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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 revision risks

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.

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.

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.

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.

 

Risks and Complications From Extra Large Breast Implants

 

 

Breast Revission With Larger Implants in San Francisco

This is a mother of two who presented for breast revision surgery. She had a 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.

Choosing Breast Implant Size

There are several factors to consider when choosing breast implant size. Women have heard of many breast augmentation patients that regret not choosing implants large enough when they had their original surgery. Many opted for breast revision surgery to get larger implants.

Before seeking breast revision surgery to increase implant size, it is recommended that women wait until they become used to their implants and many find once they do they are happy with the size.

Plastic Surgeons Consider Issues With Large Breast Implants

For women who still choose to have larger implants, the surgeon will be considering issues such as:
• The dimensions of the breast and chest wall
• How much skin and soft tissue is available to cover the implants
• Distance between the nipples
• The location of the nipples and the breast fold in relation to the chest wall

Large Breast Implants Come With Risks

There are numerous risks involved that patients need to be aware of when choosing extra-large breast implants; there are increased risks for:
• Loss of nipple sensation, the implants can place too much pressure on the nerves to the nipples
• Breast ptosis or sagging in the long term
• Rippling or visible creases
• Thinning of the breast tissue
• Stretching of the skin
• Loss of the natural inframammary fold
• Bottoming out
• Formation of a double bubble
• Higher incidence of capsular contracture
• Visibility of the implants through the tissues
• Visibility of veins in the breasts

Another unwanted risk for some women who go too big too fast is stretch marks that are irreversible. The weight of extra-large implants needs to be considered as they may cause neck, back, and shoulder pain, which is what women who seek breast reduction surgery complain about. It is noted that extra-large implants do not have a natural feel, they are much firmer.

Trust Your Cosmetic Plastic Surgeon

In deciding on breast implant size, patients should trust their board certified plastic surgeon to help them determine how large they can go without increasing the risks that come with very large implants.

Dr. Miguel Delgado, M.D. has been performing breast revision surgery since 1988 and has guided many women in making the right choice for breast implants.

Call Dr. Delgado Today

If you are considering breast augmentation or breast revision surgery, call Dr. Delgado (415) 898-4161 for a consultation so he can explain what he sees as the best choice for you based on your goals.

What is Capsular Contracture of the Breast?

When a foreign object such as breast implants, a pacemaker, or an artificial joint is inserted into the body, it will form a protective scar capsule around the object. It is a natural healing response and is expected.

Baker Scale Grades Firmness of the Breast

For some breast augmentation patients, during the first year of healing, the capsule that forms around the breast implant may shrink (contract). The web of fibrous material making up the capsule tightens and squeezes the implant, making it feel hard. There are varying degrees of encapsulation. Dr. James Baker created the “Baker Scale of Capsular Contracture,” which is used worldwide to grade the degree of firmness of an augmented breast.

• Baker Grade l     The breast feels soft and appears normal
• Baker Grade ll    The breast feels slightly firm but appears normal
• Baker Grade lll    The breast feels firm and appears abnormal
• Baker Grade lV   The breast feels hard, appears abnormal and is painful

Capsular contracture in San Francisco

A 39-year-old mother of 5 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 breast implant replacement.

Capsular Contracture Affects Only a Few

Dr. Miguel Delgado, M.D. states that capsular contracture can develop at any time, but is more prevalent in the first few months after breast augmentation surgery. Fortunately, only a small percentage of women develop a problematic contracture.

According to a publication in the US National Library of Medicine at the National Institute of Health, capsular contracture usually is a result of subclinical colonization of bacteria within the implant pocket.

New Techniques to Combat Capsular Contracture

With all the latest techniques to minimize the chances of capsular contracture, the contracture can still occur. However, the rate has been greatly reduced in recent years thanks to techniques such as placement of the implant under the muscle, the Keller funnel (a device that allows the surgeon to insert the implant without touching it), and antibiotics.

Make an Appointment Today!

If you have been suffering from capsular contracture, call now (415) 898-4161 to schedule an appointment with Dr. Delgado to find out what options are available to you.

When to Consider Breast Revision Surgery

Breast Implants in San Francisco

Breast Revision, Now or Later?

A frequent question women with breast implants ask Dr. Miguel Delgado, M.D. is, “When should I get breast revision surgery?”

Most women have been advised by their original Board Certified Plastic Surgeon when they have breast augmentation surgery, to expect that they will need to have breast revision surgery at some time in the future and for many, possibly more than once.

Breast Implants Have a Lifetime Guarantee

Most breast implant manufacturers give a lifetime guarantee on their implants if they should fail. The manufacturers will supply new breast implants for surgery, but they only give 10 years for additional financial aid to help offset surgery costs. Statistics show that on average women may need a revision after ten years.

Depending on the reason for breast revision determines when it should be done. For example, in the case of deflation or rupture, or if your breasts are painful, it is best to have surgery sooner rather than later. If however, you desire breast revision surgery to change implant size, type or position, the patient can afford to wait until it is convenient to do so.

Breast Revision Restores Youthful Breasts

The main advantage of breast revision is restoring youthful looking breasts, and possibly changing the implant size and improving breast symmetry. There are disadvantages to consider as well, such as; aging and gravity will eventually affect the shape of the breasts. Heavier implants are more likely to sag with time.

If you are not returning to your original surgeon, having a copy of your operative report is invaluable to your new surgeon.

Breast Implant Issues? Call Now!

Miguel Delgado, M.D. has been specializing in breast revision surgery since 1989. If you are having any issues with your breast implants, call now (415) 898-4161 for a consultation.

Before and After Surgery Instructions for Breast Revision Patients

Patient Participation is a Must

Breast revision patients frequently ask Miguel Delgado, M.D. “How do I prepare for my breast revision surgery?” Patient participation is necessary to achieve the best results, so Dr. Delgado is always glad to hear patients ask questions.

There are a lot of instructions for patients, both before surgery and after, therefore Dr. Delgado designed a comprehensive booklet for patients to have on hand that they and their caregiver can refer to.

Reading Surgical Booklet for Breast Revision Surgery

Comprehensive Surgery Instructions Booklet

The booklet, which is almost 40 pages in length, is divided into several sections including a table of contents for easy reference. In the first chapter, which is titled “Starting Now,” the patient is advised to stop smoking. Start taking a multi-vitamin, and get lab tests done. When it is two weeks before surgery, Miguel Delgado, M.D. warns his patients to stop taking any products that contain blood thinners such as aspirin. However, aspirin is not the only culprit that thins the blood. In the booklet, there are three pages of medications, vitamins and supplements that must be stopped as they all contribute to thinning of the blood, which can cause complications during and after all surgeries, including gynecomastia, face lifts and mommy makeovers.

Critical to Avoid Blood Thinners

Many people are not aware of many items that thin the blood, such as; Alka Seltzer, Motrin, Vitamin E, Fish Oil, St. John’s Wart, Ginkgo Biloba, just to name a few. To be safe, Dr. Delgado wants his patients to be sure and let him know of any and all supplements and medications taken on a regular basis.

In the second section which is titled “The Day Before Surgery,” patients are reminded to get all prescriptions filled, guidelines for eating, drinking and bathing are reviewed and the surgery time is confirmed.

Nothing to Eat or Drink After Midnight!

“The Morning of Surgery” patients are reminded not to eat anything after midnight the night before surgery; they may brush their teeth but do not swallow any water. They will be advised as what to wear to surgery and their check in time.

There is a section on risks and possible complications and instructions specific to their procedure.

The booklet is a handy reference for patients and their caregivers, but they are always encouraged to call (415) 898-4161 or email info@dr-delgado.com with any questions.