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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: San Francisco Bay Area

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!

When to Consider Breast Revision Surgery

Breast Implants in San Francisco

Breast Revision, Now or Later?

A frequent question women with breast implants ask Dr. Miguel Delgado, M.D. is, “When should I get breast revision surgery?”

Most women have been advised by their original Board Certified Plastic Surgeon when they have breast augmentation surgery, to expect that they will need to have breast revision surgery at some time in the future and for many, possibly more than once.

Breast Implants Have a Lifetime Guarantee

Most breast implant manufacturers give a lifetime guarantee on their implants if they should fail. The manufacturers will supply new breast implants for surgery, but they only give 10 years for additional financial aid to help offset surgery costs. Statistics show that on average women may need a revision after ten years.

Depending on the reason for breast revision determines when it should be done. For example, in the case of deflation or rupture, or if your breasts are painful, it is best to have surgery sooner rather than later. If however, you desire breast revision surgery to change implant size, type or position, the patient can afford to wait until it is convenient to do so.

Breast Revision Restores Youthful Breasts

The main advantage of breast revision is restoring youthful looking breasts, and possibly changing the implant size and improving breast symmetry. There are disadvantages to consider as well, such as; aging and gravity will eventually affect the shape of the breasts. Heavier implants are more likely to sag with time.

If you are not returning to your original surgeon, having a copy of your operative report is invaluable to your new surgeon.

Breast Implant Issues? Call Now!

Miguel Delgado, M.D. has been specializing in breast revision surgery since 1989. If you are having any issues with your breast implants, call now (415) 898-4161 for a consultation.

Miguel Delgado, M.D. Receives Top 500 Award for 2015 from RealSelf

RealSelf 500 for Miguel Delgado, M.D.

Miguel Delgado, M.D. Top Contributor to RealSelf.com

RealSelf.com is one of the most popular websites that offers information on cosmetic procedures. The site was launched in 2006 and is an outstanding resource for tens of millions of readers around the world. Each year RealSelf awards the top 500 Board Certified doctors with recognition for their contributions to the site. RealSelf has over 12,000 Board Certified member doctors, so being in the Top 500 is a real honor.

Readers are allowed to post any questions they may have about cosmetic treatments or surgeries; they will find they will receive multiple answers from surgeons from all over the United States and beyond.

5 Star Rating from Dr. Delgado’s Patients *****

All surgeon members are Board Certified and have their own page that has several tabs for easy navigation. The first tab shows reviews posted by their patients. Miguel Delgado, M.D. has earned the top rating of five stars out of a possible five stars from his patients in such categories as:
• Bedside manner
• Answers questions
• After care follow-up
• Time spent with me
• And many more

After the “Ratings” tab is the “About” tab giving personal information on Dr. Delgado such as his education, Board Certifications, society memberships, blog posts and articles.

Next is a tab for “Questions and Answers,” where Dr. Delgado’s most popular answers have been posted, out of almost 2,000 answers to date.

Dr. Miguel Delgado, M.D. has Posted Hundreds of Pictures

The next tab is for viewing over 443 before and after pictures of his patients, and also, his 28 posted videos.

There are hundreds of procedures that are reviewed including; mommy makeover, facelift, liposuction, gynecomastia and hundreds of questions about “breast revision surgery.”

For Breast Revision Questions, Call Dr. Delgado

If you have questions about breast revision check out RealSelf.com, but for immediate help, call (415) 898-4161 or email info@dr-delgado for a consultation with Dr. Miguel Delgado, M.D.

Before and After Surgery Instructions for Breast Revision Patients

Patient Participation is a Must

Breast revision patients frequently ask Miguel Delgado, M.D. “How do I prepare for my breast revision surgery?” Patient participation is necessary to achieve the best results, so Dr. Delgado is always glad to hear patients ask questions.

There are a lot of instructions for patients, both before surgery and after, therefore Dr. Delgado designed a comprehensive booklet for patients to have on hand that they and their caregiver can refer to.

Reading Surgical Booklet for Breast Revision Surgery

Comprehensive Surgery Instructions Booklet

The booklet, which is almost 40 pages in length, is divided into several sections including a table of contents for easy reference. In the first chapter, which is titled “Starting Now,” the patient is advised to stop smoking. Start taking a multi-vitamin, and get lab tests done. When it is two weeks before surgery, Miguel Delgado, M.D. warns his patients to stop taking any products that contain blood thinners such as aspirin. However, aspirin is not the only culprit that thins the blood. In the booklet, there are three pages of medications, vitamins and supplements that must be stopped as they all contribute to thinning of the blood, which can cause complications during and after all surgeries, including gynecomastia, face lifts and mommy makeovers.

Critical to Avoid Blood Thinners

Many people are not aware of many items that thin the blood, such as; Alka Seltzer, Motrin, Vitamin E, Fish Oil, St. John’s Wart, Ginkgo Biloba, just to name a few. To be safe, Dr. Delgado wants his patients to be sure and let him know of any and all supplements and medications taken on a regular basis.

In the second section which is titled “The Day Before Surgery,” patients are reminded to get all prescriptions filled, guidelines for eating, drinking and bathing are reviewed and the surgery time is confirmed.

Nothing to Eat or Drink After Midnight!

“The Morning of Surgery” patients are reminded not to eat anything after midnight the night before surgery; they may brush their teeth but do not swallow any water. They will be advised as what to wear to surgery and their check in time.

There is a section on risks and possible complications and instructions specific to their procedure.

The booklet is a handy reference for patients and their caregivers, but they are always encouraged to call (415) 898-4161 or email info@dr-delgado.com with any questions.

Breast Implant Exchange With Patient’s Own Fat

San Francisco, California-There are several reasons that a woman may elect to have her breast implants removed and/or replaced. The reasons vary greatly, from capsular contracture, to a rupture or deflation, double bubble, breast implant malposition  caused by pregnancy, aging, or capsular contracture, dissatisfaction with size or shape, and many other reasons.

Breast revision Malposition

A 28-year-old resident of Tiburon, California who presents to the San Francisco office at Union Square for evaluation for breast revision surgery. She 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. She underwent implant removal and replacement with 350cc normal saline high-profile Mentor breast implants. The breast pocket was also lowered. The photographs are seen approximately 8 months after surgery. Her procedure was performed at Dr. Delgado’s private surgical facility, Marin Cosmetic Surgery Center in Novato, Marin County, California

Most women understand that breast implant devices are not “lifetime devices” and most will need to have breast revision surgery possibly every ten years. When a woman decides to have her implants replaced, she then needs to make a decision as to what she will do to replace the volume, if anything. There are many options; she can replace with the same type of implants she previously had, or switch to a different type. Many women with saline implants want to change to silicone as they have a more natural feel. If a woman has been unhappy with the size, she may choose to go larger or smaller. Many want the new “gummy bear” implants that recently got FDA approval. Some will choose not to replace their implants with anything.

Today there is another option, and that is fat transfer to the breasts from another location on the patient’s body by liposuction, usually the tummy, flanks, or thighs. Fat transfers and fat injection procedures are increasing every year. Augmenting the face, due to loss of fullness from aging, is done many times in conjunction with a facelift. The Brazilian Butt lift, which is enhancing the butt with fat transfer, has become all the rage for the obtaining the now popular “hourglass figure.”  The back of the hands, which are a giveaway for aging, no matter how young the face looks, are rejuvenated with fat injections.

Fat Removal by Liposuction

Fat Removal by Liposuction

Breast augmentation with the patient’s own fat has been around for a while, however, the technique has been improved. For most women, 80% of the transferred fat will become permanent. For women who are “done” with breast implants, the idea of re-augmenting with their own fat is very appealing.

 

When breast augmentation by fat transfer was a new procedure, there was a higher possibility that a lot of the fat would not survive and would go through a process called fat necrosis, which leaves lumps of calcified scar tissue that could interfere with readings of mammograms. Newer techniques of harvesting the fat give the fat a much higher chance of surviving and the incidence of fat necrosis is much less. Radiologists have gotten much better at determining calcifications associated with cancer than those of benign conditions.

When the implant is removed, the capsule that formed around the breast is not removed. The capsule is normal scar tissue, unless it becomes too thick and squeezes the implant making it distorted and feel hard, then it is referred to as capsular contracture. The fat that is removed by liposuction from the tummy or the hips is not placed into the pocket but placed in tiny micro tunnels in the layers of tissue outside the capsule. The capsule prevents the fat from migrating into the space left by the pocket. Drains are usually placed to help close the pocket.

The amount of fat that can be transferred depends on a few different factors, such as; how thick the tissue is that the fat is going into, if the implants were sub muscular there is an extra layer of muscle into which the fat can be placed. Some patients can receive enough fat to be almost the same size as they were with implants.

Disadvantages are: large enhancements cannot be done, and for a  slender woman, she might not have enough donor fat available.

Dr. Delgado is a Board Certified Plastic Surgeon, who has specialized in breast surgery since 1988, serving the greater San Francisco Bay Area, San Jose and Sacramento.

 

If breast enhancement with fat or breast implant exchange with fat transfers sounds like a procedure you might be interested in, call or email today  (415) 898-4161) for a consultation with Dr. Delgado to find out if you might be a candidate, he will explain the procedure to you in detail and answer all your questions.