Richard V. Dowden, M.D., C.M., F.A.C.S.

Certified by the American Board of Plastic Surgery

Cosmetic and Plastic Surgery, Inc.
6770 Mayfield Road, Suite 410
(Mayfield Heights) Cleveland, Ohio 44124
(440) 449-7470


Answers to Frequently Asked Questions about
breast enlargement:

What is the cost of breast augmentation redo surgery?

At the outset, it must be stressed that the majority of patients will never need a major revision of their breast augmentation. On the other hand, just about every woman with implants will need a revision someday, namely replacement of a leaked implant.

Unlike first-time breast augmentation, for which each plastic surgeon's fees are fairly standardized, (see costs for details), a standard price for redo cannot be calculated because each patient's situation is so different. Redo surgery can cost much less than the original procedure; and redo surgery can cost much more than the original procedure.

Stretching the point a little, a good comparison could be made to the example of evaluating the costs of rebuilding a house damaged by a storm or hurricane. In such an example, the costs of correcting the problem would depend upon many factors:

    The costs of repairing a damaged house involve:
  1. The kind of damage that occured.
  2. The extent of the problem.
  3. The presence of residual effects from previous repairs.
  4. The characteristics of the remaining structure.
  5. The level of quality of the result that the owner wants.
  6. The time involved in the repair.
  7. The costs of the type of materials the owner requests.
  8. The degree of difficulty of the repair.
  9. Local and regional expenses, taxes, fees etc the rebuilder pays.
  10. The qualification, the experience, and the skill of the rebuilder.

Again conceding that the comparison is not exactly the same, the above is a reasonably good analogy, and can aid understanding the costs of redoing or repairing breast augmentation problems. In such an example, the costs of correcting the breast augmentation problems would also depend upon many similar factors:

    The costs of revising a breast augmentation involve:
  1. The kind of damage that occured.
  2. The extent of the problem.
  3. The presence of residual effects from previous revisions.
  4. The characteristics of the remaining tissues.
  5. The level of quality of the result that the patient is seeking.
  6. The time involved in the revision surgery.
  7. The costs of the type of implant the patient requests.
  8. The degree of difficulty of the revision.
  9. Local and regional expenses, taxes, fees etc the surgeon pays.
  10. The qualification, the experience, and the skill of the plastic surgeon.

The greatest impact is from the nature of the problem and the extent of correction needed. All the following will increase the costs of a redo:

  1. Pre-existing congenital or developmental problems
  2. Degree of capsular contracture
  3. Nature and degree of scarring
  4. The presence of leaked silicone in tissues
  5. Previous failed surgical attempts at correction
  6. Change of implant plane relative to muscle
  7. Presence of uncorrected tissue problems
  8. The need to reposition the nipples
  9. The insertion of Alloderm grafts
  10. The need for drainage tubes
  11. The patient's desire to have very large implants
  12. Use of silicone implants
  13. Possible need for an overnight stay

So let's look at some examples, based upon the 2004 fees for some large Northeastern US city, and assuming all of the following are true:

  1. The surgeon is fully certified by the American Board of Plastic Surgery.
  2. The surgeon has great experience with implant surgery.
  3. The surgeon spends considerable time explaining everything to the patient.
  4. The surgical facility is fully accredited for general anesthesia.
  5. Anesthesia will be administered by an M.D. Anesthesiologist.
  6. The surgeon will personally be the one doing the operation.
  7. The implants are fully FDA approved.
  8. The quoted fee includes anesthesia, the operating room, and implants.

The example fees for different types of redo surgery in some large Northeastern US city:

(Assume a first-time breast augmentation is $8500 in the example city)
Relatively minor redo:
- Replace one leaked implant: $4500
- Adding small amount of saline to both implants: $3900
- Replacing both implants with smaller ones: $6800
Moderate redo:
- Treating a slight degree of capsular hardening: $6200
- Replacing both implants with slightly larger ones: $7800
Relatively major redo:
- Replacing both implants with significantly larger ones: $9800
- Extensive correction of capsular contracture with distortion and new implants: $9900
Major redo:
- Correction of implant malposition and tissue distortions, revision of scars: $10000
- Readjusting the implant pocket and placing Alloderm into the pocket: $12000
Very major redo:
- Correction of implant malposition and tissue distortions, reposition nipples, revision of scarring, new saline implants, transfer to a different muscle plane: $13000
- Correction of implant malposition and tissue distortions, reposition nipples, revision of scarring, transfer to a different muscle plane, new silicone implants: $14000

These are just examples - the actual range is great. These are the rates for a redo on a patient whose prior operation was done by other surgeons. (Many surgeons have pricing policies that will lower the fees for redos on their own patients, which usually involves a higher fee for everyone getting a first-time breast augmentation.)

Clearly, the greater the problem, the more expensive the correction is going to be.


Alloderm
Alloderm grafts are thin strong sheets of collagen matrix, like a thin sponge in which the holes are microscopic. It is not living tissue, but just like collagen injections, the collagen was once part of living tissue, namely skin. It is obtained from cadavers, from people who chose to donate their organs and body parts after they died, for the benefit of other people and of science. The tissue is processed intensely to eliminate any cells, proteins, virus, bacteria, DNA etc and leave only collagen. It is the intensive processing that makes Alloderm very expensive. These thin sheets are very strong, and can be used to supplement and strengthen areas of weak tissue in the body, and are very often used in plastic surgery of the breast.

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6770 Mayfield Road, Suite 410
(Mayfield Heights) Cleveland, Ohio 44124
(440) 449-7470

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