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Category Archives: Breast implants

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!

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.

Breast Revision Surgery Has Unique Challenges

Breast revision surgery in San Francisco

Patient initially underwent bilateral breast augmentation with 275cc normal saline implants. She developed mal-position and high riding implants bilaterally, and presented for replacement of her implants with a larger size and to improve the breast implant position.

Breast revision surgery can pose unique challenges for the breast revision surgeon. Many women in need of breast revision surgery might not have access to their original surgery records. If many years have passed since their surgery, their surgeon might not have their records. Medical retention laws and regulations differ from state to state. For California, it is suggested records be kept for a minimum of 10 years from the date the patient was last seen. However, if the surgeon has retired, the patient probably has no way of getting in contact. In a perfect world, patients should ask for a copy of their records after surgery. However, that doesn’t happen very often.

Breast Revision Complications

When a patient sees a breast revision surgeon after many years, many do not remember what size their implants are or even if they are saline or silicone. The complexity of revision surgery is even higher if the patient has already had one or more previous surgeries and has resulting scar tissue that has formed.

As the patient ages the quality of the breast tissue changes, the skin becomes thinner, and the formation of scar tissue can affect the final result.

Breast Revision Surgery will Cost More

With the complexity of breast revision surgery, the fees may be substantially higher than the original surgery. Patients should not assume that a surgeon who performs a lot of breast augmentation surgeries is equally qualified to do breast revision surgery. There are even Board Certified Plastic Surgeons that may not have the expertise for the possible complications that breast revision surgery may require.

When looking for a breast revision surgeon, do not hesitate to ask the doctor how many revisions he/she performs in a year and be sure to ask to see before and after pictures of patients. Do your homework and select a Board Certified Plastic Surgeon who has extensive experience with breast revision surgery.

Before and After Pictures Speak For Themselves

Dr. Miguel Delgado, M.D. has been performing breast revision surgery since 1989. He has an extensive portfolio of before and after pictures of his patients who have been thrilled with their results.

If you are unhappy with your breasts, call now (415) 898-4161 and meet with Dr. Delgado who will explain what options you have to regain beautiful breasts..

Ruptured Breast Implants? Don’t Wait to Remove or Replace!

Saline Breast Implant Deflation

  Before and After Saline Breast Implant Deflation

Saline Breast Implants Can Deflate

Dr. Miguel Delgado, M.D. informs all breast augmentation patients that they will most likely need breast revision surgery at least once in their life. All breast implants can rupture, some within a few months, some after many years. Saline implants usually deflate quickly, and the saline will be absorbed by the body. In most cases, a deflated saline implant is harmless unless there are bacteria or fungus in the implant which can cause an infection and require immediate attention.

If you have a saline implant that deflates, it will be obvious; it will look like a deflated balloon. See your surgeon right away.

Ruptured Silicone Implants Can be Dangerous

Silicone implants that rupture may not be evident for many years and sometimes are not discovered until they are removed. When a silicone implant ruptures, if you are lucky, the silicone will remain inside the capsule (the scar tissue that naturally forms around the implant) making removal easier.

A more difficult situation is when the silicone leaks outside of the capsule and might migrate to areas of the body that are impossible to remove such as the lymph nodes, under the arms, the lungs or other major organs. Migrating silicone may cause lumps in the breast, armpits, or other areas. It is imperative to have the implant and silicone removed as quickly as possible before the silicone can travel inside the body.

Possible causes of a ruptured breast implant are:
• A fall or intense physical pressure on the implants
• Compression from a mammogram
• Capsular contracture
• Damage from surgical instruments
• Aging of the implants

Silent Rupture Only Detected by an MRI

Silicone implants may not show any evidence of a leak, known as a “silent rupture,” the FDA recommends women have an MRI 3 years after the initial surgery and then every 2 years after that.

It is much harder to remove ruptured silicone implants than it was to put them in. Your original surgeon may not be the best choice for revision surgery. Many surgeons are very experienced in breast augmentation, but many are not skilled for explantation, and many results are disastrous.

Ask that the removal is done ‘en bloc’ which means the implant and all of the scar tissue surrounding it is removed as there can be bacteria or chemicals from the implant remaining.

Choose a Breast Revision Expert for Removal/Replacement

If you are having your implants removed or replaced be sure you seek a Board Certified Plastic Surgeon who will show you before and after pictures of their patients.

Dr. Miguel Delgado, M.D., a Board Certified Plastic Surgeon, is an expert in breast revision surgery since 1989, if you are having any issues with your breasts, call (415) 898-4161 for a consultation today!

“What You Should Know About Boob Jobs”

Breast Augmentation #1 Cosmetic Surgery Procedure

Even with the increased popularity of the butt lift, breast augmentation continues to be the number one cosmetic plastic surgery procedure according to the American Society of Plastic Surgeons.

Women's Health Magazine

 

Women's Health Magazine

Women’s Health Magazine recently published an article on the “6 Things You Should Know About Boob Jobs-From Women Who’ve Had Them.”

Regrets Over Cheap Surgery

The first patient states she had her breast augmentation surgery at age 24. She chose the cheapest option she could find which was all she could afford. Now she is sorry she didn’t do more research and wait until she could afford a Board Certified Plastic Surgeon. Her stitches popped open, and her doctor told her not to worry and that it would just heal. Unfortunately, she ended up with very unsightly scars. It took her six years to save enough money to have breast revision surgery.

Another patient wants women to know that for her she was very uncomfortable for three days but was able to return to her spin class after nine days. However, she did wait six weeks before resuming her upper body workouts.

Large Implants Cause the Most Discomfort in Healing

The next patient says she went from an AA cup to a DD cup and had intense pain. Her surgeon told her that her pain level was due to the large implants stretching her pec muscles.

And another patient commented on how hard it was to try to choose the right size implants. For her, after surgery, she felt she went too large and that her breasts looked fake. Even after healing it took her almost a year to accept her new body image and feel really comfortable.

The last patient states she cried a lot after surgery, she thought it might have been her pain medication that made her weepy but worried if she made the right implant choice. However, today she is very happy with her implants and only wishes that she did it sooner.

To read the entire article, click here.

Choose the Right Surgeon

It is very important to choose a Board Certified Plastic Surgeon who you feel comfortable with and who will address all of your concerns. Dr. Miguel Delgado, M.D. emphasizes to his breast augmentation patients that most women will need to have at least one breast revision surgery at some point in their life and maybe more.

Call Today!

Dr. Delgado has been doing breast revision surgery since 1989. Call now (415) 898-4161 if you are having any issues with your breast implants.

 

Breast Revision Scars

Scars Can Be Genetically Determined

Many women have been dissatisfied with the scars from their original breast augmentation surgery. When women need or want to have breast revision surgery, it is possible that the original scars can be improved and made less noticeable.

Scar quality can be genetically determined. However, some lifestyle choices like smoking can be the cause of poor healing with the result of thick, unsightly scars. Stress may also interfere with the healing process.

Breast Revision Expert, Dr. Miguel Delgado, M.D.

Dr. Miguel Delgado, M.D. has been performing breast revision surgery since 1989; his expertise is reflected in the rate of high patient satisfaction. Expert surgical technique includes the proper placing of the breast implants and having even pressure distributed on the incisions.

Breast Revision, Dr. Delgado San FranciscoThis is a 39-year-old woman who had three previous breast revision surgeries. Now she presents with bilateral capsular contracture of the breasts and malposition. She had a complete capsulectomy (breast capsule scar removal) from the right side and replacement.

In addition to the external scars, internal scarring can be a big issue. Scar formation around an implant may distort the breasts and make a capsular contracture which is not only disfiguring but can be painful.

Scar Therapy After Surgery

Only experienced Board Certified Plastic Surgeons have the skills to minimize the incidence of scar formation which is followed by scar therapy. Scar therapy begins once the incisions have healed and includes silicone treatment and massaging. Dr. Delgado stresses the importance of avoiding direct sun exposure for about 1 year. For problematic scars, steroid injections may be an option; however, scars cannot be completely erased.

Call today (415) 898-4161 for a consultation with Dr. Delgado for any breast revision issues you may be having.

A Ten Year “Reunion” With Your Breast Surgeon is Recommended

Breast revision in San Francisco

Monterey, California – A 43-year-old mother of two presents to the Marin County office 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. Note the overall fullness and nice symmetry of her breasts. Her surgery was performed at Dr. Delgado’s private surgical facility, Marin Cosmetic Surgery Center in Novato, Marin County, California

Hopefully, when you had your initial consultation with your breast augmentation surgeon you were advised that at some time in the future, usually after ten years, you may need to have breast revision surgery, possibly replacing your breast implants.

As Women’s Bodies Change, Their Breasts Will Change!

Dr. Delgado states that there can be a lot of changes with women’s bodies after ten years, some women may have had a baby, perhaps gained or lost weight or noticeable aging to the body that may have caused sagging or asymmetry. Do not despair; see your plastic surgeon to discover the latest techniques to improve your breasts. You may want to change the shape or size of your breasts, or perhaps change from saline to silicone or vice versa, or the placement of the implants adjusted.

In the last ten years, there has been a significant advancement in breast implants. There are more choices than ever, for example, the 5th generation of silicone implants includes the cohesive gel implants nicknamed the “gummy bear” due to its consistency that is similar to the popular candy. The gummy bear implants offer some great benefits including a natural teardrop shape with lower complication rates; they cannot leak, they are less likely to ripple or develop capsular contracture.

Depending on your long term goals and your natural anatomy, you and your surgeon have many choices to select the ideal breast implant for your body.

Breast Implants Don’t Always Need to be Replaced

There is no rule stating that you must have your implants exchanged at the ten year mark, if you are not having any complications and are happy with your breasts, no changes are needed.

Even if all is well and you are not having any issues, Dr. Miguel Delgado, M.D. recommends that you have a ten year checkup a few months early just in case there may be a complication that you are not aware of. Besides a lifetime warranty on breast implants, most manufacturers include a warranty on their implants that gives some financial assistance for replacement surgery for up to ten years after the initial augmentation.

Schedule a Breast Implant Checkup!

If it has been almost ten years or more since you have had breast augmentation surgery, call now (415) 898-4161or email at info@dr-delgado.com, for a consultation with Dr. Delgado for a breast checkup. If you had your original surgery with another surgeon who may now be retired or you have moved to the San Francisco Bay Area, don’t hesitate to call Dr. Delgado. If you have your original records of your surgery including what type and size of implants you have, bring them along.