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Author Archives: Janice Nunez

Breast Revision and the Three C’s

Breast revision in San francisco

A 39-year-old mother of 5 presents to my office with recurrent breast capsular contracture on her right side. Her surgical treatment was a complete capsulectomy (breast capsule scar removal) from the right side and replacement

Capsular Contracture

One of the most frequent causes of breast revision surgery is the scar that forms around the breast implants. It is typical for a scar to form around the implant and protect it, it also keeps the implant in the pocket, but sometimes complications may arise. For example, if the scar is too thin, the implant can slide to the side or drop down. If the scar is too thick, the implant may get compressed and feel hard. This is referred to as capsular contracture.

Capsulotomy vs. Capsulectomy

There are 2 different procedures that are performed to correct capsular contracture. The first is a capsulotomy. For a milder capsular contracture, a capsulotomy may be performed. The scar tissue is scored with small incisions, and only a portion of the scar tissue is removed. In addition to correcting milder capsular contracture, it may also be used to correct breast asymmetry. For moderate to severe capsular contracture, the surgeon may choose to do a capsulectomy. A capsulectomy is where the surgeon surgically removes the entire scar capsule.

It takes an expert board certified breast revision surgeon such as Dr. Miguel Delgado, M.D., to ascertain which procedure is the most appropriate for the patient, taking into account the hardness of the breast and the severity of asymmetry.

Capsulorrhaphy

In the instance where the scar capsule is loose, and the implants slide to the sides, the middle or drop down, a capsulorrhaphy may be performed. In this case, the scar capsule is tightened and reduces the breast pocket with sutures. Sometimes an acellular dermal matrix may be used for reinforcement. This procedure is also used when downsizing the pocket for smaller implants, or correcting implant malposition, and for implants that have “bottomed out.”

View Video!

Dr. Delgado has been performing breast revision surgery since 1989 and is experienced with all various complications that may occur after breast augmentation. View the video below and call today (415) 898-4161 for a consultation for any issues you may be having with your breast implants!

 

Breast Implant Pocket Complications

 

 

Breast revision surgery in San Francisco

43-year-old mother of two presents for breast revision surgery. She underwent breast augmentation in 2001 using 300cc normal saline breast implants inflated up to 360cc. She developed a slow leak on her right side. She underwent removal of the saline implants and replacement with 500cc moderate-plus Mentor gel implants.

Breast Pocket Complications

One of the most common complications for breast augmentation patients is the breast implant pocket. When a breast implant is to be inserted, the surgeon needs to make a pocket by separating the muscles and tissues within each breast either below the glandular tissue and above or below the chest muscle. The skill of the surgeon will determine how the breasts will look once placed into the breast pocket.

What Happens When the Breast Pocket is the Wrong Size

Complications can arise if the pockets are too large or too small. If one or both pockets are too large, the implant can move around making them either asymmetrical, or they may bottom out. In some cases the implant may slide to the middle, this condition is referred to as symmastia, also known as a “uni-boob” or one boob. On the other hand, if the pocket was made too small it will affect the shape and smoothness of the breast. If the patient should gain weight or the pectoral muscle mass has increased through exercise the appearance will be worse. If only one breast is affected, the breasts will be asymmetrical and can only be corrected by breast revision surgery.

Pocket Adjustments Allow Increases or Decreases for Implant Size

In order to correct a breast pocket complication, the surgeon will either use dissection to increase the size of the pocket or use sutures to tighten and decrease the size of the pocket. Adjusting the size of the pocket allows the implant to be in the best position aesthetically, improving the shape of the breasts. Pocket adjustments will enable a woman to increase or decrease the size of their implants.

Dr. Miguel Delgado, M.D. explains to his patients that even with the perfect pocket size, other factors can lead to the necessity for breast implant pocket revision such as; gravity, aging skin, the development of scar tissue and pregnancy.

Call Today!

If you are having any issues with your breast implants, contact Dr. Delgado today (415) 898-4161 for a consultation!