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Tag Archives: breast augmentation

Breast Revision Surgery Has Unique Challenges

Breast revision surgery in San Francisco

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

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

Breast Revision Complications

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

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

Breast Revision Surgery will Cost More

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

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

Before and After Pictures Speak For Themselves

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

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

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

Saline Breast Implant Deflation

  Before and After Saline Breast Implant Deflation

Saline Breast Implants Can Deflate

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

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

Ruptured Silicone Implants Can be Dangerous

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

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

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

Silent Rupture Only Detected by an MRI

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

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

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

Choose a Breast Revision Expert for Removal/Replacement

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

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

“What You Should Know About Boob Jobs”

Breast Augmentation #1 Cosmetic Surgery Procedure

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

Women's Health Magazine

 

Women's Health Magazine

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

Regrets Over Cheap Surgery

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

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

Large Implants Cause the Most Discomfort in Healing

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

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

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

To read the entire article, click here.

Choose the Right Surgeon

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

Call Today!

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

 

Breast Revision Scars

Scars Can Be Genetically Determined

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

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

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

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

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

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

Scar Therapy After Surgery

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

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

What Happens if Your Silicone Breast Implants Rupture?

San Francisco Breast Revision

This is a 55-year-old female  who presented for revisional breast surgery. She underwent bilateral silicone breast implants in 1975. She developed bilateral ruptures of both implants and severe capsular contractures. She underwent removal of silicone material with subpectoral placement of 300 cc, Mentor silicone- gel breast implants. Her procedure was performed at Marin Cosmetic Surgery Center in Marin County, California.

“Silent Rupture” of a Silicone Breast Implant

When breast implants are placed in the body, a fibrous capsule will form around the implant. If a rupture should occur, the silicone will most likely be contained in the capsule; and it is possible that it may not be painful or be noticeable. This is referred to as a “silent rupture.” If a silent rupture is suspected, your plastic surgeon will most likely recommend an MRI to confirm.

However, sometimes a ruptured implant may cause pain; swelling and the breast may change shape, and size. You may experience lumps and the affected breast may feel hard. It is not believed that silicone implants can cause breast cancer or reproductive problems. It is also not proven that implants will cause a connective tissue disease as once thought.

See Your Plastic Surgeon

Women who suspect that their implant(s) has ruptured or if their implants have formed a capsular contracture are advised to seek a consultation with a Board Certified Plastic Surgeon who will be able to explain what options are available to them.

With a “silent rupture,” some women may choose not to have them removed unless they have a complication. However, some women will want their implants removed. If the implants are to be removed, new ones can be replaced at the same time, or some women may not want implants anymore and opt for a breast lift, or perhaps fat transfers instead of implants.

Is an MRI Necessary?

The FDA recommends that women have an MRI 3 years after their original breast augmentation surgery, and then every two years thereafter. However, this is a recommendation, not a requirement. Your surgeon will be able to advise you best .

Call Today!

Dr. Miguel Delgado, M.D. has been performing breast revision surgery since 1989 and has helped hundreds of women make educated choices. Call now (415) 898-4161 for your breast revision concerns.

Breast Revision for “Snoopy Deformity”

Snoopy Deformity in San Francisco

The Sagging Augmented Breasts

“Snoopy Deformity” got its name because it describes an augmented breast that is sagging and the nipple is too low, much like the cartoon dog “Snoopy’s” nose. Even though the implant is in the correct position, the breast tissue hangs over the inferior edge of the breast implant.

Breast Revision San Francisco

The “Snoopy Deformity” can occur over time after surgery, maybe after many years as the patient ages and the breast tissue starts to sag.

Solutions for “Snoopy Deformity”

Some patients who want to avoid a breast lift because of scarring, additional cost or other reasons, may opt for larger implants to fill the excess skin and lift the breast. However, this will be a short-term resolution. Large implants are not the solution and will lead to additional surgery.

Correction for “Snoopy Deformity” in most cases would be a breast lift, lifting the breast tissue and nipple areola complex to a higher position on the chest wall. In many cases, the lift can be performed with the lollipop incision or for some a peri-areola lift.

Call Today for a Consultation

Dr. Miguel Delgado, M.D. has been performing breast revision surgery since 1989 and is an expert in his field. If you are having any issues with your breast implants, call now (415) 898-4161 for a consultation with Dr. Delgado.

Updating Breast Implants After Weight Loss

Weight Loss and Your Breasts

Weight Loss and Your Breasts

Losing a significant amount of weight can be very rewarding. However, if you previously had breast augmentation surgery, you may be disappointed with the results the weight loss has had on your breasts.

Breasts normally store body fat; weight loss and losing fat in the breasts may cause the breasts to sag. If the breasts have less coverage with the loss of fat, the implants may be more visible and might settle into a different position, and the nipples may drop.

Drooping Breasts Can be Fixed!

With a new body shape, the size and type of implants previously selected may no longer be appropriate. How disappointing; after all the hard work to slim down to have, your breasts now be a problem. Do not despair, see a board certified plastic surgeon who will be able to offer breast revision options.

Mommy Makeover in San Francisco
This patient of Dr. Miguel Delgado, M.D. had a large weight loss through diet and exercise. She had a Mommy Makeover consisting of a full tummy tuck, breast reduction, and liposuction of her flanks. Her surgery was performed at Marin Cosmetic Surgery Center in Marin County, California.

You may need a breast lift with or without implants. A breast lift will reposition the nipples and can add upper pole fullness to the breasts. If implants are to be replaced, the size and profile can be changed to better match your new body.

Most surgeons will recommend that breast augmentation surgery be performed after the patient’s weight has stabilized. The amount of breast volume that will be lost with weight reduction is hard to determine as it is dependent on how much fat versus breast tissue a woman has, and every woman is different. A small amount of weight loss will probably have little to no effect on a woman’s breasts. However, a large amount of weight loss for a woman with a high ratio of fat in her breasts may see a big difference.

Breast Implants Over or Under the Muscle?

If implants are under the muscle the pressure of the muscle will keep the implants shape and won’t change with weight loss, but the breast tissue may sag. If the implants are over the muscle, the weight of the breast tissue might affect the shape of the breasts.

Most women who have breast augmentation surgery usually have only a small amount of fat in their breasts, and that is why they are getting an augmentation. For these women, weight loss will most likely not make a significant difference.

Contact us Today!

call or email Contact Dr. Delgado for a consultation if you are unhappy with your breasts. Call (415) 898-4161 or email info@dr-delgado.com.

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.

Decisions to be Made Before Breast Revision Surgery

Breast Revision in San Francisco

CASE DESCRIPTION: 43-year-old mother of two resident of Santa Rosa, California who presents to the Marin County office for breast revision surgery. She underwent breast augmentation in 2001 using 300cc normal saline breast implants inflated up to 360cc. She developed a slow leak on her right side. She underwent removal of the saline implants and replacement with 500cc moderate-plus Mentor gel implants. Note the overall fullness and nice symmetry of her breasts. Her surgery was performed at Dr. Delgado’s private surgical facility, Marin Cosmetic Surgery Center in Novato, Marin County, California

At the time of your consultation for breast revision surgery, it is important to clearly state your goals to Dr. Miguel Delgado, M.D., so that he can suggest your best options.

Things You Will Need to Consider Before Breast Revision Surgery

1. What type of breast implant do you want? Will you want to change from saline to silicon or vice versa? Read about the difference between the two types of breast implants from our blog of December 2014. Since then, another implant choice has become available, the cohesive gel implant, also known as “the gummy bear.” You can read details about this newer implant here.

2. Where do you want your breast implants placed, above or below the muscle? There are pros and cons for each placement. Dr. Delgado prefers under the muscle as he feels it gives a more natural look. The muscle is less likely to interfere with mammograms. Additionally, there is less rippling for women who do not have much breast tissue. However, Dr. Delgado will want to discuss which placement is best for each patient.

3. There needs to be a discussion for the size of breast implants. The size of breast implants is very important and causes a lot of concern for many women. Many women can choose larger or smaller implants. However, there are limitations that are unique to each woman. Dr. Delgado will be able to advise you your choices based on your goals.

4. Is a breast lift going to be necessary to get optimal results? As the breasts change due to aging, or weight fluctuations, a breast lift may be needed to remove excess skin and reposition the nipple higher on the breast mound.

See a Breast Revision Specialist

Dr. Miguel Delgado, M.D. has been a breast revision specialist since 1989. His expertise allows him to best advise his patients with all possible options for their breast revision surgery. Call (415) 898-4161 now for a consultation to learn what may be available to you.

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

Calendar appointments for San Francisco

Breast Revision at Ten Years?

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

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

Are Gummy Bear Implants For You?

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

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

No Complications? No Surgery!

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

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

Schedule a Breast Checkup!

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