Breast revision surgery encompasses a multitude of procedures that address those individuals who maintain issues consequent to a previous breast surgery. This surgery may be categorized as either aesthetic (cosmetic) or reconstructive in nature. Although the category of procedure may be distinct, the concerns and considerations relative to each are not dissimilar and, indeed, overlap.
Both aesthetic (cosmetic) and reconstructive procedures have been associated with issues consequent to the presence of a mammary prosthesis, or implant, or those that simply relate to breast aesthetics, or a combination thereof. These issues may be the result of poor communication, a lack of compliance or technical error. Regardless of the root cause, correction mandates an accurate history, physical examination and diagnosis with a well conceived treatment plan.
Implant-related issues may include capsular contracture, which is a term used to denote firmness, or hardening, of the breast, implant deflation or rupture, the use of devices which are too large, too small, or those which are malpositioned. It might also entail problems of deficient coverage with resultant rippling, palpability or poor aesthetics. Corrective measures most notably include capsulectomy, or capsule removal, the safe and efficacious removal of an implant or implant material, pocket modification via internal suture fixation and the need to re-position the implant to ameliorate the symptom complex of rippling, palpability and poor aesthetics referenced above. Issues that relate to overall breast aesthetics may include asymmetry, matters of breast shape or size and poorly healed, conspicuous incisions. Corrective measures require attention to detail and the satisfactory modification of each contributing factor.
In sum, the surgeon must have a grasp of breast aesthetics and those issues delineated above. They, too, must have the technical expertise and experience necessary to address these concerns and to remedy them.