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Breast Augmentation Revision

The majority of women who have breast augmentation attain beautiful, natural-looking results; however, occasionally results are disappointing or complications arise. Board-certified plastic surgeon Dr. Paul G. Ruff IV specializes in breast augmentation in Washington, D.C. He has the training and experience needed to help women attain the breast size and shape they want though breast augmentation revision surgery. He also can exchange or remove implants as a woman's aesthetic vision and body change over time.

If you'd like to improve your breast augmentation results or you're interested in changing your implants, request a consultation online to meet with Dr. Paul G. Ruff IV, M.D., F.A.C.S., or call our office at (202) 785-4187 to speak with a member of our staff to schedule a consultation.

Why Breast Augmentation Revision?

Women visit Dr. Ruff in Washington, D.C. for breast augmentation revision surgery for a variety of reasons, including:

  • Exchanging breast implants for a different size, style, or fill material (called elective implant exchange)
  • Replacing ruptured or leaking implants
  • Improving disappointing results from previous breast augmentation by other surgeons
  • Balancing uneven breast size, height, and other asymmetries
  • Correcting a complication such as capsular contracture (hardening of the scar tissue around the implant), bottoming out (implant drops too low), or symmastia (implants placed too close together)
  • Removing implants without replacing them (called explantation)

Paul G. Ruff IV,
M.D. F.A.C.S.

Personalized, compassionate patient care is the foundation of West End Plastic Surgery's philosophy. Our board-certified surgeon, Dr. Paul G. Ruff IV embraces innovative techniques to ensure our patients get the best treatments available.

Meet Dr. Ruff Request a consultation

Before & After Photo Gallery

We're as thrilled with our patients' results as they are. Check out our before-and-after photo gallery and see for yourself the kind of work our talented surgeons do.

Are You a Good Candidate for Breast Implant Revision?

If you are in good general health and have realistic expectations regarding the results of your revision surgery, you are an ideal candidate for the procedure. Dr. Ruff and our staff will work with you to ensure that you know what to expect from your surgery, both physically and psychologically.

Meeting With Dr. Ruff

During your initial evaluation and consultation with Dr. Ruff, he makes sure you are a good candidate for breast augmentation revision or implant removal surgery and ensures you understand and are comfortable with the procedure. He wants you to have a clear picture of how your breasts will look after the surgery.

During your consultation we will:

  • Review the various breast augmentation options with you
  • Discuss other procedures such as implant replacement or a breast lift that you may want to consider to enhance your breasts
  • Clearly discuss the potential risks of the procedure
  • Outline in detail how the surgery is performed and what you can expect before, during, and after the procedure
  • Provide detailed cost, insurance (if applicable), and payment information
  • Answer all your questions

You will be asked to provide:

  • Details about your medical history
  • A list of all medication you currently take, including over the counter medications such as aspirin, vitamins, and herbal supplements
  • Information regarding your tobacco and alcohol use

How Revision Breast Augmentation Is Performed

Your breast augmentation revision or breast implant removal procedure will be performed in our state-of-the-art surgical suite or at one of the area hospitals where Dr. Ruff operates. When performed to correct complications or improve previous results, revision procedures are usually more complex and time-consuming than the original procedure. Dr. Ruff may encounter scar tissue, thinning breast skin, compromised chest muscles, reduced blood supply, or even silicone gel that has leaked out of an older, ruptured implant.

Dr. Ruff and his staff are dedicated to ensuring your complete comfort during and after the procedure. The surgery may be performed under either general anesthesia or local anesthesia with sedation. The procedure can take from 30 minutes to 3 or more hours, depending on the correction required. You will go home shortly after your surgery is completed.

Dr. Ruff makes small incisions on 1 or both breasts using the original incision placement whenever possible. The skin pocket around the implant is cut into, and the implant is carefully removed. If the implant is filled with saline, Dr. Ruff may elect to deflate the implant to facilitate removal (the saline solution will be naturally absorbed by your body over time). If the implant is filled with a silicone gel, Dr. Ruff will inspect the implant for any signs of damage or leaking before removal. He then makes necessary corrections to one or both breasts. If you suffer from capsular contracture, the doctor removes all or part of the scar tissue that has formed around the implant.

Stitches are used to close the incision; the stitches generally extend around the areola or along the crease of the breast. After your surgery is completed, your breasts are bandaged with gauze, and a special surgical bra is placed over your breasts to hold them in the best position for healing.

What to Expect After Your Surgery

Activity When
Shower or bath 1 to 2 Days After Surgery
Back to work 2 to 7 days after surgery
Physical contact with breasts 3 to 4 weeks after surgery
Driving When You Are Pain Free
Strenuous activity 3 to 4 weeks after surgery
Fading of scars Several months to 1 year after surgery

Immediately After Your Surgery

In most cases, you will be ready to go home shortly after your surgery. You may be a bit sleepy after the anesthesia, so it is important to have someone drive you home.

The First 24 to 48 Hours After Your Surgery

During the first 24 to 48 hours after your procedure, you may feel tired from the anesthesia and sore from the surgery. Dr. Ruff will prescribe pain medication to alleviate most of the discomfort. Your discomfort level will improve rapidly after the first 2 days. Call the staff at West End Plastic Surgery if you have any questions or concerns in the days after your surgery.

The First 2 Weeks After Surgery

You will notice a marked improvement in your discomfort level during the first few weeks after your surgery. Other things to be aware of:

  • The gauze dressings placed over your breasts will be removed a few days after your surgery. Once they are removed, you can take a shower or bath.
  • Your first post-operative visit usually takes place 2 to 3 days after surgery. Subsequent visits are scheduled every 1 to 2 weeks for the first 6 weeks and then every 1 to 2 months for the next 6 months.
  • Any bruising you experience will usually disappear in about 2 weeks.
  • You may experience some numbness in the area of the surgery. This numbness is caused by the swelling of your breasts after surgery and usually disappears within 6 weeks of surgery.
  • Most of the stitches used are dissolvable. If non-dissolvable stitches are used, they will be removed within 7 to 10 days after surgery.

You should sleep on your back for the first week after surgery to help with the healing process. You should wear the special surgical bra placed over your breasts after surgery at all times for the first few days. The softer support bra provided by West End Plastic Surgery should be worn at all times for the first 2 weeks after your surgery. The bra should be worn even while sleeping to help hold your breasts in the correct position. You may take the bra off to shower or bathe but it must be put back on immediately after drying off. If the bra is too tight, call the staff at West End Plastic Surgery immediately - bras that are too tight can cause skin problems.

Resuming Your Normal Routine

Everyone heals at different rates, and you are the best judge of when you are ready for certain activities, but the following are general guidelines:

  • You can most likely return to work or school within 1 to 2 days of your surgery.
  • You can resume driving as soon as you experience no pain when you turn the steering wheel and are no longer taking pain medication.
  • You should avoid sex for at least the first week after your surgery.
  • Two weeks after surgery, you can begin to sleep without the special elastic bra you've been wearing. However, you should continue to wear this bra during the day for 4 to 6 weeks after your surgery.
  • Do not go without a bra for at least 6 weeks after your surgery.
  • Strenuous exercise can begin about 3 to 4 weeks after your surgery, but remember that everyone heals at different rates, so take these activities slowly until you feel ready. Our patients are encouraged to plan an exercise program and discuss it with the staff prior to resuming exercise.
  • The scars on your breasts should be protected from sunlight for at least a year after surgery.

Things to Be Aware of After Your Surgery

It is imperative throughout the postoperative process that you follow the directions Dr. Ruff provides. Things to keep in mind during your recovery include:

  • The skin of your breasts may appear shiny due to swelling. Within a few weeks, the swelling will disappear and the skin will return to a normal appearance.
  • You may experience some numbness in the area of your surgery, but this generally goes away within 6 weeks of your surgery.

What Are Possible Side Effects or Risks?

As with all surgical procedures, there are risks associated with revision breast augmentation and breast implant removal. As with any surgery, you can help reduce these risks by closely following the instructions provided to you by the staff of West End Plastic Surgery. We will be with you every step of the way to ensure a safe and pleasing outcome. Possible side effects include:

  • Infection
  • Loss of nipple sensation
  • Breast sagging or loose skin
  • Scarring

How Long Will the Results of Your Breast Implant Removal Last?

Revision surgery provides long-lasting results; however, as your body ages, your breasts may sag or droop due to the natural effects of aging. It is possible have your implants replaced in the future to maintain as youthful a figure as possible, but this is not a necessity.

Questions You May Have

Do I need new implants if I've had mine longer than 10 years?

The implants available today are safer and more durable than implants of the past. There is no need to replace them if you are happy with the look and feel of your breasts and you are not having any complications.

Why do women choose to have their implants removed?

There are many reasons women choose implant removal, including repeated complications, natural enlargement of the breasts due to weight gain or pregnancy, or changes in self-image. Some simply decide they no longer want to have breast implants. After removing breast implants, Dr. Ruff can perform a breast lift to reshape the breasts if desired.

Are there other procedures that could be done along with my revision procedure?

If you are having your implants exchanged or removed, Dr. Ruff may determine it's safe to perform additional procedures during the same surgery such as liposuction or a tummy tuck. He will review your options with you in detail during your consultation.

Will my insurance pay for my revision surgery?

In most cases, breast augmentation revision and breast implant removal are considered cosmetic procedures; therefore, these procedures are typically not covered by insurance. You are responsible for the full payment for your procedure. Cost and payment options will be discussed fully with you at your initial consultation. In a few cases where significant capsular contracture has caused breast distortion or severe pain, insurance may be provided.

Are there alternatives to breast implant removal?

If your breast implants have leaked or ruptured, there is no alternative for repairing them outside of removal and possible replacement. Unless other problems are occurring, there is no need to remove the implants. In some cases, revision without removal is possible for hardened implants.

How long after my breast augmentation do I need to wait to have revision surgery?

Dr. Ruff recommends waiting until you have fully healed from the surgery and your implants have settled, which takes about 6 to 9 months. If you are experiencing a complication such as bottoming out or capsular contracture, it may make sense to have surgery sooner. As a board-certified plastic surgeon experienced in breast revision surgery, Dr. Ruff will help you determine what can be accomplished with revision surgery and give you his opinion about the best timing and approach.

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West End Plastic Surgery 2440 M Street Northwest #200
Washington, District of Columbia 20037 (202) 785-4187 Monday–Friday: 8 a.m.–4:30 p.m. Get Directions
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