According to the American Society of Plastic Surgery there were 286,000 breast augmentations in the United States last year, an increase of over 200% since 1997. In my last blog, I reported on evidence that shows a high degree of satisfaction with the choice to have breast implants. We know that breast implants do not last a lifetime, but women want the satisfaction with their procedure to last a very long time. The US implant manufacturers advise that implants will need to be removed or replaced eventually. So what are some of the reasons for revising breast surgery?
A study (published last month in Aesthetic Surgery Journal) looked at 110 consecutive women that underwent revision of their breast implants between the years 2004 and 2009. The reoperation rate in this study was 16.3% with an average time from first surgery to revision of 8.9 years.
Here are the reasons for re-operation in this surgeon’s practice:
1. 42%developed sagging (ptosis) of their breast, a natural progression of biological change.
2. 29% had capsular contracture (scar tissue around the implant resulting in firmness).
3. 19% were re-operated for a high riding implant.
4. 14% indicated implant position was not where it belonged (malposition).
5. 7% had infection.
6. 5% developed breast cancer.
7. 4% objected to rippling of implant.
8. 4% had synmastia (implant pocket lifting up over the sternum).
9. 3% had a “double-bubble” where implant and breast did not merge in a smooth transition.
10. 2% deflation.
As humans age their skin thins, loosing elasticity. As breast volume fluctuates with weight changes and pregnancy, there is a natural sagging of the breast. Implant placement can accelerate these natural changes. This report shows that the majority of revisionary breast implant surgery is to improve appearance and reverse changes of aging, rather than for medical necessity. That is a good thing if you are the patient, because you can choose the time when it matters to you. www.aestheticsurgeryjournal.com