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Category Archives: Breast revision risks

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.

Will I Need More Than One Breast Revision Surgery?

San Francisco Plastic Surgeon, Miguel Delgado, M.D.

Miguel Delgado, M.D.

An experienced Board Certified Plastic Surgeon will inform his or her breast augmentation patients to expect that they will need to have breast revision surgery at least once in their life. Many women ask Miguel Delgado, M.D., “Will I need more than one breast revision surgery?”

Breast Augmentation is Just the Beginning

Every woman is different; there is no way to know how many breast revision surgeries may be needed. There is the rare woman, who may not ever need a revision, but most will need at least one, and many may need two or more. It is important for women to understand that having breast implants is a lifelong endeavor that will require maintenance.

As noted in this website, there are several reasons for breast revision; the most common is changing the size or type of implant, and or the development of a capsular contracture. There have been many advances to minimize the occurrence of the formation of scar tissue; however some women seem to be more susceptible than others. For unknown reasons some women continue to develop capsular contractures and, therefore, they may not be good candidates for breast implants.

Breast Revision Surgery Can be Tricky!

Breast revision is more complex than the initial breast augmentation surgery. Some of the procedures for a breast revision would include:

  • making new pockets for the implants
  • removal of scar tissue
  • a breast lift may be indicated

It is very important to select an experienced Board Certified Plastic Surgeon who specializes in breast surgery the first time around to minimize the potential for breast revision surgery.

Miguel Delgado, M.D., San Francisco’s Breast Revision Specialist

Call today (415) 898-4161 or email info@dr-delgado.com for a consultation with Dr. Delgado for your breast revision concerns.

The Dangers of Smoking for the Plastic Surgery Breast Revision Patient

Almost 1 in 5 Americans smoke. It is not surprising that Miguel Delgado, M.D. is frequently asked by his breast revision patients, “How important is it to quit smoking before surgery?” His reply is always, “Extremely important, I can’t emphasize enough the dangers that smoking can cause for a cosmetic plastic surgery patient.”

No smoking for the cosmetic plastic surgery patient

San Francisco Patients Beware! Complications Smoking Can Cause

Plastic surgery changes the shape of different areas of the body; this is achieved by moving skin and tissue around and thereby altering the blood supply. Cigarette smoke contains over 250 known toxins, besides nicotine; there is carbon monoxide, nitric oxide, and hydrogen cyanide, all of which compromise wound healing. The blood vessels bring oxygen to the tissues, in addition to healing aspects; the oxygenated blood fights infection and delivers important medication such as antibiotics.

Nicotine affects blood flow because the blood vessels constrict, and then the blood may clot more easily clogging small blood vessels and capillaries. This clogging could result in a reduction of blood to the tissues causing necrosis, which is the death of cells in living tissue. When this happens, the surrounding tissues become inflamed requiring surgical removal called debridement. When this type of surgery becomes necessary, the outcome of the cosmetic surgical procedure may be compromised.

Medical Studies Report the Risks of Smoking

The American Society of Anesthesiologists reported a study that shows surgery results between smokers and non-smokers:

• Smokers 50% more likely to develop pneumonia
• Smokers 57% more likely to have cardiac arrest
• Smokers 73% more likely to have a stroke
• Smokers 80% more likely to have a heart attack

In another recent study by The European Society of Anesthesiology, smokers need 33% more anesthesia throughout surgery and 23% more pain medication. Surprisingly, those exposed to second-hand smoke needed 20% more anesthesia and 18% more pain medication.

Smoking Addiction is Serious

Addiction to cigarettes should not to be taken lightly. Most people who smoke wish they could quit, but addiction to nicotine can be an uncontrollable dependence causing severe mental, emotional and even physical reactions for someone trying to kick the habit.

For a plastic surgery patient who smokes and is anticipating elective surgery, it is important to understand the complications that smoking can cause. Some patients may be tempted not to disclose their smoking status to their surgeon. Preoperative testing can show if nicotine is present in the blood and thereby affecting the safety of surgery. All qualified Board Certified Plastic Surgeons make safety for their patients their number one goal.

Miguel Delgado, M.D. does not wish to scare patients with this information but to make them aware of the seriousness smoking poses. Dr. Delgado has helped many patients overcome their smoking habit by prescribing medications such as Chantix so that they can move forward safely to their cosmetic surgery goals.

Call Miguel Delgado, M.D. Today!

San Francisco Email and PhoneCall (415) 898-4161 or email info@dr-delgado.com for an appointment with Dr. Delgado.