A number of women who have undergone Breast Augmentation may find – especially after many years / weight fluctuation / or pregnancy that they are not 100% happy with their breasts. The good news is something can be done for a majority of these women.

Dr Nicholas Moncrieff

Dr Nicholas Moncrieff

According to Hunter Plastic Surgery’s Dr Moncrieff, the solutions vary from patient to patient. For instance, when it comes to removing or replacing breast implants, “everyone woman is different and may or may not seek revision at different points in time. As a general rule, it reasonable to expect 10 or more years from a breast augmentation procedure. After that is when women start looking at a change for reasons more closely related to changes in their body shape post weight changes and babies, than problems with their implants.”

“While some patients may seek a revision before the 10-year mark, we have known other patients who have gone decades happily with their original implants,” added Dr Moncrieff.

Complications which may arise after breast augmentation include implant rupture and capsular contracture, which will require an implant removal revision surgery.  If you are experiencing complications, it is suggested, where possible, you contact your original surgeon or an experienced Plastic Surgeon for review.

How to start your breast implant revision journey

If you only recently had surgery elsewhere, Dr Moncrieff recommends that you be patient before deciding if you like the end result as a lot changes in those early months. He prefers not see patients within 6 months following surgery elsewhere because the original doctor is required by law to provide post-operative care and surgery takes time to settle.

“We also have no insight into exactly how the surgery has been performed, what implants were used and the infection control employed so we can’t have a full insight into how patients from other clinics should be managed in the post-operative phase, unlike our own patients,” explains Dr Moncrieff.

If you are experiencing a serious complication from surgery elsewhere such as an infection or wound breakdown, you should contact that clinic urgently. You should also consider presenting at hospital emergency or your GP if you are unable to get in contact with that clinic.

If you remain unhappy about your results after 6 months and you have been unable to get an agreed path forward with your original doctor, then Dr Moncrieff recommends that you see your GP for a referral to see him, plus a referral for an ultrasound before you see him. “This way we can have a good idea of your medical history and any issues with your current implants before your initial consultation,” explains Dr Moncrieff.

Implant Removal and Replacement

Breast implant replacement surgery involves the removal of existing implants and replacement with new implants. Implant replacement can be used to correct improper technique and improve the appearance of the breasts, modify the size, shape or symmetry or update the implant material.

Breast implant replacement typically does not attract a Medicare item number or health fund rebates (except in exceptional cases of medical need). This cost is inclusive of Dr Moncrieff’s surgical fee, implants, hospital stay, garment, anaesthetist’s fee and LED therapy for scar minimisation and does vary upward depending on the complexity of the case and additional operating time required. More details can be found on his website.

Implant removal

In some cases, generally for smaller implants which have only been in a short time, it is possible to remove implants and not lift the remaining skin. For younger patients this is more successful as the skin is more likely to “snap back” given higher levels of collagen. However, for patients willing to accept the lax skin that will result, this is the lowest cost option to revise breast implants.

The price point varies depending on the complexity of the removal, if a Medicare item number applies (if there is a medical need to remove the implants) and the patient’s private health insurance coverage.

Implant Removal and Breast Uplift

The most common procedure that Dr Moncrieff performs for women who wish to remove their implants without replacing them is an implant removal with a breast uplift. Dr Moncrieff explains; “I generally do not recommend a removal without lift because the skin and tissue will usually be too stretched to retract, and the result is not usually cosmetically pleasing. This can also lead to chronic skin irritation under the lax breast tissue.”

However, it does depend on the patient and the removal and lift can be staged over two surgeries if the patient wants to see if they truly need a lift after removal.

Fat Grafting

A common “add-on” many of Dr Moncrieff’s patients choose alongside their implant revision surgery is fat grafting. Fat transfer is the processing of removing fat from one area (commonly the lower abdomen, inner or outer thighs) and reinjecting it into another – in this case, the breasts!

“This can be a fantastic way to add volume back to the breasts without the use of another implant. It is important to note that fat transfer cannot change the shape of the breast, it can only add volume,” explains Dr Moncrieff. “For this reason, I will generally only recommend fat grafting as the ‘icing on the cake’ when combined with a breast uplift or implant replacement for the best long-term result.”

Will Medicare cover the cost of my implant removal or replacement surgery?

If you can demonstrate that you are experiencing medical complications with your implants, such as capsular contracture or leakage, then you may be eligible for Medicare item number 45551. This item number is only valid if you are undergoing an implant removal or implant removal and uplift procedure and does not apply to implant replacement. With this item number your private health fund will “kick in” and cover the cost of your hospital fees, and you will be able to claim a small portion of the surgical fee back from Medicare.

If you are not experiencing any symptoms or complications related to your current breast implants and are looking for revision surgery purely for cosmetic reasons, unfortunately Medicare cannot will not assist in the costs.

I’ve visited my GP for a referral and had an ultrasound: What is my next step?

For all of Dr Moncrieff’s patients considering any type of breast surgery, it is highly recommend booking in for a 3D Vectra Surgery Simulation with Hunter Plastic Surgery’s Practice Managers Jessica and Alicia before booking a consultation with him.

Although their 3D Vectra machine is unable to produce an image of an implant removal or replacement, it is still a great opportunity to sit down and talk about the costs involved, your eligibility for rebates, and your timeline for surgery. This appointment is $100, which is rebated against your consultation with Dr Moncrieff if you do decide to go ahead.

Generally, the wait time for a 3D Vectra appointment is 4-6 weeks, in comparison to the 14 weeks wait for a consultation with Dr Moncrieff. You do have the option to hold a surgery date from this appointment, and your consultation with Dr Moncrieff can be fast tracked.

About Dr Moncrieff

Dr Moncrieff focuses exclusively on breast reductions, breast lifts, breast augmentation, tummy tucks and body lifts. He is one of only a handful of Plastic Surgeons across Australia with this sole breast and body focus.

Dr Moncrieff has performed thousands of surgical procedures over more than two decades in medicine. Over 20,000 of these procedures have been in Newcastle.

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