Breast augmentation is one of the most frequently performed cosmetic surgical procedures. Even if your breast augmentation was performed perfectly, your breast implants can migrate or bottom out over time. Sometimes, implants that were placed above the muscle develop capsular contracture, or women have intervening pregnancies after their breast augmentation procedure that changes that appearance of their breasts. Other times, a patient may simply have been unfortunate suffered a poor surgical result. Today, the demand for breast revision surgery is increasing. As stated above, reasons for breast revision procedures may include: patient dissatisfaction with lateral displacement or bottoming out of previously placed implants that simply migrated over time or were improperly placed at the initial procedure; visible rippling and sagging of implants that were placed in the subglandular position (above the muscle); complications such as symmastia (uniboob) caused by over dissection medially; residual breast ptosis (drooping) after implants because a breast lift was indicated; and many other reasons. Patients are often upset from their prior breast procedures, and patients must understand that secondary and especially tertiary revision breast procedures are much more complicated than simple first-time breast augmentation. Often, there are multiple issues that must be corrected that include: nipple-areolar malposition; implant malpositition; and residual breast ptosis. Although every effort is made to correct all of these problems with a single, complex revision procedure, patients must understand that additional procedures may be necessary – especially in the setting of capsular contracture.

Perhaps one of the most difficult situations a patient can face is when she has undergone a breast augmentation that has gone wrong. Before undergoing a revision breast augmentation, it is time to do some serious homework. Patients must carefully seek an experienced cosmetic surgeon who has mastered basic primary breast augmentation procedures, including more complex augmentation-mastopexy (breast lift with augmentation) procedures, to perform their revision breast augmentation surgery. Always ask to see your surgeons before and after photos to judge their experience with these more advanced procedures. As part of a revision breast procedure many patients require a revision breast lift as well as internal restructuring (capsulorrhapy) and new implants. Often, revision breast augmentation patients also need additional internal support using advanced materials (such as Seri® Surgical Scaffold – See Below) to achieve their goals and maintain long-lasting results.

The recovery from revision breast augmentation is more involved and required strict compliance with your surgeons’ post-operative instructions. Often, an underwire bra must be worn 24-hours/day for 6 weeks to support your repair. Your cosmetic surgeon will discuss your recovery in more detail based on your specific surgical needs.

Seri® Surgical Scaffold (Allergan Inc., US) is a newer bioresorbable product that is FDA approved for use as a transitory scaffold for soft tissue support and repair to reinforce deficiencies where weakness or voids exist that require the addition of material to obtain the desired surgical outcome. Seri® Surgical Scaffold now provides patients an excellent, cost-effective alternative for their complex revision breast augmentation needs.

Seri® Surgical Scaffold is a silk-derived bioprotein with substantial bioreplacement over 24 months. Seri® Surgical Scaffold facilitates the generation of native, well-vascularized tissue that is almost twice the starting thickness of the scaffold alone at 24 months (based on research from Allergan Inc., US). Hence, the Seri® Surgical Scaffold provides immediate and long-term support for complex repairs and larger implants.

Patients know that all cosmetic surgery should be approached by carefully reviewing their surgeon’s education, skill and experience. Surgeons who are cosmetic fellowship trained and board certified is a good place to start.