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Unhappy with your breast implants?

Consult with one of San Francisco’s Top Doctors, board-certified plastic surgeon Miguel Delgado Jr. M.D. Correcting aesthetic and medical complications due to problematic breast augmentation surgeries is one of his specialties. Read about the main surgical techniques he employs in breast implant replacements, watch videos of the doctor and patients to know what to expect, and view actual patients before and after photos to evaluate the results.

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The Value of Before and After Surgery Pictures

Before and After Breast Revision Surgery

                                          Before and After Breast Revision

Board Certified Plastic Surgeons receive specialized training in taking before and after pictures of their surgery patients. The attention to detail in the photos may reflect the surgeons’ attention to detail in the operating room. Images are one of the most valuable tools surgeons have in communicating with patients their aesthetic talents. When consulting with a plastic surgeon, you want both quantity and quality of the pictures presented.

Look for Consistency

An important factor to watch for is consistency in the photographs. The ratio of the height to the width should be the same for both before and after pictures. The position and distance of the patient from the camera lens should be the same. Lighting and color saturation needs to be comparable. More than one angle should be presented so that you do not see just the “best view.” The background should be the same.

There are photography tricks that can make after pictures look better. Be wary if the before picture has the arms at the sides and the after picture has the arms raised, which will make the breasts look perkier.

Are Pictures Aesthetically Pleasing?

Look for patients that may be about the same age, ethnicity, and body type as you. Notice if the after pictures look natural and are aesthetically pleasing.

All pictures presented on Dr. Miguel Delgado, M.D.’s website and office photo albums have written consent from the patients. Sharing of before and after photos are very beneficial to new patients and are much appreciated by Dr. Delgado. However, it is entirely optional, Dr. Delgado respects the privacy of all of his patients.

Call Today!

If you are considering breast revision surgery, call now (415) 898-4161 for a consultation with Dr. Delgado.

What is Symmastia and How is it Corrected?

Symmastia in San Francisco

                                      Symmastia

Symmastia is a condition where the breasts have merged making one breast. There is “web-like” tissue that crosses the sternum connecting to breasts medially.This is also referred to as; “breadloafing,” “kissing implants,” and “uniboob.”

Congenital Symmastia

There are 2 types of symmastia; one is congenital, and the other is iatrogenic. Congenital symmastia, meaning you were born with it, is very rare. There have not been many cases reported, with limited knowledge on the ideal treatment. To date, the 2 most common procedures for congenital symmastia are; reduction mammoplasty and liposuction.

Iatrogenic Symmastia

More common but still fairly rare is iatrogenic symmastia. This rare complication follows breast augmentation surgery which may present right after surgery or develop later. Symmastia can be minimal where the implants look too close together, to the extreme where the implant pockets merge.

Symmastia Causes

The cause for symmastia can be a surgical error or sometimes occurs when the surgeon is attempting to increase cleavage. Thin women are more prone to getting symmastia due to insufficient breast tissue over the breastbone. Patient with “pectus excavatum,” which is a concave chest, also have a higher risk of symmastia as their implants tend to lean toward the center of their chest.

Correcting Symmastia

Breast revision for symmastia can be complicated. Repair for some patients is for the surgeon to reattach fat and skin to the sternum, closing the pockets that have become too wide. More recently, some plastic surgeons use a technique known as “neosubpectoral pockets.” For this procedure, the surgeon creates new pockets under the muscle. Strattice (acellular dermal matrix) may be used on select patients for additional support if the patient’s tissues are thin. If the symmastia is sub-glandular or on top of the muscle the easy correction would be to place it sub-muscular.

Corrective procedures will vary depending on whether the implants were placed over or under the muscle. Fortunately, this complication is rare, but it is essential to choose the correct size and placement for the implants.

Dr. Miguel Delgado, M.D. warns that selecting implants that are too large for your chest size increases the possibility of symmastia.

Call Today!

Breast revision specialist, Dr. Delgado is available for consultation by calling (415) 898-4161.

Asymmetrical Augmented Breasts

Asymmetrical Breasts in San francisco

Asymmetrical Breasts Before and After Surgery

Breast augmentation patients may end up with asymmetrical breasts due to various conditions that include:
• False asymmetry
• Hematoma
• Seroma
• Rotation of the breast implant

Breast Implants May Take Months to Drop

For a woman to notice that her breasts are asymmetrical after breast augmentation surgery can be very upsetting. Noticeable uneven breasts can diminish the excitement of breast augmentation.

It is important for women to understand that it can take several weeks and even months for implants to settle into their permanent position. Post-surgical swelling may affect one breast more than the other and until the swelling resolves and the implants drop they may appear uneven. This condition is referred to as “false asymmetry.”

Understandably, it is tough for women to be patient for several months before determining if breast revision surgery will be necessary. In some instances, the asymmetry is so minor that many women choose to ignore it.

Many women naturally have uneven breasts, and in the hands of a qualified Board Certified Plastic Surgeon, the breasts can be made symmetrical with the use of different size implants.

Causes for Asymmetry of the Breasts

Another cause for asymmetry would be the development of a hematoma. A hematoma is where there is a collection of blood around the implant pocket. Hematomas usually occur within 24 to 48 hours after surgery. The body may absorb small hematomas, and no treatment is required. If the hematoma is significant, surgical intervention may be necessary. If you notice any unusual swelling, be sure to notify your surgeon.

It is also possible for the breast augmentation patient to develop a seroma, similar to a hematoma but instead of blood, a seroma is clear lymph fluid.

Under some circumstances, the breast implant may rotate. If the implants are round, there is no issue. If the implant is teardrop or anatomical and it should rotate, the asymmetry will be apparent. The muscle of the upper part of the breast will be stretched and makes correction difficult if not addressed in a timely manner.

Avoiding Asymmetry

To avoid asymmetry, Dr. Miguel Delgado, M.D. recommends patients choose their surgeon carefully. An experienced Board Certified Plastic Surgeon will be able to help a patient determine the right size and shape breast implants that will fit their chest wall.

Call Now!

Women who are experiencing any issues with their breasts are invited to call Dr. Delgado (415) 898-4161 for a consultation.

Breast Revision Recovery

breast revision with larger implants

Breast Revision With Larger Implants

Breast revision recovery is different for each patient. Some patients have a very high pain threshold, and others do not, so you cannot compare someone’s recovery to your own.

Sometimes the Original Pocket is Used

If the original pocket is being used, recovery may be easier unless the pocket is being made smaller or larger depending on the new implants. However, many women choose the change the size of their breast implants when breast revision is necessary for other reasons. Usually, a change in size is for larger implants, and many times the placement of the pocket maybe going from overs to unders. In this case, recovery will be somewhat longer as the surgical procedure is slightly more complex and invasive.

If the implants are smaller than the originals, the pocket size may be fine depending on the difference in size. If there is a significant change, the pocket may need to be reduced with internal stitches, or for some patients, a breast lift may be required.

Recovery for Each Patient is Different

Dr. Miguel Delgado, M.D. states that recovery for each patient is different. The amount of revision surgery will determine how much discomfort will be present. With that being said, some women sail right through their recovery with little to no discomfort, requiring only Tylenol for pain control.

No matter what degree of discomfort is experienced, women need to take care to sleep with their head and back elevated to reduce swelling. Showers are allowed 24 hours after the removal of the drains, prior to that just sponge baths are permitted. Return to normal activities is usually in 7 to 10 days, and formal exercise is allowed in 4 to 6 weeks, depending on how the recovery is going.

Make an Appointment With Dr. Delgado Today!

If you have concerns about your breast implants, Dr. Delgado has been performing breast revision surgery since 1988, and he would be happy to see you in consultation, call today (415) 898-4161.

Updating Breast Implants after Weight Loss

Breast Revision in San Francisco

                                    Before and After Breast Revision Surgery

Many women choose to lose weight after having a breast augmentation because they are pleased with their new look and are motivated to do more. It is difficult to lose weight, but a new slimmer body can be quite rewarding.

Significant Weight Loss May Affect Your Breasts

A common question that is asked of Dr. Miguel Delgado, M.D. is “how will I look if I lose weight after my breast augmentation?” Depending on the amount of weight loss there can be some downsides. For example, if you have breast implants, the size and shape that were selected for you before weight loss, may no longer look right.

It is difficult to say how a woman’s breasts will look after significant weight loss as women have different ratios of fat and breast tissue. Usually, women who seek breast augmentation do not have a lot of breast fat. For most, 10 to 20 pounds of weight loss won’t make a visible difference. In some cases, losing weight may make the breast implants more visible with less tissue for coverage. When there are physical changes, the implants may settle into a new position. It is possible that the nipples will be lower and the breasts will sag. However, women gain and lose weight in different areas of their body. If in the past (before breast augmentation surgery), if you noted how your breasts responded to weight fluctuations, it will be the same.

There Are Many Implant Choices

If it has been several years since you have had your breast augmentation, there are several new breast implants available offering more choices. Additionally, if you are unhappy with sagging breasts, you might want to consider a breast lift along with new breast implants.

Call Now!

Call today (415) 898-4161 for a consultation with Dr. Delgado and learn what options are available to you.

When to Have Breast Revision Surgery

Breast revision surgery in San Francisco

This 30 year old patient wanted larger implants and correction of some slight asymmetries. She changed from 350cc saline implants to 600cc silicone on the left and 650cc silicone on the right.

When to have breast revision surgery will depend on your unique situation. There are several factors to consider before scheduling surgery.

Breast Implants Take Time to Settle

Most women are immediately happy with their breast augmentation surgery. However, some women are disappointed with their results and want a breast revision right away. Patients need to understand that their results may take 6 months to a year before the implants relax into their final position. Once the implants have settled in, most patients find that they are happy with their outcome. The body needs time to recover from major surgery. If after a year the patient is still unhappy, then revision surgery should be considered.

The most common reasons for dissatisfaction with breast augmentation are; the size of the implants, the choice of saline or silicone, the shape, or the style.

Choosing the Right Breast Implant

Dr. Miguel Delgado, M.D. spends a great deal of time with his breast augmentation patients to help them choose the right implant the first time. He has them do the “rice test” which allows them to visualize the size. He has them hold a saline implant and a silicone implant so they can feel the difference. Dr. Delgado explains in detail how different projections and size will fit their chest based on their chest size.

 

Each patient needs to decide how comfortable they are waiting to have surgery for aesthetic purposes. At some point, they may need a revision for a complication that needs to be addressed such as; a capsular contracture, a ruptured or deflated implant(s), a double bubble, asymmetry, symmastia or other complication. If the patient wants to change the size, style, or type of implant, ideally the time would be best when another revision is needed. However, this is a personal decision and the right time for surgery is when she is ready, and her body is ready.

Call Today!

Call (415) 898-4161 for an appointment today to meet with Dr. Delgado to discuss any breast revision concerns you may have.

What Women Need to Know About Breast Revision Surgery

breast revision in San Francisco

A mother of 5 presents with recurrent capsular contracture of the right breast. She had a complete breast capsule scar removal from the right side and replacement

Dr. Miguel Delgado, M.D. has been performing breast revision surgery since 1989. He has made a point of informing women who choose to have breast augmentation surgery that it will be a long-term marriage between her and maintenance of her implants. In most cases, breast implants do not last a lifetime but will require some type of revision surgery at least once or more during their lifetime.

6 Part Video Shows Breast Revision Surgery

In order to fully explain and show examples of some breast revision cases, Dr. Delgado has put together a 6 part video showing the journey of 2 patients over a period of 6 to 7 months, from consultation through 5 weeks post-operative visits.

The first case is Michelle, who had silicone implants at the age of 18 in 1990. After a car accident, she had her implants replaced in 1996 when they became encapsulated. At this time she chose normal saline implants, for both surgeries her implants were placed over the muscle. She presents for breast revision surgery 10 years later due to her breasts feeling hard, uneven, painful, and sagging.

The second patient is Bea, to date, she has had 3 surgeries. In 1999, she had saline implants placed under the muscle desiring more volume after having 3 children. However, Bea developed mastitis, an infection of the breast tissue usually caused by breastfeeding. She had one implant removed for 8 months and then had smaller implants inserted. Within a year her left implant dropped, and the right implant developed a painful contracture creeping up high on her chest wall.

Consultation Through Post-Operative Visits

Dr. Delgado’s informative 6 part video follows the journey of these 2 women from their initial consultation, through their pre-operative visit with Dr. Delgado and Dr. Gaynor, the anesthesiologist, along with actual footage of their surgery in part 3. Part 4 is the first post-operative exam showing the removal of the drains. At the second post-operative visit, the sutures are removed. Part 5 shows the follow-up exams and the beautiful results for both women.

In the Patient’s Own Words!

The last part, part 6 is the patient’s impressions after 6 months. Michelle and Bea share with you how their breast revision surgery met their expectations. If you are having issues with your breast implants, call today (415) 898-4161 to schedule a consultation with Dr. Delgado.

Are Bras Necessary After Breast Revision Surgery?

Support bra after breast revision surgeryMany women ask Dr. Miguel Delgado, M.D. if wearing a bra after breast augmentation or breast revision surgery is necessary. They love their perky new breasts, and many would enjoy the freedom of going bra-less.

Dr. Delgado says, “Not so fast!” There are several things to consider before “burning that bra!” After surgery, your breasts will continue to fight gravity. Going bra-less for special occasions where you want to wear that fabulous backless cocktail dress probably won’t make any difference, but going bra-less long term can make a difference.

Larger Implants More Likely to Droop!

Things to take into consideration are the weight of your breasts. Large natural breasts weigh more than small breasts and tend to droop more. The ratio of fat to breast tissue can make a difference; fat weighs less than breast tissue. The same is true for breast implants, the larger the implants, the more likely they will eventually droop. The type of implant can make a difference; it is surprising that saline implants weigh more than silicone. If you compare saline to silicone implants, the silicone feels a bit heavier but based on specific gravity; the saline implant is slightly heavier.

More important considerations than saline versus silicone are:
• The patient’s age
• Genetics
• Breast size
• Smoking
• Bra wearing habits

The larger the implants, the more likely sagging will occur. Wearing a bra on a regular basis can help support breast tissue, while sagging may still happen it can help with the severity and delay onset.

Keep Your Breasts Perky

With many factors that you can’t control regarding sagging, there are several things you can do to keep your breasts perkier longer.

1. Sleep bras, it is unknown if a sleep bra will make a difference, but most are very comfortable to sleep in, and it is worth a try!
2. Smoking, if you smoke, STOP! Smoking is proven to be a factor in sagging breasts, besides all the other detriments smoking causes.
3. Wear a high-quality support bra.
4. Follow all post-operative instructions from your surgeon.

Most surgeons will tell you that you may need breast revision surgery on average, every 10 years, but following these guidelines may delay breast revision surgery.

Call Now!

Call today (415) 898-4161 for a consultation for any concerns you may have about your breast implants.

Breast Revision and the Use of Drains

Many women have voiced concern over the use of drains after their breast revision surgery. They have heard stories how they are bulky, somewhat awkward to manage and painful when the tubes are pulled out.

Understanding the Need for Drains

They are a little cumbersome, but only take a few minutes to empty. There is a slight burning sensation that only lasts seconds when they are removed. Understanding the need for drains and what they can accomplish makes the 2 to 3 days of having drains tolerable.

Breast revision and drains

The Jackson Pratt is the most common type of drain; its purpose is to remove fluid by mild suction from the surgery site. There is a clear tube that goes from the surgical site to a small bulb. The bulb needs to be emptied periodically and then gently squeezing it when reattaching it to the tube makes a suction to aid in the removal of fluids. Fluids that collect inside of the body can increase the chance of infection or other complications. The use of drains promotes healing and recovery.

Measure Color and Amount of Fluid

By monitoring the amount of fluid, and the color gives the surgeon valuable information on how you are healing. Serosanguinous is the most common type of drainage. It is usually thin, watery, and pink to darker red in color, which is caused by red blood cells in the fluid. On the other hand, purulent exudate, is thick, opaque and sometimes tan, yellow, green or brown, and associated with infection or high levels of bacteria.

It is normal for a small amount of drainage during the inflammatory stage of healing. Dr. Miguel Delgado, M.D. has his patients keep a log to document the output of fluids and the color. Patients are instructed to notify Dr. Delgado if any of the following should occur:
• Fever
• An increase of discharge that is green or yellow or brown
• A noticeable change in the odor of the discharge
• Increase in pain

Dr. Delgado Has More Than 25 Years of Experience

Some surgeons use drains, and some do not. Dr. Delgado has more than 25 years of experience, and he believes in using drains for certain procedures to help with healing and fewer chances of infection.

Call Now!!

If you are having any concerns about your breast implants, call today (415) 898-4161 for an appointment with Dr. Delgado.

Can Breast Implants be Reused During Revision Surgery?

Breast revision surgery in San Francisco

Many women ask if it is possible to reuse their breast implants during breast revision surgery. In some cases it may be possible, it depends on the reason for revision surgery and the condition of the breast implants. The primary concern is proper sterilization of the implants.

Breast Implants May Have Bacteria

If the reason for the revision is with the implants themselves, replacement is necessary. Implants that have ruptured or deflated must be replaced. If a revision is due to capsular contracture, implants should be replaced because it is possible a layer of bacteria has developed on the surface that may not be entirely removed, increasing the risk of capsular contracture forming again.

Age of the Breast Implants Makes a Difference

If the implants are less than 5 years old and there is no issue of contamination or rupture, there are some situations the implants can be used again such as; malposition, bottoming out and symmastia. If implants are over 5 years old, there is less usable life left, and they should be replaced.

In the hands of an expert breast revision surgeon such as Dr. Miguel Delgado, M.D. the pockets may be adjusted, sterility maintained, and the implants reinserted.

Implants do not need to be retreated for sterility as long as sterility is maintained during revision surgery.

Ask About Breast Implant Warranty

The manufacturers of breast implants give a lifetime warranty on their implants and will replace them at no charge if there is a deflation or a rupture. If a more expensive implant is chosen for replacement, the patient is only required to pay the difference. Manufacturers state that their implants are for a one time use only and reusing them will void the warranty.

 Breast Implant Deflation

Before and After Saline Breast Deflation

Dr. Delgado uses Mentor implants for his patients. When scheduling surgery ask about Mentor’s Enhanced Protection Plan that offers 10 years of financial assistance for surgical and operating room costs should revision surgery be necessary.

There are exclusions to Mentor’s replacement warranty, Dr. Delgado’s staff will be happy to give you details. Call today (415) 898-4161 for a breast revision consultation with Dr. Delgado.