Call Us: 415.898.4161

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.

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.

Recovery for Breast Revision Surgery

Breast-Revision

 47-year-old mother of two and resident of San Francisco, California who presents to the Marin County office for breast revision surgery. She underwent a vertical breast lift with normal saline breasts implants approximately 10 years ago.  She underwent a second vertical breast lift with removal of the normal saline implants and placement of 360cc high-profile Mentor silicone breast implants. Her photographs are seen approximately six months after surgery. Her surgery was performed at Dr. Delgado’s private Marin Cosmetic Surgery Center in Novato, Marin County, California.

Breast Revision at Least Once

Miguel Delgado, M.D. emphasizes to all his breast augmentation patients that they will most likely need breast revision surgery at least once in their life. For many women, more than one breast revision surgery may be needed. There are many different reasons why breast revision may be warranted, and they are explained in detail on this website.

The recovery can vary depending on the type of revision surgery that is to be performed. If a woman is just having her implants removed, generally only minor discomfort is experienced. Over the counter analgesics are usually all that are needed. However, if a woman is having a breast lift done in conjunction with breast implant removal, recovery will be longer. There will be possible numbness and tingling resulting, but usually lasts only a few weeks.

Important Factors, Technique and Skill

For breast implant replacement, recovery may be about the same as the original breast augmentation surgery. The degree of discomfort will be dependent on the size and placement of the implants, and of course, the skill of the surgeon.

Miguel Delgado, M.D. advises that patients need to follow their surgeon’s post-operative instructions to avoid complications during their recovery. Most likely a compression bra is to be worn for 2 weeks or more. The bra will help prevent the accumulation of fluid, help control swelling, and keep the implants in place. Sleeping elevated is also recommended to help with swelling.

Patients of Miguel Delgado, M.D. are given a comprehensive booklet that details all pre-operative and post-operative instructions at their pre-operative visit.

Follow Surgeon’s Instructions

Among the post-operative instructions, patients will be advised to stop all blood thinning products, vitamins, herbs, and medications. An extensive list is in the booklet of what should be avoided. It is a good idea to bring in a list of any and all medications and supplements that you take at your pre-operative visit.
Patients will need to arrange to have a friend or family member take them home after surgery and look after them for the first 24 hours. If drains have been placed to remove extra fluid buildup, the patient must wait until they are removed before bathing, to avoid possible infection. However, sponge baths are allowed.

Before resuming strenuous exercise or any heavy lifting, you need to get clearance from your surgeon, usually within a few weeks.

Call the Expert

Since 1989, Miguel Delgado, M.D. has been performing breast revision surgery with great success. If you have issues with your breast implants or are unhappy with your results, call now (415) 898-4161 or email (info@dr-Delgado.com)for an appointment.

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.