“If pregnancy, weight change, or time has caused a change with your breast implants, a revision may be the next step.”
Common name – Breast Revision.
Technical name/also known as – Augmentation/Capsulectomy/Capsulotomy/Capsulorrhapy.
Benefits of a Breast Revision
Breast implants are not expected to last a lifetime, and over time, the implants may shift, tighten, or rupture. Similarly, the breast tissue itself can change with time, pregnancy, and age. Revision surgery may be able to restore a more balanced appearance and improved feel and position of the breasts.
How it is done:
This surgery is as individual as the women who come to talk about it. For capsular contracture, removal of scar tissue around the implant is a solution, commonly performed with placement of a new implant. For women dissatisfied with shape or size of the breast, a different sized implant may be chosen or surgery on the breast to reposition the nipple or remove skin may be suggested. For a ruptured implant, replacement or removal with lift may be discussed. For an implant which is out of positon, several techniques are available to reposition the implant in the proper place. Contour irregularities may be improved by fat transplantation from another part of the body to the breast. You will find which is right for you at your consultation.
Usually women who seek revision surgery are unhappy with some component of their breast and or/implant. This is an opportunity to make that better.
For surgery done to treat capsular contracture, recurrence is a possibility. Additional permanent scars may be required for women wishing to downsize or remove their implant completely. For an implant which is out of position (for example, a double bubble) additional implanted materials may be recommended. Sensation to the nipple can change. A drain may or may not be used.
Who pays for this
This is a cosmetic procedure, paid for by the patient. However, in some cases of symptomatic contracture, insurance may pay for a portion of the operation. This varies by insurance plans.
My Post-Operative Bra Suggestions
Please click this link for suggested bras to be worn after surgery.
What to expect
Length of operation
3 – 5 hours (depending on the extent of procedure).
General anesthesia, you will be asleep and monitored the entire time.
In or out patient
Outpatient surgery, you will go home the same day.
Time until final appearance
3 to 4 months, depending on how swelling resolves.
Length of results
6 months to one year.
Implants may temporarily “ride high” on the chest. The change in shape of the breast may come with a trade off for permanent scars. If acellular dermal matrix is needed, a drain may be placed temporarily. Nipple sensation may change or be absent after surgery. Women who want to breastfeed after this operation may be unsuccessful.
Risks of procedure
All surgery carries risk. I recommend patients carefully weigh the benefits of having surgery against the potential risks which may arise. Risks include pain, bleeding, infection, damage to nearby structures, need for other procedures, recurrence of skin laxity, dissatisfaction with appearance, asymmetry, seroma, sensory changes including permanent loss of sensation, temporary or permanent changes in facial movement, wound healing delays requiring wound care, deep vein thrombosis, and pulmonary embolus. A complete list of risks will be discussed with you before surgery.
“These are some of my happiest patients. Some women live a long time with breast changes they find unacceptable because they do not know methods to fix their issues are available.”
– Dr. Danielle DeLuca-Pytell
While we are under social distancing and shelter at-home instructions, I am offering virtual consultations for new patients interested in meeting with me.
You can do this from a computer (via an invitation) or a smartphone (via an invitation and the Google Meet app).
There are four parts to the consultation:
1. Arrange a consultation by phone or email,
2. Download the new patient forms. Click here.
After you fill them out, you can either fax or email them to me.
3. Once the consultation is arranged, a meeting invite will be sent to you with the link for the consultation. At our prearranged time, follow the link to our secure and private consultation.
There, you and I will have time to talk about your goals, medical history, and all about the procedure.
While the examination is limited to observation in two dimensions, I should be able to determine whether or not you are a candidate for surgery.
4. If you are indeed a surgical candidate, you will be contacted by Andrea, my patient coordinator, to get a surgical quote (or if insurance-based, your expected out of pocket costs), and an opportunity to hold a surgical date.
You will also be given a follow-up visit to confirm with your exam that you are a candidate and preoperative visit time for us to prepare you for surgery.
I hope to virtually see you soon!
Your Next Step!
Call or email us to schedule an appointment and find out if you are a suitable candidate for this procedure.
Our phone number
Give our office a call Monday to Thursday, 9am to 5pm, Friday 9am to 3pm.
Our email address
Please also email us anytime with questions you have.
Quick Contact Form
Before and After Gallery
When you come into the office for your appointment, you will be able to see more ‘before and after’ photos of this procedure including different options.
If healing proceeds as expected:
Rest at home (princess treatment) 2 weeks (no housework or exercise) or until drains are removed. Outsource housework and child care while you rest. Walk around the house, but do not work out.
Return to gentle exercise and household chores at two weeks or once drains are removed (whichever is last), but no heavy lifting or bouncing for six weeks.
Return to full activity 6 weeks after surgery.
Returning to Work
This depends on the type of work that you do. Many women can return to sedentary work at three to four weeks, though not everyone is ready to return to work by then. Surgery affects different people differently. If your work is more strenuous, six weeks off work may be needed.
Time until final appearance
6 – 12 months, depending on how swelling resolves
Length of results
Should be long-lasting, implant maintenance will continue to be needed. Pregnancy or other hormonal changes can also increase breast size. Changes with age are expected.
Smoking and Surgery
If you smoke, it is imperative that you quit six weeks both before and after surgery. To better understand why, please click this link:
It will take time for the breast size and shape to settle. I usually recommend waiting until at least 3 months after surgery to be sized and shop for new bras. A list of bras that can be worn after surgery are available here. The scars can stay red for up to a year after surgery then fade as time goes on. Scar care will be discussed. This is a cosmetic procedure, paid for by the patient. Health insurance does not cover this operation.
If you color your hair, do so right before surgery as you will not be able to color your hair until three weeks following the procedure. Plan to bring a scarf with you to the hospital on the day of the procedure as well as dark glasses to camouflage your temporarily swollen appearance on leaving the hospital.
See what her patients have to say about their surgical experience.
Follow the link to read some of the many letters received by Dr. Danielle DeLuca-Pytell.
When you visit the office for your appointment, we will talk about the side effects and risks of this procedure.
You will have the chance to ask any questions you might have.
Don’t forget: it is your body! There is no such thing as a bad or silly question!