Here’s an interesting fact about revision breast surgery: The biggest predictor of the need for a revision is a failed revision. The third time may be the charm as they say, but not when it comes to plastic surgery; we expect to get it right the first time, or at least the second. Another fact is that no matter how talented and careful, every plastic surgeon has patients who require additional procedures. An increasing part of my practice in recent years has been devoted to these often complex revisions, both for breasts and other areas such as tummy tucks and facelifts.
One thing I always try to keep in mind when seeing a patient considering revision surgery is that because I wasn’t there at the time of the first (or second) operation, I can’t really know everything about what happened, no matter how complete the records are. It is natural for patients to feel that something must have gone wrong, but sometimes problems occur even after doing everything according to standard. The body has a remarkable ability to heal and many things improve with time, but much of that is simply beyond our control. So the best approach is usually to analyze the problem as it presents at that time. When a revision has already been done and the results are still not optimal, what we don’t want to do of course is repeat the same procedure hoping for a different outcome. Each surgery potentially makes subsequent operations more difficult, so repeating the same approach is even less likely to work.
Usually, the best scenario is to have the original surgeon take care of the problem. There is often a revision policy, or at least a willingness to keep the patient’s out-of-pocket costs to a minimum. The original surgeon knows all the relevant details, and for these reasons they are in the best position to deal with the problem. When finding a new surgeon for a revision is necessary, here’s one thing to consider: Not every plastic surgeon has the temperament for taking on revision cases. They are challenging, expectations are high, and patients are often upset at having to undergo more surgery and expense. For someone who gets his fix by creative problem-solving like I do, it can be quite rewarding. But it’s worth asking your plastic surgeon if it is a focus of his or her practice.