Expert Doctor

Corrective Breast Surgery

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Neal Handel, MD, FACS

Santa Barbara, CA

Corrective Breast Surgery

Breast augmentation is one of the most common types of cosmetic surgery in the United States. Each year, hundreds of thousands of people go under the knife to achieve the bust of their dreams. However, for every two people satisfied with the results of their procedures, a third patient has to undergo revision surgery. Revisions are much more common in breast surgery than in any other kind, due to the very nature of the surgery. When an implant—or any foreign object—is placed in the body, a wide variety of unpredictable results could occur. Fortunately, with the aid of a skilled surgeon, patients can have beautiful results, even after their second surgery.



Corrective breast surgery is, to put it simply, any secondary surgery of the breast, whether it’s a lift, implants, or a reduction, performed to improve a poor result or a complication from a previous breast operation. There are a wide variety of complications that revision surgery can correct, including capsular contracture (a common problem where the breast gets firm as a result of scar tissue around the implant), breast asymmetry, animation deformities (the breast becomes deformed when the pectoral muscles move), implant ruptures, waviness, rippling, and more. Sometimes, a patient simply wants to increase the size of her implants. All of this can be helped with corrective breast surgery.



There are many new innovations and technological advances being developed in order to improve results and decrease the likelihood of complications in corrective breast surgery. Firstly, an entirely new generation of breast implants, form-stable shaped implants, are now available. These have only existed for a couple of years, and they have an anatomical shape, instead of the traditionally round shape that implants tend to be. Form-stable shaped implants have a more teardrop shape, which is more accurate to the human anatomy, and are made of a highly cohesive, stiffer silicone gel, which helps to prevent common problems like waviness and rippling. In addition, these new implants help to prevent breast ptosis—or sagging—by causing the nipple to project more than it would with a standard implant.

Another innovation that prospective patients should be excited about is the Acellular Dermal Matrix (ADM), which is used when the natural anatomy of the pectoralis muscle does not provide adequate coverage for the implant. (This happens frequently after a patient has undergone radiation, but can be caused by a variety of other factors as well.) The ADMs come from either human donors or pigs, and can be used as an adjunct to improve the quality of the tissues and strengthen the repair. Though ADMs have been around for a while, they’ve only recently been used for revision breast surgeries.

Lastly, fat grafting is a very helpful advance in the world of breast revision surgery. Fat grafting can be used all over the body—in the lips, for the face, and even in the buttock—but it’s great for secondary breast procedures due to the thinning of tissues in the pectoral area. If a surgeon is able to harvest fat from another part of the body (e.g. the stomach, hip, or thighs) and graft it into the breast, it can help to improve the quality of the tissues, making them thicker and removing waviness and rippling. Additionally, it improves the blood supply of the tissue, which is extremely important in breast surgery as it prevents many circulation-related complications common in revision procedures.



What patients may not realize is that the risk of needing another surgery dramatically increases after a revision. Many times, patients have to return for a third—or even a fourth—surgery. This is due to the complex and mercurial nature of revision surgery—it is often difficult to predict the way a previously operated-on body will react to a new surgery. The surgeon has many factors to consider when operating—for instance, whether the blood supply to the breast and nipple has been compromised by the primary operation. As was previously mentioned, many of the complications that can occur after corrective surgery are related to circulatory problems of the breast or nipple, and can result in a variety of unfortunate side effects, including nipple death. However, with the right surgeon, patients can minimize their risk of complication and achieve satisfactory results.



Though corrective breast surgery is inherently risky, there are many experienced surgeons and notable advances capable of reducing the chance of complications. Prospective patients needing to correct a previous surgery can rest easy knowing that they the appearance that they always wanted is achievable. With a good doctor and the latest technology, just about anything is possible, and patients can rest easy knowing that a solution is out there for them.


Written by Cosmetic Town Editorial Team based on an exclusive interview provided by Dr. Neal Handel in Santa Barbara, CA.