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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.

Category Archives: Breast implant pocket

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.

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.

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!