REVISION BREAST SURGERY By Joshua Zuckerman, MD, FACS in New York City
Frontal view of a before and after of breast augmentation and mastopexy revision surgery Dr. Zuckerman performed. Patient was unhappy with asymmetry from a previous cosmetic surgery procedure, which had also damaged her left nipple. Images taken before surgery and one month after surgery.
Introduction to Revision Breast Surgery
If you have previously undergone a cosmetic breast surgery procedure from another practitioner which requires correction or with which you are unhappy, Dr. Zuckerman can help you achieve your original desired results. He performs revision breast surgery, or secondary breast surgery, for patient unsatisfied with any cosmetic breast procedure including previous breast augmentation with breast implants, breast lift (mastopexy) or breast reduction. Unfortunately as the popularity of cosmetic surgery has grown, so too has the number of unqualified practitioners, who are generally not board-certified plastic surgeons, attempting to perform these surgeries both in the United States and internationally. Revision surgery is most often more complex than the original procedure due to scar tissue, abnormalities of what was previously normal anatomy, and intraoperative uncertainty as to what was done during the previous procedure. Dr. Zuckerman trained at some of the most elite medical institutions in the world including Brown University and New York University and is an experienced board-certified plastic surgeon. He possesses high technical surgical skill and has a long history of performing these corrective breast surgery procedures, often being asked by other plastic surgeons to help with difficult cases.
Revision Breast Surgery for Augmentation
Dr. Zuckerman encounters a variety of reasons patients seek revision breast augmentation surgery with him. Many involve poor quality surgical outcomes, which often were avoidable. According to a retrospective medical study in the Aesthetic Surgery Journal, top reasons patients seek to undergo correction of a previous breast augmentation include:
- Development of ptosis (sag): This may due to natural aging and gravity or poor placement by the previous surgeon.
- Capsular contracture: Painful or hardened breasts may result from tightening of scar tissue surrounding the implant. Bacteria contamination during the original procedure is thought to be possibly responsible.
- Lower pole deformity or high-riding implant: This phenomenon is informally known as “double bubble” and typically results when a breast lift (mastopexy) should have been performed but only an augmentation was done.
- Other implant malpositioning: A compromised aesthetic outcome may result from a poorly created “breast pocket” by a previous surgeon. Common issues include asymmetry or an unnatural-looking breast shape.
- Implant exposure or infection: Placing an overly large implant can lead to healing problems.
- Rippling: This typically occurs in saline implants but can also appear in silicone.
- Implant deflation: Saline implants may lose volume over time. Implants, while highly safe and durable, may also rupture after a serious trauma such as a blow to the chest.
Dr. Zuckerman also commonly performs revision surgeries for patients unsatisified with the size of implants previously placed by another surgeon. Many patients were too conservative in size of implants they seleced during the prior operation and wish to increase implant size. For both primary and secondary augmentation, it is important that your plastic surgeon understand your communication style and that he/she can translate yours surgical goals into proper implant size and placement.
Revision Breast Surgery for Lift or Reduction
According to a study in the Aesthetic Surgery Journal, the most common reasons that patients sought reoperation for a breast reduction were related poor surgical technique in the prior procedure:
- Overresection: Too much breast tissue was removed in the prior procedure.
- Asymmetry: A poorly performed procedure may leave a patient with a difference in size between the two breasts or a unnatural, non-round breast shape.
- Unnatural areola: Prior procedure left the patient with poorly reshaped the nipple-areola complex. The areola is the darkly-pigmented tissue surrounding the nipple.
Revision breast procedures are highly customized to the individual, as patients may have a range of surgical needs. Dr. Zuckerman will develop a treatment plan for you based on existing anatomy and your desired sugical outcome, and he will describe all aspects of the planned procedures and answer any and all questions.
Some of the issues above are more difficult to correct than others. In some cases, Dr. Zuckerman will recommend a mastopexy, or breast lift, to address ptosis or deformities in breast shape, which may lead to external scars on the breast. Some procedures may require the removal or removal and replacement of existing implants. Depending on the issues at hand, your revision procedure may require the removal of some breast tissue or excess skin. If you would like to undergo implant replacement, Dr. Zuckerman typically is able to remove existing implants and place new ones in a single operation. Dr. Zuckerman typically removes existing scar tissue before proceeding with the placement of new implants or with a new breast reduction / lift procedure.
Most breast revision surgery requires general anesthesia, but you may undergo breast reduction surgery on an out-patient basis at Dr. Zuckerman’s state-of-the-art, fully equipped operating room located inside his office in midtown Manhattan. This operatory facility has been certified by the American Association for Accreditation of Ambulatory Surgery Facilities, Inc. (AAAASF), certifying it as a facility that offers an equally high standard of care as a hospital. The privacy, discretion, and convenience of Dr. Zuckerman’s private in-office operating room facility is an exclusive benefit of Zuckerman Plastic Surgery that many patients appreciate. Should you desire, you may also undergo surgery with Dr. Zuckerman at Manhattan Eye, Ear & Throat Hospital, a major hospital in Manhattan in the Northwell system where all types of breast, body, and face cosmetic surgery procedures are performed. Dr. Zuckerman is on staff in the department of plastic surgery for Northwell system hospitals in Manhattan among others.
Recovery after revision breast surgery varies depending on the procedures performed, but recovery after a secondary augmentation will be similar to primary augmentation in most cases: patients often return to work within a few days. In most cases, patients should some bruising and swelling after surgery, and a lift or reduction may require a post-surgical bra to expedite the healing process. Dr. Zuckerman will discuss postoperative care during your initial consultation, but you may also visit the individual guides linked below for the relevant procedure:
Left oblique view of a before and after of breast augmentation / mastopexy revision surgery Dr. Zuckerman performed. Patient was unhappy with asymmetry from a previous cosmetic surgery procedure, which had also damaged her left nipple. Dr. Zuckerman performed an implant exchange and breast lift. Images taken before surgery and one month after surgery.
Right oblique view of a before and after of breast augmentation / mastopexy revision surgery Dr. Zuckerman performed. Patient was unhappy with asymmetry from a previous cosmetic surgery procedure, which had also damaged her left nipple. Dr. Zuckerman performed an implant exchange and breast lift. Images taken before surgery and one month after surgery.
More Before & Afters
Dr. Zuckerman publishes many of his previous revision breast surgery results with patient consent. The before and after image gallery has pairs of high resolution images from three to four angles for each patient. Many prospective patients enjoy finding a similar case to their own that Dr. Zuckerman has performed in the past. Take a look through the gallery by clicking on the button below.
Risks will vary depending on the procedures performed, but revision surgery is more complex than primary operation. Dr. Zuckerman is highly experienced with revision breast surgery and is often asked by plastic surgery peers to consult on difficult cases. He and his team will make every effort to ensure that you undergo revision surgery with safety and comfort and that you achieve your original desired surgical outcome.
Below are the answers to some questions Dr. Zuckerman most frequently receives from prospective patients. If you don’t see your question below, feel free to contact Dr. Zuckerman’s office, and a member of his staff will be glad to reach out to you.
Please see the frequently asked questions on the breast augmentation page, breast lift (mastopexy), and breast reduction guide pages.
Are you ready for your revision breast surgery consultation with Dr. Zuckerman? He will perform a thorough evaluation of your desired outcome and needs based on your anatomy and medical history. Dr. Zuckerman will also address any questions or concerns you may have about the surgery and discuss with you the details of his approach: incision location(s), procedure length and techniques, likely operative outcome, etc. Contact his office by clicking the button below or by calling 212-231-9897. Dr. Zuckerman also offers consultations via Skype and a process for out-of-town patients to visit New York City to have surgery with him.
OTHER LINKS
Dr. Zuckerman has been selected as a SuperDoctor and profiled in The New York Times Magazine SuperDoctors issue three years in a row.
Dr. Zuckerman was quoted on the use of Kybella to eliminate submental, under the chin, fat. He also opined on how an angular jaw line is essential to societal classical perceptions of facial beauty.
Dr. Zuckerman appeared on an episode of The Doctors TV show on CBS for a preoperative evaluation of a severe burn victim who requires a complex plastic surgery reconstruction.
A mother and daughter pair of Dr. Zuckerman’s patients were interviewed by the New York Post about how much they enjoy their experience at Dr. Zuckerman’s office, undergoing cosmetic Botox and Juvederm treatments.
Dr. Zuckerman opined on the trend of “Trophy Husbands” where men undergo plastic surgery for Fox5 News.
Dr. Zuckerman was interviewed on nipple piercings, their implications for breastfeeding, and why plastic surgery intervention may be required to remove them.
Dr. Zuckerman was selected as a SuperDoctor for New York state for plastic surgery. This selection is Dr. Zuckerman’s third year in a row and recognizes him as one of the best plastic surgeons in New York.
Dr. Zuckerman discussed the fact that liposuction is not a shortcut to weight loss. It is a sculpturing tool best used to shape and contour targeted problem areas with excess, stubborn fat.
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