem undesirable but significantly improves results.

RIRS is a complex undertaking which requires detailed planning and execution. No-cost touch up and revisional surgery is often necessary to achieve superior results.

Learn More About Revisional Breast Reconstruction

To find out more about revisional breast reconstruction, schedule a complimentary consultation with Dr. Landsman. Contact his office by calling (631) 864-4111 today.