En español Haga Clic Aqui Call Us: 415.898.4161
"Finding the right plastic surgeon can be a very challenging experience. You want to find one that not only has expert skills but also understands exactly what your own personal goals are."
Patient J.G.
HIDE / SHOW TESTIMONIAL

Tag Archives: capsular contracture

Can Breast Implants be Reused During Revision Surgery?

Breast revision surgery in San Francisco

Many women ask if it is possible to reuse their breast implants during breast revision surgery. In some cases it may be possible, it depends on the reason for revision surgery and the condition of the breast implants. The primary concern is proper sterilization of the implants.

Breast Implants May Have Bacteria

If the reason for the revision is with the implants themselves, replacement is necessary. Implants that have ruptured or deflated must be replaced. If a revision is due to capsular contracture, implants should be replaced because it is possible a layer of bacteria has developed on the surface that may not be entirely removed, increasing the risk of capsular contracture forming again.

Age of the Breast Implants Makes a Difference

If the implants are less than 5 years old and there is no issue of contamination or rupture, there are some situations the implants can be used again such as; malposition, bottoming out and symmastia. If implants are over 5 years old, there is less usable life left, and they should be replaced.

In the hands of an expert breast revision surgeon such as Dr. Miguel Delgado, M.D. the pockets may be adjusted, sterility maintained, and the implants reinserted.

Implants do not need to be retreated for sterility as long as sterility is maintained during revision surgery.

Ask About Breast Implant Warranty

The manufacturers of breast implants give a lifetime warranty on their implants and will replace them at no charge if there is a deflation or a rupture. If a more expensive implant is chosen for replacement, the patient is only required to pay the difference. Manufacturers state that their implants are for a one time use only and reusing them will void the warranty.

 Breast Implant Deflation

Before and After Saline Breast Deflation

Dr. Delgado uses Mentor implants for his patients. When scheduling surgery ask about Mentor’s Enhanced Protection Plan that offers 10 years of financial assistance for surgical and operating room costs should revision surgery be necessary.

There are exclusions to Mentor’s replacement warranty, Dr. Delgado’s staff will be happy to give you details. Call today (415) 898-4161 for a breast revision consultation with Dr. Delgado.

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

Saline Breast Implant Deflation

  Before and After Saline Breast Implant Deflation

Saline Breast Implants Can Deflate

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

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

Ruptured Silicone Implants Can be Dangerous

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

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

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

Silent Rupture Only Detected by an MRI

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

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

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

Choose a Breast Revision Expert for Removal/Replacement

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

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

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.

Risks and Complications From Extra Large Breast Implants

 

 

Breast Revission With Larger Implants in San Francisco

This is a mother of two who presented for breast revision surgery. She had a breast augmentation in 2001 using 300cc normal saline breast implants inflated up to 360cc. She developed a slow leak on her right side. She underwent removal of the saline implants and replacement with 500cc moderate-plus Mentor gel implants.

Choosing Breast Implant Size

There are several factors to consider when choosing breast implant size. Women have heard of many breast augmentation patients that regret not choosing implants large enough when they had their original surgery. Many opted for breast revision surgery to get larger implants.

Before seeking breast revision surgery to increase implant size, it is recommended that women wait until they become used to their implants and many find once they do they are happy with the size.

Plastic Surgeons Consider Issues With Large Breast Implants

For women who still choose to have larger implants, the surgeon will be considering issues such as:
• The dimensions of the breast and chest wall
• How much skin and soft tissue is available to cover the implants
• Distance between the nipples
• The location of the nipples and the breast fold in relation to the chest wall

Large Breast Implants Come With Risks

There are numerous risks involved that patients need to be aware of when choosing extra-large breast implants; there are increased risks for:
• Loss of nipple sensation, the implants can place too much pressure on the nerves to the nipples
• Breast ptosis or sagging in the long term
• Rippling or visible creases
• Thinning of the breast tissue
• Stretching of the skin
• Loss of the natural inframammary fold
• Bottoming out
• Formation of a double bubble
• Higher incidence of capsular contracture
• Visibility of the implants through the tissues
• Visibility of veins in the breasts

Another unwanted risk for some women who go too big too fast is stretch marks that are irreversible. The weight of extra-large implants needs to be considered as they may cause neck, back, and shoulder pain, which is what women who seek breast reduction surgery complain about. It is noted that extra-large implants do not have a natural feel, they are much firmer.

Trust Your Cosmetic Plastic Surgeon

In deciding on breast implant size, patients should trust their board certified plastic surgeon to help them determine how large they can go without increasing the risks that come with very large implants.

Dr. Miguel Delgado, M.D. has been performing breast revision surgery since 1988 and has guided many women in making the right choice for breast implants.

Call Dr. Delgado Today

If you are considering breast augmentation or breast revision surgery, call Dr. Delgado (415) 898-4161 for a consultation so he can explain what he sees as the best choice for you based on your goals.

What is Capsular Contracture of the Breast?

When a foreign object such as breast implants, a pacemaker, or an artificial joint is inserted into the body, it will form a protective scar capsule around the object. It is a natural healing response and is expected.

Baker Scale Grades Firmness of the Breast

For some breast augmentation patients, during the first year of healing, the capsule that forms around the breast implant may shrink (contract). The web of fibrous material making up the capsule tightens and squeezes the implant, making it feel hard. There are varying degrees of encapsulation. Dr. James Baker created the “Baker Scale of Capsular Contracture,” which is used worldwide to grade the degree of firmness of an augmented breast.

• Baker Grade l     The breast feels soft and appears normal
• Baker Grade ll    The breast feels slightly firm but appears normal
• Baker Grade lll    The breast feels firm and appears abnormal
• Baker Grade lV   The breast feels hard, appears abnormal and is painful

Capsular contracture in San Francisco

A 39-year-old mother of 5 with recurrent breast capsular contracture on her right side. Her surgical treatment was a complete capsulectomy (breast capsule scar removal) from the right side and breast implant replacement.

Capsular Contracture Affects Only a Few

Dr. Miguel Delgado, M.D. states that capsular contracture can develop at any time, but is more prevalent in the first few months after breast augmentation surgery. Fortunately, only a small percentage of women develop a problematic contracture.

According to a publication in the US National Library of Medicine at the National Institute of Health, capsular contracture usually is a result of subclinical colonization of bacteria within the implant pocket.

New Techniques to Combat Capsular Contracture

With all the latest techniques to minimize the chances of capsular contracture, the contracture can still occur. However, the rate has been greatly reduced in recent years thanks to techniques such as placement of the implant under the muscle, the Keller funnel (a device that allows the surgeon to insert the implant without touching it), and antibiotics.

Make an Appointment Today!

If you have been suffering from capsular contracture, call now (415) 898-4161 to schedule an appointment with Dr. Delgado to find out what options are available to you.

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.

Breast Revision Surgery, How it is Performed

San Francisco Plastic Surgeon, Miguel Delgado

Dr. Miguel Delgado, M.D.

Variations of Breast Revision Surgery

The reason for breast revision surgery will determine how the procedure will be done.

• Capsular Contracture: The surgeon most likely will use the same incision location as the original breast augmentation surgery. The hardened capsule will be removed during breast revision surgery, and the implants will be replaced.
• Mal-positioned Breast Implants: Sometimes the breast implant pockets may be placed too close together or too far apart, to correct this, the surgeon will reconstruct the pocket by manipulating the capsule’s scar tissue that surrounds the implant. Then the surgeon will use suturing techniques to get the implant into the appropriate position.
• Rippling Breast Implants: Rippling may be caused by saline implants and sometimes the edges of the implants can be felt. To correct the rippling, the implants may be repositioned to under the muscle or changing to silicone implants or both.
• Changing Breast Implant Size: If a larger implant is desired, the surgeon will need to make the pocket bigger. For smaller implants, the surgeon may reduce the size of the pockets with sutures. Sometimes, Dr. Miguel Delgado, M.D. will suggest that a breast lift may be needed when the pockets are reduced or permanently removed.

Are You a Candidate for Breast Revision Surgery?

Each patient is unique, and the method for breast revision needs to be tailored to that patient.

If you are having issues with your breast implants, call today (415 898-4161) for a consultation with Dr. Delgado to learn what options are available.

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.