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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: Marin County

The Value of Before and After Surgery Pictures

Before and After Breast Revision Surgery

                                          Before and After Breast Revision

Board Certified Plastic Surgeons receive specialized training in taking before and after pictures of their surgery patients. The attention to detail in the photos may reflect the surgeons’ attention to detail in the operating room. Images are one of the most valuable tools surgeons have in communicating with patients their aesthetic talents. When consulting with a plastic surgeon, you want both quantity and quality of the pictures presented.

Look for Consistency

An important factor to watch for is consistency in the photographs. The ratio of the height to the width should be the same for both before and after pictures. The position and distance of the patient from the camera lens should be the same. Lighting and color saturation needs to be comparable. More than one angle should be presented so that you do not see just the “best view.” The background should be the same.

There are photography tricks that can make after pictures look better. Be wary if the before picture has the arms at the sides and the after picture has the arms raised, which will make the breasts look perkier.

Are Pictures Aesthetically Pleasing?

Look for patients that may be about the same age, ethnicity, and body type as you. Notice if the after pictures look natural and are aesthetically pleasing.

All pictures presented on Dr. Miguel Delgado, M.D.’s website and office photo albums have written consent from the patients. Sharing of before and after photos are very beneficial to new patients and are much appreciated by Dr. Delgado. However, it is entirely optional, Dr. Delgado respects the privacy of all of his patients.

Call Today!

If you are considering breast revision surgery, call now (415) 898-4161 for a consultation with Dr. Delgado.

What is Symmastia and How is it Corrected?

Symmastia in San Francisco

                                      Symmastia

Symmastia is a condition where the breasts have merged making one breast. There is “web-like” tissue that crosses the sternum connecting to breasts medially.This is also referred to as; “breadloafing,” “kissing implants,” and “uniboob.”

Congenital Symmastia

There are 2 types of symmastia; one is congenital, and the other is iatrogenic. Congenital symmastia, meaning you were born with it, is very rare. There have not been many cases reported, with limited knowledge on the ideal treatment. To date, the 2 most common procedures for congenital symmastia are; reduction mammoplasty and liposuction.

Iatrogenic Symmastia

More common but still fairly rare is iatrogenic symmastia. This rare complication follows breast augmentation surgery which may present right after surgery or develop later. Symmastia can be minimal where the implants look too close together, to the extreme where the implant pockets merge.

Symmastia Causes

The cause for symmastia can be a surgical error or sometimes occurs when the surgeon is attempting to increase cleavage. Thin women are more prone to getting symmastia due to insufficient breast tissue over the breastbone. Patient with “pectus excavatum,” which is a concave chest, also have a higher risk of symmastia as their implants tend to lean toward the center of their chest.

Correcting Symmastia

Breast revision for symmastia can be complicated. Repair for some patients is for the surgeon to reattach fat and skin to the sternum, closing the pockets that have become too wide. More recently, some plastic surgeons use a technique known as “neosubpectoral pockets.” For this procedure, the surgeon creates new pockets under the muscle. Strattice (acellular dermal matrix) may be used on select patients for additional support if the patient’s tissues are thin. If the symmastia is sub-glandular or on top of the muscle the easy correction would be to place it sub-muscular.

Corrective procedures will vary depending on whether the implants were placed over or under the muscle. Fortunately, this complication is rare, but it is essential to choose the correct size and placement for the implants.

Dr. Miguel Delgado, M.D. warns that selecting implants that are too large for your chest size increases the possibility of symmastia.

Call Today!

Breast revision specialist, Dr. Delgado is available for consultation by calling (415) 898-4161.

Asymmetrical Augmented Breasts

Asymmetrical Breasts in San francisco

Asymmetrical Breasts Before and After Surgery

Breast augmentation patients may end up with asymmetrical breasts due to various conditions that include:
• False asymmetry
• Hematoma
• Seroma
• Rotation of the breast implant

Breast Implants May Take Months to Drop

For a woman to notice that her breasts are asymmetrical after breast augmentation surgery can be very upsetting. Noticeable uneven breasts can diminish the excitement of breast augmentation.

It is important for women to understand that it can take several weeks and even months for implants to settle into their permanent position. Post-surgical swelling may affect one breast more than the other and until the swelling resolves and the implants drop they may appear uneven. This condition is referred to as “false asymmetry.”

Understandably, it is tough for women to be patient for several months before determining if breast revision surgery will be necessary. In some instances, the asymmetry is so minor that many women choose to ignore it.

Many women naturally have uneven breasts, and in the hands of a qualified Board Certified Plastic Surgeon, the breasts can be made symmetrical with the use of different size implants.

Causes for Asymmetry of the Breasts

Another cause for asymmetry would be the development of a hematoma. A hematoma is where there is a collection of blood around the implant pocket. Hematomas usually occur within 24 to 48 hours after surgery. The body may absorb small hematomas, and no treatment is required. If the hematoma is significant, surgical intervention may be necessary. If you notice any unusual swelling, be sure to notify your surgeon.

It is also possible for the breast augmentation patient to develop a seroma, similar to a hematoma but instead of blood, a seroma is clear lymph fluid.

Under some circumstances, the breast implant may rotate. If the implants are round, there is no issue. If the implant is teardrop or anatomical and it should rotate, the asymmetry will be apparent. The muscle of the upper part of the breast will be stretched and makes correction difficult if not addressed in a timely manner.

Avoiding Asymmetry

To avoid asymmetry, Dr. Miguel Delgado, M.D. recommends patients choose their surgeon carefully. An experienced Board Certified Plastic Surgeon will be able to help a patient determine the right size and shape breast implants that will fit their chest wall.

Call Now!

Women who are experiencing any issues with their breasts are invited to call Dr. Delgado (415) 898-4161 for a consultation.

Breast Revision Recovery

breast revision with larger implants

Breast Revision With Larger Implants

Breast revision recovery is different for each patient. Some patients have a very high pain threshold, and others do not, so you cannot compare someone’s recovery to your own.

Sometimes the Original Pocket is Used

If the original pocket is being used, recovery may be easier unless the pocket is being made smaller or larger depending on the new implants. However, many women choose the change the size of their breast implants when breast revision is necessary for other reasons. Usually, a change in size is for larger implants, and many times the placement of the pocket maybe going from overs to unders. In this case, recovery will be somewhat longer as the surgical procedure is slightly more complex and invasive.

If the implants are smaller than the originals, the pocket size may be fine depending on the difference in size. If there is a significant change, the pocket may need to be reduced with internal stitches, or for some patients, a breast lift may be required.

Recovery for Each Patient is Different

Dr. Miguel Delgado, M.D. states that recovery for each patient is different. The amount of revision surgery will determine how much discomfort will be present. With that being said, some women sail right through their recovery with little to no discomfort, requiring only Tylenol for pain control.

No matter what degree of discomfort is experienced, women need to take care to sleep with their head and back elevated to reduce swelling. Showers are allowed 24 hours after the removal of the drains, prior to that just sponge baths are permitted. Return to normal activities is usually in 7 to 10 days, and formal exercise is allowed in 4 to 6 weeks, depending on how the recovery is going.

Make an Appointment With Dr. Delgado Today!

If you have concerns about your breast implants, Dr. Delgado has been performing breast revision surgery since 1988, and he would be happy to see you in consultation, call today (415) 898-4161.

Updating Breast Implants after Weight Loss

Breast Revision in San Francisco

                                    Before and After Breast Revision Surgery

Many women choose to lose weight after having a breast augmentation because they are pleased with their new look and are motivated to do more. It is difficult to lose weight, but a new slimmer body can be quite rewarding.

Significant Weight Loss May Affect Your Breasts

A common question that is asked of Dr. Miguel Delgado, M.D. is “how will I look if I lose weight after my breast augmentation?” Depending on the amount of weight loss there can be some downsides. For example, if you have breast implants, the size and shape that were selected for you before weight loss, may no longer look right.

It is difficult to say how a woman’s breasts will look after significant weight loss as women have different ratios of fat and breast tissue. Usually, women who seek breast augmentation do not have a lot of breast fat. For most, 10 to 20 pounds of weight loss won’t make a visible difference. In some cases, losing weight may make the breast implants more visible with less tissue for coverage. When there are physical changes, the implants may settle into a new position. It is possible that the nipples will be lower and the breasts will sag. However, women gain and lose weight in different areas of their body. If in the past (before breast augmentation surgery), if you noted how your breasts responded to weight fluctuations, it will be the same.

There Are Many Implant Choices

If it has been several years since you have had your breast augmentation, there are several new breast implants available offering more choices. Additionally, if you are unhappy with sagging breasts, you might want to consider a breast lift along with new breast implants.

Call Now!

Call today (415) 898-4161 for a consultation with Dr. Delgado and learn what options are available to you.

How Will I Look if I Have My Breast Implants Removed?

Breast Implant Removal, Breast Enhancement By Fat

                           Before and After Breast Enhancement By Fat Transfer

Breast implants are not for all women. There are several reasons women may decide to have their implants removed, such as; capsular contracture, discomfort, droopiness, avoiding future revisions, not happy with the appearance. Some just don’t want them anymore as they feel they no longer fit their lifestyle.

Why Some Women Want Their Breast Implants Removed

Every woman is different, but many women are happy with their breasts after implant removal. Initially, their breasts may look like a deflated balloon after removal. There will not be upper pole fullness that the breast implants provided. Other factors to consider are:

• Skin elasticity determines how much the skin will “bounce” back
• Large implants may cause more sagging skin
• The amount of natural breast tissue may have changed since before implants
• Changes in weight
• Pregnancies
• Sagging due to aging

A Breast Lift May Be Needed

Once the breasts have healed, most women are pleased with the appearance of their breasts. However, some women may benefit from a breast lift, and some opt to have to have a lift done at the same time as the explantation.

About 2 or 3 weeks after the implants have been removed, they will “fluff” back out. It is important to note that the breasts appearance right after surgery is not the final look.

Dr. Miguel Delgado, M.D. tells women who no longer want breast implants but still desire fuller breasts might consider fat transfer to the breasts as an alternative. By removing fat by liposuction from another part of the body, after a purification technique, it can be transferred to the breasts. This is a two part procedure with the benefit of reducing the abdomen and/or the love handles to harvest fat for the breasts. The procedure takes about 3 hours, and recovery is about 7 to 10 days.

Call Now!

If you have been considering breast implant explantation, call today (415) 898-4161 for a consultation with Dr. Delgado to find what options are available to you.

When to Have Breast Revision Surgery

Breast revision surgery in San Francisco

This 30 year old patient wanted larger implants and correction of some slight asymmetries. She changed from 350cc saline implants to 600cc silicone on the left and 650cc silicone on the right.

When to have breast revision surgery will depend on your unique situation. There are several factors to consider before scheduling surgery.

Breast Implants Take Time to Settle

Most women are immediately happy with their breast augmentation surgery. However, some women are disappointed with their results and want a breast revision right away. Patients need to understand that their results may take 6 months to a year before the implants relax into their final position. Once the implants have settled in, most patients find that they are happy with their outcome. The body needs time to recover from major surgery. If after a year the patient is still unhappy, then revision surgery should be considered.

The most common reasons for dissatisfaction with breast augmentation are; the size of the implants, the choice of saline or silicone, the shape, or the style.

Choosing the Right Breast Implant

Dr. Miguel Delgado, M.D. spends a great deal of time with his breast augmentation patients to help them choose the right implant the first time. He has them do the “rice test” which allows them to visualize the size. He has them hold a saline implant and a silicone implant so they can feel the difference. Dr. Delgado explains in detail how different projections and size will fit their chest based on their chest size.

 

Each patient needs to decide how comfortable they are waiting to have surgery for aesthetic purposes. At some point, they may need a revision for a complication that needs to be addressed such as; a capsular contracture, a ruptured or deflated implant(s), a double bubble, asymmetry, symmastia or other complication. If the patient wants to change the size, style, or type of implant, ideally the time would be best when another revision is needed. However, this is a personal decision and the right time for surgery is when she is ready, and her body is ready.

Call Today!

Call (415) 898-4161 for an appointment today to meet with Dr. Delgado to discuss any breast revision concerns you may have.

What Women Need to Know About Breast Revision Surgery

breast revision in San Francisco

A mother of 5 presents with recurrent capsular contracture of the right breast. She had a complete breast capsule scar removal from the right side and replacement

Dr. Miguel Delgado, M.D. has been performing breast revision surgery since 1989. He has made a point of informing women who choose to have breast augmentation surgery that it will be a long-term marriage between her and maintenance of her implants. In most cases, breast implants do not last a lifetime but will require some type of revision surgery at least once or more during their lifetime.

6 Part Video Shows Breast Revision Surgery

In order to fully explain and show examples of some breast revision cases, Dr. Delgado has put together a 6 part video showing the journey of 2 patients over a period of 6 to 7 months, from consultation through 5 weeks post-operative visits.

The first case is Michelle, who had silicone implants at the age of 18 in 1990. After a car accident, she had her implants replaced in 1996 when they became encapsulated. At this time she chose normal saline implants, for both surgeries her implants were placed over the muscle. She presents for breast revision surgery 10 years later due to her breasts feeling hard, uneven, painful, and sagging.

The second patient is Bea, to date, she has had 3 surgeries. In 1999, she had saline implants placed under the muscle desiring more volume after having 3 children. However, Bea developed mastitis, an infection of the breast tissue usually caused by breastfeeding. She had one implant removed for 8 months and then had smaller implants inserted. Within a year her left implant dropped, and the right implant developed a painful contracture creeping up high on her chest wall.

Consultation Through Post-Operative Visits

Dr. Delgado’s informative 6 part video follows the journey of these 2 women from their initial consultation, through their pre-operative visit with Dr. Delgado and Dr. Gaynor, the anesthesiologist, along with actual footage of their surgery in part 3. Part 4 is the first post-operative exam showing the removal of the drains. At the second post-operative visit, the sutures are removed. Part 5 shows the follow-up exams and the beautiful results for both women.

In the Patient’s Own Words!

The last part, part 6 is the patient’s impressions after 6 months. Michelle and Bea share with you how their breast revision surgery met their expectations. If you are having issues with your breast implants, call today (415) 898-4161 to schedule a consultation with Dr. Delgado.

Breast Revision and the Three C’s

Breast revision in San francisco

A 39-year-old mother of 5 presents to my office 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 replacement

Capsular Contracture

One of the most frequent causes of breast revision surgery is the scar that forms around the breast implants. It is typical for a scar to form around the implant and protect it, it also keeps the implant in the pocket, but sometimes complications may arise. For example, if the scar is too thin, the implant can slide to the side or drop down. If the scar is too thick, the implant may get compressed and feel hard. This is referred to as capsular contracture.

Capsulotomy vs. Capsulectomy

There are 2 different procedures that are performed to correct capsular contracture. The first is a capsulotomy. For a milder capsular contracture, a capsulotomy may be performed. The scar tissue is scored with small incisions, and only a portion of the scar tissue is removed. In addition to correcting milder capsular contracture, it may also be used to correct breast asymmetry. For moderate to severe capsular contracture, the surgeon may choose to do a capsulectomy. A capsulectomy is where the surgeon surgically removes the entire scar capsule.

It takes an expert board certified breast revision surgeon such as Dr. Miguel Delgado, M.D., to ascertain which procedure is the most appropriate for the patient, taking into account the hardness of the breast and the severity of asymmetry.

Capsulorrhaphy

In the instance where the scar capsule is loose, and the implants slide to the sides, the middle or drop down, a capsulorrhaphy may be performed. In this case, the scar capsule is tightened and reduces the breast pocket with sutures. Sometimes an acellular dermal matrix may be used for reinforcement. This procedure is also used when downsizing the pocket for smaller implants, or correcting implant malposition, and for implants that have “bottomed out.”

View Video!

Dr. Delgado has been performing breast revision surgery since 1989 and is experienced with all various complications that may occur after breast augmentation. View the video below and call today (415) 898-4161 for a consultation for any issues you may be having with your breast implants!

 

Breast Implant Pocket Complications

 

 

Breast revision surgery in San Francisco

43-year-old mother of two presents 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.

Breast Pocket Complications

One of the most common complications for breast augmentation patients is the breast implant pocket. When a breast implant is to be inserted, the surgeon needs to make a pocket by separating the muscles and tissues within each breast either below the glandular tissue and above or below the chest muscle. The skill of the surgeon will determine how the breasts will look once placed into the breast pocket.

What Happens When the Breast Pocket is the Wrong Size

Complications can arise if the pockets are too large or too small. If one or both pockets are too large, the implant can move around making them either asymmetrical, or they may bottom out. In some cases the implant may slide to the middle, this condition is referred to as symmastia, also known as a “uni-boob” or one boob. On the other hand, if the pocket was made too small it will affect the shape and smoothness of the breast. If the patient should gain weight or the pectoral muscle mass has increased through exercise the appearance will be worse. If only one breast is affected, the breasts will be asymmetrical and can only be corrected by breast revision surgery.

Pocket Adjustments Allow Increases or Decreases for Implant Size

In order to correct a breast pocket complication, the surgeon will either use dissection to increase the size of the pocket or use sutures to tighten and decrease the size of the pocket. Adjusting the size of the pocket allows the implant to be in the best position aesthetically, improving the shape of the breasts. Pocket adjustments will enable a woman to increase or decrease the size of their implants.

Dr. Miguel Delgado, M.D. explains to his patients that even with the perfect pocket size, other factors can lead to the necessity for breast implant pocket revision such as; gravity, aging skin, the development of scar tissue and pregnancy.

Call Today!

If you are having any issues with your breast implants, contact Dr. Delgado today (415) 898-4161 for a consultation!