woman holding fabric over her breasts

woman holding fabric over her breastsCosmetic plastic surgery procedures generally produce the desired results and successfully address patients’ concerns. In many cases, correcting or improving physical features also provides psychological benefits, with a boost in patient self-esteem, self-confidence, and self-image. In situations where less than optimal results fall short of patients’ wishes, however, additional surgery which aims to fix problems may be beneficial. For these patients, pre-operative consultation involves evaluation of the results from prior surgery, as well as assessment of how those results were produced and what options are available to improve upon them. Less than perfect outcomes may occur despite adequate surgical planning and management, and are due to extraneous factors. Managing patient expectations in terms of potential outcomes from further surgical interventions is of paramount importance.

Although some of the problems that arise after surgery (such as swelling and asymmetry) often resolve on their own with time, others warrant revisions or reoperations. Here is a sampling of concerns patients may present with following some aesthetic surgery procedures, along with possible corrective measures:

  • Breast Implants:
    • capsular contracture – abnormal scarring and tightening of capsule around the implant
      • treated with oral medication or surgery to remove the capsule and possibly the breast implant
    • implant rupture – silicone gel filled implants can tear and leak, resulting in either intracapsular rupture (also called “silent rupture”), which is confined within the capsule; or extracapsular rupture, where the gel leaks outside the capsule into surrounding tissues; saline filled implants can rupture and deflate, but the saline is reabsorbed by the body
      • treated with removal of implant and silicone gel if present
      • additional surgeries may include implant replacement with new breast implants, or in patients who do not wish to replace their implants, a breast lift may be beneficial
    • visible implant – implant position may shift position and become visible, with rippling or folding
      • treated by correcting implant position, and internal sutures to adjust implant pocket
      • implant edge and ripples may also be concealed with fat injections or covering the implant with soft tissue
    • BIA-ALCL – rare disease called breast implant associated anaplastic large cell lymphoma, that may occur in capsule around textured shell implants
      • treated with removal of capsule, implant, and abnormal tissue
  • Breast Reduction and Breast Lift:
    • misshapen breasts, such as boxy, square shaped breast or bottomed out shape
      • treated with revision surgery to create round, perky breasts and remove excess loose skin
    • irregular or asymmetric areolas, the pigmented skin around the nipples
  • Rhinoplasty:
    • breathing difficulties – nasal airway narrowing may manifest on either or both sides of the nose, can cause runny nose and nasal congestion
      • treated with adding support to the nose with cartilage grafts, or revising internal nasal scarring
  • Liposuction:
    • irregular contour: dimples or depressions in the fatty layer under the skin
      • treated by releasing scar tissue and fat injections to the depressed areas

If you have concerns about the results from your previous plastic surgery, consult with an experienced, board certified plastic surgeon to discuss what options may be available to help you look and feel better. Revisions and reoperations in cosmetic surgery can be challenging and complex procedures that are best performed by surgeons with special expertise.

Dr. Olivia Hutchinson is a female board certified plastic surgeon in New York City with advanced specialty fellowship training in aesthetic plastic surgery. Her practice on Manhattan’s Upper East Side is dedicated to cosmetic surgery of the face, breast, and body. Our office off Park Avenue is equipped with a fully certified AAAASF Operating Room for the safety, privacy, and convenience of our patients. To schedule a consultation with Dr. Hutchinson, please contact us or call us at (212) 452-1400.

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