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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: Santa Rosa

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 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.

Dow Corning Awards $5,000 for Breast Explant Claims

San Francisco, California-Dow Corning is once again in the news as the final deadline to submit an explant claim is fast approaching.

The Dow Corning Plan of Reorganization set June 2, 2014 as the deadline for eligible claimants to file for Explant Benefits. To be eligible, you must already be registered in the database, and the deadline for that was August 2004.

The $5,000 explant benefit (for class 5 only) is for women who have their Dow Corning silicone implants removed by June 2, 2014. Women who replace their Dow Corning implants with new silicone implants will not be eligible for the award; however, saline implants are allowed. To file a claim, you must submit the Explant Form and the operative report from the explant surgery.

If you choose to participate in the Explant Assistance Program, please be aware that these claims may take up to 60 days to process.

Dow Corning has had a vast number of individual and class action lawsuits regarding their silicone breast implants, starting in 1977 and growing to over 20,000 claims by 1995.

Shell of 1976 Dow Implant

Shell of 1976 Dow Implant

Silicone being removed from 1976 Dow Corning implant

Silicone being removed from 1976 Dow Corning implant

 

 

 

 

 

 

 

 

 

Connie Chung’s show “Face to Face with Connie Chung” is credited with bringing widespread public attention to the dubious safety of silicone breast implants of that time. The show aired in 1990 where Ms. Chung interviewed women who claimed their autoimmune disease was caused by their silicone breast implants, used in their breast augmentation surgery. Her report was a consumer opinion rather than based on scientific study.  Due to the reaction of thousands of women who saw the show,  in 1992 the FDA responded to their complaints by severely restricting the use of silicone implants by imposing a moratorium on the use of silicone gel-filled implants, (except in the case of clinical trials for breast reconstruction patients). The moratorium was not because the implants were proved to be dangerous but because the manufacturers had been unable to prove them safe.

After many years of research and clinical trials, in 2006 the FDA deemed the newer silicone implants to be safe and lifted the moratorium. It didn’t take long for silicone to become the number one choice for 80% for women having breast augmentation surgery due to their more natural feel.

Claims for damages continue to be filed with the “Settlement Facility for Dow Corning Trust” (SFDCT). If you previously filed to be part of the class action suit, you most likely are aware of the deadlines and are getting letters from SFDCT. Meanwhile, many deadlines have already passed. Go to this link to see the schedule for deadlines: https://www.sfdct.com/_sfdct/index.cfm/deadlines/.  For instructions for filing forms and additional information go to the SFDCT site: https://www.sfdct.com/_sfdct/index.cfm/. Their phone number is (866) 874-6099.

As a breast revision specialist since 1988, Dr. Delgado has treated hundreds of women in the San Francisco Bay Area for breast implant removal and/or replacement. If you have any issues with your breast implants, call or email today for a consultation with Dr. Delgado at (415) 898-4161 to find out what your options are.

Scar Treatment After Breast Revision Surgery

Breast revision3

This is a 38-year-old, female resident of Sonoma who presented to the Novato office in Marin County for evaluation for revisional breast surgery. She underwent a short-scar breast lift in 1995 and then a breast augmentation in 1996 using 120 cc, silicone breast implants. This was done at another facility. Her complaints on presentation to me were high-riding breast implants with breast contractures. She underwent complete capsulectomies on both sides with replacement with 300cc normal-saline breast implants inflated up to 325 cc bilaterally. Her procedure was performed at Marin Cosmetic Surgery Center in Marin County, California. Note the improved contour and projection of her breasts and how well the incisions have healed, especially the vertical breast lift incisional scars.

 

San Francisco, California-Breast revision surgery can be any surgery done after the initial breast surgery.

Breast revision surgery is not uncommon for the woman who has breast implants; she will most likely need at least one revision in her lifetime and maybe more. Breast augmentation complications necessitating revision surgery would include: capsular contracture, deflation or rupture of implant(s), double bubble, etc. Women who have had other types of breast surgery other than breast augmentation; such as a breast lift with or without breast implants, and/or a breast reduction, will find different factors requiring a revision such as, weight fluctuations, aging or trauma.

Women who need to have breast revision surgery have several concerns that include; how will recovery compare to the initial surgery, will the outcome be satisfactory, what will the cost be?  Many are concerned about scarring.

There are several factors that can determine the degree of scarring, for example:

•    Age-As we age our skin loses elasticity and becomes thinner and, therefore, doesn’t      heal as well.

•    Genetics-If your parents or siblings tend to scar easily, you may, as well.

•    Size and depth of the incision-Larger and deeper incisions take longer to heal giving more opportunity to scarring.

•    Race-Dark skin people are more prone to hypertrophic and keloid scars

•    Smoking-People who smoke are at a greater risk of infection, scarring and slower healing. Most Board Certified Plastic Surgeons will not operate on patients that smoke.

•    Dehydration-The patient needs to stay well hydrated, or many complications can occur and interfere with healing.

 

It is extremely important for a woman to choose her Board Certified Plastic Surgeon carefully, look for one that specializes in breast revision surgery. Examine before and after pictures of the surgeon’s patients with special attention to the final result.

The expert breast revision surgeon will know how to minimize scarring and may even be able to revise and improve on initial scars.

There are various methods of treatment for the healing of incisions, and it is important for the patient to follow her surgeon’s instructions carefully.

Patients are warned to avoid direct sunlight on their healing incisions to prevent hyper-pigmentation. Collagen is what heals a wound, and fibroblasts are a certain type of cell in the skin that is responsible for the production of collagen. Our bodies need vitamin C to produce collagen. Vitamin C supplements are important both before and after surgery. 500 mg twice a day is recommended until the incision is healed. In addition, protein is very important in the healing process as the amino acids in protein is used by your cells for building blocks in creating new cells.

Silicone Sheeting

Silicone Sheeting

Once the incision is healed, Dr. Delgado recommends his patients use silicone sheeting to promote healing. They will be given specific instructions on how to apply the silicone. All patients are given a detailed surgery information packet at their pre-operative visit that explains all pre-operative and post-operative instructions specific to their surgery.

Dr. Delgado has been doing breast revision surgery since 1988, serving all of the San Francisco Bay Area, including Sacramento, San Jose and Los Angeles. Call today (415) 898-4161 for an evaluation of your breast revision surgery needs.

How is Strattice Used in Breast Revision Surgery?

San Francisco, CaliforniaStrattice Tissue Matrix is a surgical mesh from LifeCell. Plastic surgeons use Strattice for breast lift and breast augmentation revision surgeries. Strattice works as a scaffold to support and position weakened or thinned breast tissue.

strattice-02
For the skilled cosmetic plastic surgeon, Strattice Tissue Matrix aids the surgeon with breast revision surgeries such as:

1.    Bottoming out-when the skin has lost elasticity the breast implant may drop lower than desired. Strattice helps the surgeon maintain the implant to the correct position.

2.    Capsular contracture-When scar tissue forms around one or both breast implants, the implant can’t move freely, and the implant feels hard. In some cases,  capsular contracture can become quite painful. During revision surgery, the surgeon can use Strattice to reinforce the breast tissue.

3.    Rippling and Wrinkling-some women do not have enough breast tissue to completely cover the implant which can cause rippling and wrinkling of the skin. With the use of Strattice, the tissue is reinforced, and the breast pocket will have support.

4.    Fold Malposition-If the tissue is weakened; the breast border may move down or to the side but can be redefined surgically with support from Strattice.

5.    Symmastia-If the tissue is weak between the breasts they may move too close together. During breast revision surgery, the plastic surgeon can use Strattice to have control over positioning and the size of the pocket.

strattice-03

In addition to breast revision surgeries, Strattice Tissue Matrix aids the surgeon for the patient with lax tissue that is undergoing a mastopexy (breast lift) augmentation.

To successfully correct breast deformities of these types, will require a surgeon with extensive knowledge and surgical skill.

 

LifeCell designed Strattice Tissue Matrix to reinforce inadequate tissue. It is a flexible product derived from porcine dermis. It is used in many various surgical procedures, including heart valves. However, it cannot be used for patients that have sensitivity to porcine products or Polysorbate 20.

Dr. Delgado is a top cosmetic plastic surgeon who has specialized in breast revision surgery since 1988. He treats patients in the greater San Francisco Bay Area, Sacramento, San Jose and Los Angeles.

 

For a consultation for your breast revision surgery needs, call (415) 898-4161 or email today.