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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.

Preparing for Breast Revision Surgery

The patient that prepares for breast revision surgery is going to have an easier and faster recovery. There are several things that patients can do to be proactive in the outcome of their breast implant revision surgery.

  •   Being in good health for surgery is of utmost importance or surgery will likely be postponed.
  •   Eating a healthy diet and getting exercise is always recommended.
  •   Beyond that, Miguel Delgado, M.D. recommends that his patients start taking high quality multi- vitamins. He has    found Vitamedica vitamins are superior and, therefore, provides them to his patients, they take them 2 weeks before and 2 weeks after surgery.
  • For patients that smoke, they must stop at a minimum of 2 weeks before surgery and if they start again (hopefully not) must wait until 2 weeks after surgery. This is extremely important as smoking will compromise the healing ability of the body.

Supplements and Breast Revision Surgery

At the pre-operative visit, the patient will be given a booklet that has detailed pre and post-operative instructions. Within the booklet is an extensive listing of blood thinners that need to be discontinued 2 weeks prior and 2 weeks after surgery. Blood thinners can cause complications with surgery and blood clotting abilities. In addition to aspirin, there are many medications, herbs and vitamins that the patient must be aware of. It is recommended that the patient bring in a list of all medications; prescription and over the counter, vitamins and herbal supplements, to be reviewed at the pre-operative appointment.

You will have an easier time after breast revision surgery if you prepare meals in advance and freeze them. Get your wardrobe ready with clothing that opens in the front, not something you need to pull over your head. Slip-on shoes are much easier than something that needs to be laced up.

Family Member or Friend

As you probably remember from your original breast augmentation surgery, you will not be able to drive yourself home from surgery. If you live alone arrange to have a family member or a friend stay with you for the first 24 hours; you may be groggy from the anesthesia and need assistance.

You will be given prescriptions at your pre-operative visit, get them filled before surgery and have them available for when you get home.

Be sure to read your surgery booklet completely before breast revision surgery and if you have any concerns or questions, please call the office at (415) 898-4161.

Having a Smooth Recovery

Miguel Delgado, M.D. maintains that patients who follow all the instructions should have a smooth recovery and enjoy exceptional results.

If you are considering breast revision surgery, you are encouraged to schedule an appointment with Miguel Delgado, M.D. by calling (415 898-4161) or emailing at (info@dr-Delgado.com).

Ten Important Questions to Ask Your Breast Revision Surgeon

Breast Revision Specialist Miguel Delgado, M.D.

Before and After Breast Revision Surgery

 

The Consultation

Last month’s blog gave several suggestions in helping you to choose your breast revision surgeon. After all your research and you have picked a surgeon, it is time to meet for your first consultation. The following are ten important questions you should ask, don’t hesitate to write your questions down and take them with you; it is easy to forget when you are finally face to face.

 

Important Questions

1.    Are you Board Certified by the American Board of Plastic Surgery?

2.    Will the surgery be done in a surgery center or hospital? Is it fully accredited?

3.    Is the anesthesiologist Board Certified?

4.    What type of anesthesia will be used?

5.    How many breast revision surgeries do you perform per year?

6.    May I see before and after pictures of your patients?

7.    Do you recommend saline or silicone implants for me?

8.    What size and shape implant would be good for me?

9.    Should my implants be placed over or under the muscle? Why?

10.    Where will the incisions be?

 

Write Down Your Questions                       make a question list

This is not a complete list, but a good starting point. Be sure to add more questions as you think of them, but again write them down, it is easy to forget.

 

Two or Three Consultations are Fine!

If after your consultation you are not totally satisfied with the answers you received, or you are not comfortable with the surgeon, go for a second consultation or even a third. It is important for you to have confidence in your surgeon.

Miguel Delgado, M.D. has been doing breast revision surgery since 1989 and is an expert in breast surgery. If you are having issues with your breasts, or you have had your breast implants for more than 10 years and need an evaluation, contact the office today (415 898-4161) for an appointment with Miguel Delgado, M.D.

When Choosing a Breast Revision Surgeon, Read the Reviews!

Miguel Delgado, M.D. Cosmetic Plastic Surgeon

Miguel Delgado, M.D.
Cosmetic Plastic Surgeon
★★★★★ Ratings: 4.74 -118 Reviews

 

 

 

 

 

 

 

 

 

 

Breast Revision Surgeon

 

The informed woman knows that she will need breast revision surgery, following her original breast augmentation, at least once in her life and maybe more. When the time comes, many women wonder if they should see their same surgeon or seek out a new one.

If you were happy with your original surgeon and the outcome of your surgery, there is no reason to change surgeons unless you have moved, or your surgeon has retired. If you need to find a new surgeon, there are several factors to consider.

Probably the most important qualification you want to look for is that your surgeon is a Board Certified Plastic Surgeon and one that specializes in breast surgery. Doing a web search can provide you with an abundance of information, in fact so much it may be daunting trying to weed through it all!

Board Certified in Plastic Surgery

Miguel Delgado, M.D. suggests that you choose several surgeons in your area that are Board Certified. Before you even view their website; you might want to bring up reviews that have been posted by previous patients. There are several sites that patients can go to that give ratings from actual patients, some reviews are good, some not so much.

Some of the more popular ratings sites that you can check out are:
1.    Healthgrades.com
2.    Vitals.com
3.    RealSelf.com
4.    LocateADoc.com
5.    Yelp.com

 

Read the Reviews!

 

Some of the sites have different categories to give you an indication on how the doctor and the staff rated. An example of the ratings would be; friendliness of the staff, ease of scheduling an appointment, how long did you have to wait to see the doctor? Did the doctor make you feel rushed? Were all your questions answered? Were you happy with your surgical results? These are all important questions and are valuable information to have before making a decision in choosing a new surgeon.

Don’t be too critical, no one is perfect, one or two bad reviews are not unusual. Some people are impossible to please, look for the majority of the reviews to be good.Once you have found two or three surgeons that have good ratings, go to their website and view before and after pictures to get an idea of the results you can expect.

 

Breast Revision Before and After

Sonoma, California – This is a 38-year-old, female resident of Sonoma who presented to the Novato office in Marin County for evaluation for revisional breast surgery. She underwent a short-scar breast lift in 1995 and then a breast augmentation in 1996 using 120 cc, silicone breast implants. This was done at another facility. Her complaints on presentation to me were high-riding breast implants with breast contractures. She underwent complete capsulectomies on both sides with replacement with 300cc normal-saline breast implants inflated up to 325 cc bilaterally. Her procedure was performed at Marin Cosmetic Surgery Center in Marin County, California. Note the improved contour and projection of her breasts and how well the incisions have healed, especially the vertical breast lift incisional scars.

Call Today!

 

phone

Miguel Delgado, M.D. has been doing breast revision surgery since 1989 and is considered an expert in his field, call (415 898-4161)for your breast revision needs.

Consider “Gummy Bear” Implants for Breast Revision Surgery

Miguel Delgado, M.D. Cosmetic Plastic Surgeon

Miguel Delgado, M.D.
Cosmetic Plastic Surgeon

 

 

 

 

 

 

 

 

 

★★★★★  Ratings: 4.74 -118 Reviews

 

New Implants for Breast Revision

 

When considering breast revision surgery, one of the decisions to be made will be what type of breast implants to choose. Depending on what issues have determined the need for breast revision, implants can make a difference.

Sientra is the importer and distributor of Silimed implants from Brazil, being the only company outside the United States that has FDA approved breast implants. Brazil is now considered a first world economy, and uses the same FDA inspectors as Mentor and Allergan, the major implant manufacturers in the United States.

Gummy Bear Implants Get FDA Approval

Sientra was the first company to get FDA approval for their highly cohesive, form stable implants. Sientra’s form stable implants are referred to as the “gummy bear” implants, due to their consistency of the popular candy. All manufacturers now offer highly cohesive implants, but each with their own proprietary variation.

One of the biggest advantages of Sientra’s “gummy bear” implants is that they cannot leak; they do not have any “inner gel.” Due to the texture of the implant, it is believed there is less possibility of a capsular contracture forming. Additionally the teardrop shape gives upper pole fullness that may help correct minor sagging or drooping and possibly avoiding a breast lift.

Natural Teardrop shape

 

When a woman is standing, the teardrop shape is very natural, with a youthful perky appearance. However when a woman is lying down the Sientra gummy bear implants do not flatten out as much as the round implant will, like a real breast. The Sientra implant appears to be softer than the 410 (Allergan), and CPG (Mentor) form stable implants and maintains its shape better than all standard round silicone gel implants, including their own.

The gummy bear implants can only be inserted through an inframammary incision (under the breast). Therefore, there will be a scar hidden only by the fold of the breast. Normally, Miguel Delgado, M.D. will use the peri-areolar approach for breast  surgery so that the incision heals to almost invisible around the areola.

There has been a lot of press about the “new” implants, and due to requests from his patients; Miguel Delgado, M.D. has made them available, even though they are more expensive.

Contact Miguel Delgado, M.D.

 

If you think the gummy bear implants may be a good option for you, you are encouraged to contact the office for a consultation with Miguel Delgado, M.D. He will review your specific situation with you and help you determine the best implant for your breast revision surgery.

Breast Revision Surgery Statistics for 2014

Miguel Delgado, M.D. Cosmetic Plastic Surgeon

Miguel Delgado, M.D.
Cosmetic Plastic Surgeon

 

 

 

 

 

 

 

 

 

★★★★★  Ratings: 4.74 -118 Reviews

 

Most Women Will Need Breast Revision at Least Once

 

As previously noted in other areas of this website and blogs, there are several reasons that a woman may have breast revision surgery. It may be to change the size or type of breast implant or to correct any complications from the original breast augmentation surgery. The complications include; capsular contracture, deflation or rupture of an implant, bottoming out, rippling, double bubble and implant malposition.

Miguel Delgado, M.D. always emphasizes to his breast augmentation patients that they must be aware that they will most likely need to have breast revision surgery at least once in their life and possibly more. Even though implants are made to last a lifetime, situations can occur that will necessitate revision surgery.

ASAPS Publishes Statistics for Breast Revision

The American Society for Aesthetic Plastic Surgery (ASAPS) recently published their statistics for the calendar year of 2014. The number oASAPS Logof breast augmentation surgeries was 286,694. The number of breast revision surgeries was 71,916.

Miguel Delgado, M.D. wants to remind all breast augmentation patients to save all information from their original surgery for possible future revisions. Your original surgeon may have retired, and no longer has your medical records when you may be in need of a revision. Be sure to obtain your registration card that gives the information on what size, type, serial numbers and the manufacturer of your implants. You might also ask for a copy of your operative report and file all of this important information away in a safe place.

Warranty May Cover Some of Breast Revision Costs

Remember, the manufacturers of breast implants have a lifetime warranty where they will replace your implants at no charge should they rupture or deflate. Additionally, most companies include a ten year warranty that will aid in financial reimbursement toward your surgical expenses.

Breast Revision Specialist

 

email and phone iconMiguel Delgado, M.D. has been a breast revision surgery specialist since 1988. If you are having any issues with your breast implants, call today (415 898-4161) or email (info@dr-delgado.com) for a personal consultation.

What Causes Breast Implants to Ripple?

 

Miguel Delgado, M.D. Cosmetic Plastic Surgeon

Miguel Delgado, M.D.
Cosmetic Plastic Surgeon

 

 

 

 

 

 

 

 

 

★★★★★  Ratings: 4.74 -118 Reviews

 

Causes of Rippling of Breast Implants

 

One of the risks of breast augmentation is the possibility of rippling or wrinkling, although this risk can be rare if the surgery is done properly, for those patients that have rippling, it can be very bothersome.
Rippling of breast implants that can be seen through the skin is usually at the sides or bottom of the breast but can also be in the middle, near the cleavage.

Dr. Delgado informs his patients that the risk of rippling may be caused by several different factors:
1.    Under filling of the breast implant
2.    Overfilling of the breast implant
3.    Poor tissue coverage
4.    Placement of the implant over the muscle

Silicone implants cannot be overfilled as they come “pre-filled.” Saline implants that are overfilled beyond the manufacturer’s

Overfilled saline implants causes scalloping

Overfilled saline implants causes scalloping

recommendation may cause the edge of the implant to pull which will result in ripples, even if they are not visible, they might be able to be felt.

Over and Under Filled Breast Implants

If the implant is under filled (again only an issue with saline implants) it will leave the shell emptier that it should be which may result in folds and wrinkles of the implant.

Patients that have poor tissue coverage may get wrinkling with saline or silicone implants, however, the form-stable breast implants (also known as the gummy bear implants) offer the least risk of rippling.

Women with little breast tissue that have their implants placed over the muscle are at the highest risk for rippling. Textured implants are designed to adhere to the tissues that can cause pulling on the breast tissues and result in what is referred to as “traction rippling.” The more breast tissue the patient has, the less likely of getting traction rippling.

Correction of Rippling Breast Implants

In order the correct rippling problems, it is possible to add or subtract the amount of saline in breast implants. However, the manufacturer warns against re-opening the port once it has been sealed, and if adjustments are made, the warranty will most likely be voided.

If the rippling is caused by implants being over the muscle, consideration may be given to having the implants placed under the muscle.

Whatever the cause for rippling may be, be sure to seek out a Board Certified Plastic Surgeon to evaluate your situation and inform you of your options.

Contact the Breast Revision Expert

Dr. Delgado has been doing breast revision surgery since 1988 and invites you to call (415 898-4161) or email (info@dr-delgado.com)for a consultation for any breast revision concerns.

Prevention of Capsular Contracture

 

Miguel Delgado, M.D. Cosmetic Plastic Surgeon

Miguel Delgado, M.D.
Cosmetic Plastic Surgeon

 

 

 

 

 

 

 

 

 

 

★★★★★  Ratings: 4.74 -118 Reviews

 

Breast Capsular Contracture|San Francisco,CA

 

San Francisco, CABreast Capsular contracture is defined by Wikipedia as a response by the body’s immune system to a foreign object such as a breast implant. The result is the formation of collagen fibers that tighten and squeeze the breast implant.

The cause of capsular contracture, for the most part, remains unknown. Dr. Delgado tells his patients it is not possible to guarantee that a woman will not get a capsular contracture. While it is not always known what may be the cause, there are new theories and  ongoing studies being presented. In general, it is believed a low grade infection or excessive inflammation may be to blame. In particular bio-films have been implicated as the possible primary cause of capsular contracture. Bio-films are bacterial colonies surrounded with a covering protecting them from antibiotics and the immune system. Bacteria present during surgery may create a bio-film around a breast implant. The result may be a low grade infection without puss or becoming red, swollen or hot in the manner of infections that we are familiar with. Bio-film inflammation may cause a thick, tight capsule around the implant.

Before and After Breast Revision Surgery

Before and After Breast Revision Surgery

 

Breast Implant Contracture prevention option

 

There are preventative measures that can be taken to reduce the risk, and women who have a propensity to form capsular contracture should discuss all possibilities with their surgeon.

1.    It appears that the placement of the implants can make a difference. Partial or complete placement of the implants under the muscle versus on top of the muscle has been proven to have less incidence of capsular contracture. It is believed that when implants are placed over the muscle they come into contact with bacteria that can be harbored in the ducts of the breasts.

2. The peri-areolar incision seems to have a higher incidence of capsular contracture than the inframmary approach.

3.    Textured breast implants were designed to reduce the incidence of the development of scar tissue. However, there does not seem to be any advantage for implants under the muscle and a slight advantage for implants placed over the muscle.

4.    Massaging after breast augmentation surgery is believed to help keep the pocket open and reduce the likelihood of capsular contracture. However, it is not recommended for textured implants as they are supposed to adhere to tissue and massaging could interfere with this.

5.    Vitamin E is known to thin the blood and must be avoided 2 weeks before and two weeks after surgery. The use of vitamin E after 2 weeks postoperatively may be of benefit. It is believed that vitamin E softens the collagen fibers, and the capsule is made up of collagen fibers. There are not any studies that neither support nor disprove the use of vitamin E.

Check With Your Plastic surgeon about Breast Contractures| San Francisco, CA

 

Whatever methods are tried, be sure you have the approval of your surgeon. Every patient is unique, and your surgeon will be able to advise you as to what is best for you.

 

Call the Expert

 

Dr. Delgado has been doing breast revision surgery since 1988 and is an expert in his field. Call (415 898-4161) or email (info@dr-delgado.com)today for a personal consultation for any breast revision issues.

Breast Revision Surgery, Choosing a New Implant

 

Miguel A. Delgado, M.D.

Miguel A. Delgado, M.D.

 

 

 

 

 

 

 

★★★★★  Ratings: 4.74 -118 Reviews

 

 

Reasons for Changing  Breast Implants

 

Dr. Delgado emphasizes to his San Francisco breast revision patients that they will most likely need breast revision surgery at least once in their lifetime and maybe more.

There can be several different reasons for the need of breast revision surgery, the main one being that women want to change the size or type of implants. Other reasons include; capsular contracture, deflation of saline implants, rupture of silicone implants, shifting of position of the implants and changes in the breasts due to aging or weight fluctuations.

Breast implants are always evolving and being improved. If breast revision surgery is to be scheduled, many women opt to change the type of implant to be used. Depending on the issue a woman is having, will help determine the choice for new implants. For example, if a woman with saline implants has wrinkling, she may want to change to silicone.

With so many choices available, a woman needs to have an evaluation with a Board Certified Plastic Surgeon, who specializes in breast surgery, to help guide her to make the right selection for her individual situation.

Silicone or Saline Breast Implants?

Saline implants have an advantage in that the size can be adjusted during surgery as they do not come pre filled as silicone implants do. Saline implants are less expensive and can be inserted through a smaller incision. The advantage of silicone implants is a more natural feel and appearance. Today, 80% of women choose silicone over saline.

Moderate, Moderate Plus or High Profile Breast Implants?

 

The difference between these implants is their diameter and projection. A woman’s chest size will determine which profile is best suited for her.

Smooth or Textured?

 

The majority of implants used today are smooth. The textured implants were designed to reduce the incidence of capsular contracture and appear to do so but only when the implant is placed above the muscle. The disadvantage of a textured implant is a thicker shell which may be more visible through the skin and more easily felt.

Round or Anatomical?

 

Most implants are round, but there is a teardrop shaped or anatomical. The anatomical are textured and therefore have the disadvantages of the textured implants.

With all the variables of breast implants, it is important to choose your surgeon carefully, be sure to ask to view before and after pictures of actual patients.

 

Saline to silicone

Saline to silicone

Dr. Delgado has been performing breast revision surgery since 1988, if you are in need of breast revision surgery, call today (415 898-4161) or email (info@dr-delgado.com) for  a consultation.

If an MRI Shows a Leak, What Happens Next?

 

Miguel A. Delgado, M.D.

Miguel A. Delgado, M.D.

 

 

 

 

 

 

 

 

★★★★★  Ratings: 4.74 -118 Reviews

San Francisco, California-In 1992, the FDA placed a ban on silicone breast implants except for; research studies, reconstruction and breast revision surgeries where silicone was previously used. The FDA feared there may have been a connection to a variety of diseases including lupus and cancer. Studies for the next 14 years failed to show any evidence that silicone breast implants were the cause of any diseases.

Therefore, in 2006 the FDA determined silicone breast implants were safe and once again they became available for breast augmentation surgery. The FDA did stipulate, however, that a woman must be 22 years of age in order to have silicone implants. In addition, after 3 years they recommend that women have Magnetic resonance imaging (MRI) and then every two years after that to make sure that there is not a silent leak. Note that this is a recommendation, not a requirement.

Even with the added stipulation, 72% of women are choosing silicone implants over saline implants, according to a report by the American Society of Plastic Surgeons. The main reason for choosing silicone over saline is the more natural feel of the implant.

Dr. Delgado explains to his breast revision patients that an MRI is different than a mammogram in that there is not any use of radiation; instead it uses a powerful magnetic field, radio frequency pulses and computer imaging of the breast. It is not a painful procedure and it usually takes about 30 minutes. An MRI should not take the place of a mammogram but should be done in addition  if it is recommended.

Breast Revision Before and After

This is a 61-year-old, female resident of Santa Rosa, California who presented to the Novato office in Marin County for evaluation for revisional breast surgery. She has had her silicone implants for over twenty-four years. The silicone implants have ruptured on her left side with bilateral capsular contractures, or hardening. She underwent complete capsulectomies on both sides with removal of silicone material and replacement with 250 cc, silicone breast implants in the sub-muscular position. Her procedure was performed at Marin Cosmetic Surgery Center in Marin County, California. Note the more natural appearance of the breasts postoperatively.

With all the recent changes with medical insurance, it is hard to know if an MRI will be a covered test under any particular policy; it is advised that you check with your insurance company. If medical insurance doesn’t cover the MRI, it can be quite expensive, from about $1,500 to $2,000 or even more. Therefore, most surgeons tell their patients if they have any unusual symptoms or concerns they should be seen, and their surgeon will help them determine if an MRI may be appropriate.

If you discover you have a silent leak, Dr. Delgado will discuss your options of having your implants removed and/or replaced. If your original surgery was less than 10 years ago, the manufacturer will contribute to your breast revision surgery. Implants have a lifetime guarantee and will be provided at no charge if they are ruptured.

If you are having any issues with your breast implants, Dr. Delgado invites you to call (415 898-4161) or email (info@dr-delgado.com) for a consultation.

Breast Revision Costs and Payment Options

Hopefully, when you first got your breast implants for breast augmentation surgery, your surgeon explained that this is most likely, not a “one time” procedure. Dr. Delgado is very careful to explain to his San Francisco Bay Area patients that usually within ten years’ time some type of revision most likely will need to be done so that it will not come as a surprise. Some women may need more than one revision in their lifetime.

Breast Revision Before and After

Sonoma, California – A 45-year-old female of Monterey, California who presents to the San Francisco office at Union Square for breast revision surgery. She has had five previous breast revision surgeries. In 1996, she underwent breast augmentation using 270cc anatomic normal saline implants. Because of implant wrinkling, in year 2000 she had 35cc of saline placed within the same implant. In 2001, she had ex-plantation of the normal saline implants because of the persistent wrinkling and had placed 360cc silicone breast implants. In 2005 she wanted increase in size and underwent replacement of her 360 cc implants to 500 cc high profile silicone implants. In 2006 she developed a capsular contracture on her right side and underwent capsular contracture removal and replacement with 500cc Mentor silicone breast implants.

As stated under the “breast revision procedures” section of this website, there are several different reasons for breast revision surgery. The cost of breast revision surgery can vary quite a bit depending on what the issue is, such as;

  • Do the implants need to be replaced?
  • Are the implants ruptured or deflated?
  • Will there need to be a new pocket for the implants?

There are many other variations and combinations so it is hard to give an idea of the cost since it is a case by case situation. It will most likely be as much as the original surgery and perhaps more.

The good news is you may not be responsible for all of the fees. For example, depending on the reason for breast revision surgery, the manufacturer may supply replacement implants at no cost to you. If your revision surgery takes place less than 10 years of the original surgery, the manufacturer sometimes offers limited financial assistance.

Mentor (which is the manufacturer of the implants Dr. Delgado uses) includes a limited warranty with the purchase of their implants to assist with surgical fees during the first 10 years should a revision be necessary. Mentor also offers an extended warranty to patients for a nominal fee which may double the amount of assistance.

However, if your original surgery was more than 10 years ago, there may still be help for you. Your implants come with a lifetime guarantee, so depending on the reason of failure of the implant(s) the manufacturer will most likely replace them at no cost to you. Additionally, depending on the reason for revision, your medical insurance may cover some costs. Dr. Delgado’s patient coordinator will be able to help you apply for coverage to your insurance.

email and phone icon

 

Dr. Delgado has been doing breast revision surgery since 1989, call today (415) 898-4161 or email (info@dr-delgado.com) for an evaluation for all breast revision complications.