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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.

Tag Archives: breast implants

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.

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.

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.

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.