Although the majority of breast augmentation patients have a smooth postoperative course and excellent outcome, a small percentage of patients occasionally develop a long term complication. Dr. Kapoor and Dr. Schlenker performed numerous breast implant revisions on patients who have had various issues with their surgery. These issues include breast implant displacement (mispositioned implant) and encapsulation or handling of the internal scarring around the implant. Our Beverly Hills Plastic Surgery patients highly recommend Dr. Kapoor and Dr. Schlenker for their breast implant revision at Beverly Hills Wellness Surgery Center, a state-of-the-art JCAHO-certified facility in Beverly Hills.
Silicone gel implants are the most common type of breast implant used when undergoing breast augmentation. The silicone can vary in firmness and consistency. Unlike some saline implants, they are pre-filled before insertion.
Advantages of silicone gel implants include:
Breast implants filled with the firmer silicone gel are called cohesive gel implants. Either soft or firm silicone gel can be used for breast augmentation and breast implant revision procedures.
Advantage of soft and cohesive silicone gel implants:
Saline breast implants have a durable silicone shell. These implants are either pre-filled with sterile salt water or filled through a valve once they have been inserted into your breast.
Advantages of saline breast implants include:
VISHAL KAPOOR, M.D.
DR.ROBERT E. SCHLENKER M.D.FACS
Board Certified Plastic Surgeons
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Bottoming out is when the implants end up sitting very low on the chest dropping down below the existing infirmary fold (natural crease beneath your breast), and there is lack of internal support for the implant itself. This occurs when the fold has been released excessively during breast implant revision operation or may be due to factors of the patient’s collagen and tissue integrity.
Stretch deformity occurs when the breast fold is in the correct position; however, the length of the tissue between the nipple and the fold stretches. This may be due to the patient’s soft tissue inelasticity or the size or shape of the implant that is used. In addition, skin laxity can change with age, pregnancy, weight changes, or heredity.
Capsular contracture is a condition where the capsule around the implant thickens and squeezes the implants causing it to become hard and often changing the shape and position of the implants itself. Capsular contracture is more common in nicotine users (e.g. smoking or nicotine patches or gum).
A rupture or deflation of the implant may occur at any point after the initial breast augmentation. This complication may increase by an under-filling or overfilling of saline solution into the implant, excessive compression, trauma, and other causes. If the implant shell is not filled with the correct amount of saline, there may be a crease or fold in the shell, which often leads to a rupture.
This usually occurs when there is not enough tissue coverage or when the implants are excessively large, relative to the patient’s breast and breast tissues. This commonly happens at the bottom of the breasts but may also be seen towards the middle or on the sides; less commonly in the superior or top position. This occurs more frequently with saline implants and with saline gel implants.
Displacement of the implants refers to the space or insertion of the breast implants and how it can become too large on the side of the chest. In some cases, the tissues can stretch, and the implants can fall too much to the sides. This is most easily seen when the patient is lying on her back. On a rare occasion, the implants can move towards the patient’s armpit as well.
Symmastia or Synmastia is a condition which can occur when the breast implants are too close together. Patients often refer to this as a “uniboob.” This can occur for the same reasons as displacement of implants noted above, but in this case the pocket(s) is/are too far towards the center.
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