A large part of Dr. Wade’s practice involves helping those who are not satisfied with their results from previous plastic surgery. Despite the best efforts and intentions of both surgeons and patients, sometimes the surgical outcomes are not up to the quality and expectations all had hoped to obtain. Additionally, the longevity of an early good result can be less than ideal and evolve into something that is no longer satisfactory. This can be caused by many things, including simply gravity and time. Sometimes, a simple touch-up is all that is needed to remedy a less than optimal situation.
In general, revision surgery is more difficult to perform than the original surgery. It requires considerable input from both the patient and the surgeon as well as a thoroughly researched and planned approach based upon anatomy and realistic patient objectives. Dr. Wade’s considerable experience and expertise in this area are invaluable in helping people achieve the maximum benefit from their previous surgical experience.
Breast Implant Revision
Unfortunately, surgical outcomes from breast implant surgery are not always what a woman had anticipated. The causes can be multi-factorial but in many cases it is related to loss of elasticity in the skin. Additional contributing factors can be thinning of the underlying breast tissue, development of scar tissue around the implant (capsular contracture), or even the type/size of implant that was utilized. Also, no one’s body remains constant over time and, especially after pregnancy, changes in weight and breast size can lead to less than ideal presentations from prior breast implant procedures.
Breast implants are man-made and thus are not perfect products. Older generations of implants had a relatively high rupture rate which can lead to reoperation. However, today’s implants are extremely safe and significantly more durable. They offer more options than ever to address problems from earlier surgical procedures. These can include not only rupture, but malposition, rippling and wrinkling with saline implants, insufficient size and shape.
Dr. Wade’s vast experience with virtually all types of implants from many different manufacturers helps him to choose the right implant for each woman’s particular needs. Sometimes, very good results can be obtained by simply removing the implants and utilizing a woman’s own tissues to restore form and consistency.
Facelift revision surgery isn’t always performed because of problems with the original facelift. Even after a successful facelift, the skin and underlying tissues continue to age, and there may come a point when a patient wants to once again “turn back the clock” by reversing some of the signs of aging.
Problems that are caused by the original surgery include over- or undercorrection, asymmetry, and wound healing difficulties with unfavorable scars. In cases of overcorrection, the skin may have been pulled too tight, causing problems with the ears and hairline as well as an unnatural (operated) appearance. In cases of undercorrection, areas of loose skin (jowls and neck) may still be evident.
Revisions of facelift surgery require careful and accurate delineation of the problem(s) and a well thought-out surgical approach for correction. This may range from the very simple touch-up under local anesthesia with sedation to a more in depth operation requiring more aggressive measures to achieve an outcome favorable to all. Dr. Wade has considerable experience with all of these approaches to facelift revision.
Despite the impression that liposuction is a fairly simple and straightforward procedure, it is actually one of the most difficult operations performed by plastic surgeons. Even in the best of hands, the plastic surgery literature indicates that anywhere from 15-50% of patients undergoing liposuction actually undergo a secondary “touch-up” procedure. The implication is that as many as 75% may actually benefit from a touch-up but some opt not to pursue it. Usually this touch-up is a relatively minor procedure to remedy small residual irregularities, oftentimes under local anesthesia with sedation.
Today, however, we’re seeing more and more non-plastic surgeons (cardiologists, ophthalmologists, emergency room physicians, orthopedists, & gynecologists) doing liposuction procedures and the reoperation rate is even higher than is reported with plastic surgeons. Oftentimes, these primary procedures are done on the basis of advertising of “simple” procedures with rapid recovery, even done over a lunch hour. Unfortunately, the results rarely live up to the expectations and the advertised results. Revisions are quite common. Additionally, these revisions of procedures done by insufficiently trained physicians often require a more aggressive approach toward correction. This can incorporate fat grafting and different modalities of liposuction under general anesthesia. Dr. Wade has a long history of dealing with these sorts of problems and will be happy to consult with you if you’re unhappy with a previous liposuction procedure, regardless of the technique utilized.
Reoperative Abdominoplasty (Tummy Tuck)
Sometimes the problem is the scars. Sometimes it’s a residual paunch. Maybe it’s irregular contours. Other times it just may be the effects of life and time on one’s body, such as pregnancy or weight gain or loss. Regardless of the issue or the cause, the results of a prior abdominoplasty may not be to your liking. A surgical revision may offer the added benefit necessary to achieve a more favorable outcome. Occasionally, secondary liposuction alone can dramatically improve the results from an otherwise good tummy tuck. Dr. Wade has considerable experience turning a less than desirable abdominoplasty result into one that is to everyone’s satisfaction.