Project Category: Breast implant Revision

Why Remove Breast Implants?
Removing breast implants, whether saline or silicone, can be motivated by various factors. Some women opt for breast implant removal surgery due to changes in personal preference, health concerns, or complications. Common reasons include dissatisfaction with the appearance or feel of the implants or more complex issues such as capsular contracture (scar tissue forming around the implant).

Additionally, lifestyle changes or evolving aesthetic goals can prompt individuals to reconsider their implants. Whether opting for a more natural breast appearance or addressing complications, understanding the reasons and outcomes associated with implant removal is crucial for making an informed decision.

What Will My Breasts Look Like After Breast Implant Removal?

After removing breast implants, the appearance of your breasts will largely depend on several factors including the condition of your natural breast tissue, the size of the implants removed, and how long you have had them. Initially, your breasts may appear slightly deflated or less full due to the absence of implants and potential changes in breast tissue over time.

For some, the natural breast tissue may have shifted or altered in shape due to the long-term presence of implants. It is common to see a decrease in volume and some residual scar tissue that may affect the final outcome. However, many women find that their natural breast shape and size are more closely aligned with their current preferences and that the results, although different from their augmented state, are satisfactory.

Will My Breasts Look Flat After Implant Removal?

It is possible that your breasts may look flatter after implant removal, especially if you had large implants that provided significant volume. Without implants, the breasts might lose the fullness and roundness that they previously had. However, this outcome varies widely among individuals.

The degree to which your breasts might look flat depends on the amount of natural breast tissue you have, the size of the implants removed, and the condition of your skin and underlying tissue. In many cases, the breasts will gradually adjust to a more natural appearance over time, though some women might choose additional procedures to enhance or reshape their breasts.

Breast Implant Removal and Replacement

For some individuals, the goal is not just to remove implants but to replace them with new ones. This could be due to dissatisfaction with the current implants, changes in breast shape, or the desire for a different size or type of implant.

Breast implant replacement involves a similar process to the initial augmentation surgery. The old implants are removed, and new ones are inserted, which may involve choosing between different types of implants or adjusting their size. It is important to discuss your options with a board-certified plastic surgeon who can help you decide on the best approach based on your goals and health considerations.

Breast Implant Removal and Lift

If you are considering removing your implants and are concerned about sagging or changes in breast shape, a breast lift (mastopexy) can be an excellent option. A breast lift can help reposition and reshape the breast tissue, giving a more youthful and natural appearance.

During a breast lift, excess skin is removed, and the remaining tissue is lifted and tightened. This procedure can be combined with implant removal to improve the overall aesthetic outcome. Discussing your concerns with a board-certified plastic surgeon will help you determine whether a lift or any other additional procedure is appropriate for your needs.

Breast Implant Removal Scarring

Scarring is a natural part of any surgical procedure, including breast implant removal. The extent and visibility of scars depend on several factors, including the size of the incisions, the technique used, and your body’s healing process.

Typically, the incisions made for implant removal are like those used in the initial breast augmentation and are strategically placed to minimize visible scarring. Your plastic surgeon will discuss the potential for scarring and provide post-operative care instructions to promote optimal healing.

Procedure Options

When considering breast implant removal, several procedure options are available to address different needs and outcomes:
1. Implant Removal Only: This involves removing the implants and leaving the breast tissue as is. This option might be suitable if you are satisfied with the size and shape of your natural breasts or if you are opting for a future procedure.
2. Implant Removal and Replacement: If you desire a change in implant type or size, your surgeon will remove the existing implants and replace them with new ones.
3. Implant Removal or Replacement and Lift: If you want to address sagging or changes in breast shape, a breast lift can be performed alongside implant removal or replacement to enhance the appearance of the breasts.
How Do I Schedule a Consultation?

Scheduling a consultation with a board-certified plastic surgeon is a crucial first step in considering breast implant removal or any related procedures. Start by researching plastic surgeons with expertise in breast surgery, focusing on their credentials and patient reviews. You can find recommendations through healthcare providers, online resources, or professional plastic surgery associations.

To schedule a consultation, contact the surgeon’s office directly, either via phone or through their website. During the consultation, you will discuss your reasons for removing your implants, any concerns about scarring, and potential outcomes. Your surgeon will evaluate your breast tissue, explain the available procedure options, and help you set realistic expectations for the results.

Preparing for your consultation by listing any symptoms or concerns, including previous surgeries and current health conditions, will help ensure a thorough and productive discussion.

In summary, removing breast implants can be driven by various personal and health-related reasons, and understanding what to expect post-surgery is key to achieving desired outcomes. From potential changes in breast appearance to exploring options like a breast lift or fat transfer, consulting with a skilled plastic surgeon will provide you with the guidance needed to make informed decisions and achieve the best possible results. Contact us today to learn more about how you could change your life with a single procedure.
August 15, 2024
Common Signs You Need a Breast Implant Revision

Breast augmentation procedures have become increasingly common in recent years, offering women the opportunity to enhance their appearance and boost their self-confidence. While breast implants are designed to be long-lasting, they are not permanent fixtures and may require maintenance or replacement over time. Understanding the signs that indicate the need for a breast implant revision is crucial for ensuring the continued satisfaction of patients. Here are some common signs to watch out for:

Changes in Breast Appearance

One of the most noticeable signs that your breast implants may need revision is a change in the appearance of your breasts. This could include asymmetry between the breasts, changes in shape or size, or the development of visible rippling or wrinkling of the implant.

Capsular Contracture

Capsular contracture occurs when the scar tissue (capsule) that naturally forms around the implant tightens and contracts, causing the breast to feel firm or become misshapen. Severe cases of capsular contracture may cause pain or discomfort and may necessitate surgical intervention to correct.

Implant Rupture or Leakage

While modern breast implants are designed to be durable, they are not immune to damage or wear over time. Rupture or leakage of the implant can occur due to trauma, manufacturing defects, or natural aging of the implant material. Symptoms of implant rupture may include changes in breast shape, swelling, pain, or the development of lumps or hardened areas.

Bottoming Out or Double Bubble Deformity

Bottoming out occurs when the implant descends below the natural inframammary fold, resulting in a low position of the nipple-areola complex on the breast mound. Double bubble deformity, on the other hand, refers to a situation where the implant sits below the natural breast tissue, creating a visible line or bulge along the lower breast contour. Both conditions may require surgical correction to achieve optimal breast aesthetics.

Persistent Pain or Discomfort

While some discomfort immediately following breast augmentation surgery is normal, persistent pain or discomfort that develops months or years later may indicate an underlying issue with the implants. This could include capsular contracture, implant malposition, or other complications that require attention from a qualified plastic surgeon.

How Do I Know if My Breast Implants Need Replacing?

As a patient, it is essential to be proactive about monitoring the health and appearance of your breast implants. Regular self-examinations and routine follow-up appointments with your plastic surgeon can help identify any changes or issues early on. Additionally, be on the lookout for the following signs that may indicate the need for breast implant replacement:

Change in Breast Size or Shape

If you notice a significant change in the size or shape of your breasts, it could be a sign of implant rupture, capsular contracture, or implant malposition. This may include asymmetry between the breasts, deflation or collapse of the implant, or visible rippling or wrinkling of the implant surface.

Breast Pain or Discomfort

Persistent pain or discomfort in the breasts, chest, or armpit area should not be ignored, as it may indicate an underlying issue with the breast implants. This could include capsular contracture, implant rupture, or nerve compression, all of which may require further evaluation by a plastic surgeon.

Changes in Breast Sensation

Changes in nipple sensation, such as numbness, tingling, or hypersensitivity, may occur following breast augmentation surgery. While some alterations in sensation are normal and typically resolve within a few months, persistent changes or loss of sensation may indicate nerve damage or other complications that require medical attention.

Visible Rippling or Wrinkling

Visible rippling or wrinkling of the breast implant may occur, particularly in thin individuals with little natural breast tissue to conceal the implant. While mild rippling is relatively common and may not necessarily require intervention, significant rippling that is visible or palpable through the skin may warrant further evaluation by a plastic surgeon.

Difficulty Performing Mammograms

Breast implants can interfere with the imaging of breast tissue during mammography, making it challenging to detect abnormalities such as breast cancer. If you experience difficulty obtaining clear mammogram images or if your radiologist recommends additional imaging studies due to implant-related issues, it’s essential to follow up with your plastic surgeon for further evaluation.

How Often Should My Breast Implants Be Changed?

Unlike routine maintenance tasks such as oil changes for a car, breast implants do not have a predetermined expiration date. Instead, the decision to replace breast implants should be based on individual factors such as the patient’s goals, preferences, and any complications or changes that may arise over time. While some women may choose to undergo breast implant revision surgery for aesthetic reasons, others may do so out of medical necessity. Here are some factors to consider when determining the appropriate timing for breast implant replacement:

Implant Type and Material

The lifespan of breast implants can vary depending on the type and material used. Saline implants are typically filled with sterile salt water and may deflate if they rupture, making it easy to detect and address the issue promptly. Silicone implants, on the other hand, are filled with a cohesive silicone gel that closely mimics the feel of natural breast tissue and may require periodic monitoring via MRI to detect silent ruptures.

Patient Age and Health Status

As women age, their bodies undergo natural changes that can affect the appearance and integrity of breast implants. Additionally, changes in weight, pregnancy, breastfeeding, and hormonal fluctuations can all impact the size and shape of the breasts over time. Patients should discuss their medical history, lifestyle factors, and aesthetic goals with their plastic surgeon to determine the most appropriate timing for breast implant replacement.

Complications or Issues

Certain complications or issues may arise following breast augmentation surgery that necessitate implant revision or replacement. These may include capsular contracture, implant rupture or leakage, implant malposition, or changes in breast appearance or sensation. Patients experiencing any of these issues should seek prompt evaluation and treatment from a qualified plastic surgeon.

Aesthetic Preferences

Some women may choose to undergo breast implant revision surgery to achieve their desired aesthetic outcome or address changes in breast appearance over time. This could include changing the size, shape, or type of implant, adjusting the position of the implant, or addressing issues such as bottoming out or double bubble deformity.

Follow-Up Care and Monitoring

Regular follow-up appointments with your plastic surgeon are essential for monitoring the health and appearance of your breast implants over time. Your surgeon can assess the condition of your implants, address any concerns or issues that may arise, and recommend appropriate interventions or treatments as needed.

To schedule a consultation, contact Dr. Maman today and inquire about appointment availability.

March 14, 2024
What Does Breast Implant Revision Involve?

Breast augmentation procedures are one of the most popular plastic surgical procedures in the world, offering many individuals the chance to enhance their body and boost confidence. In some cases, individuals may choose to undergo breast implant revision surgery to address aging or issues with a previous augmentation. Whether due to complications, changes in preferences, or aging effects, breast implant revision aims to correct or modify previous augmentation outcomes.

What Is Breast Implant Revision Surgery?

Breast implant revision surgery involves the removal, replacement, or adjustment of existing breast implants. It can address various concerns, including implant rupture, capsular contracture (scar tissue tightening around the implant), dissatisfaction with size or shape, or changes in breast appearance over time. The procedure’s specifics depend on the individual’s needs and the nature of the revision required.

Are You a Candidate for Breast Revision?

Not everyone who has undergone breast augmentation is necessarily a candidate for revision surgery. Individuals experiencing issues such as implant rupture, dissatisfaction with size or shape, or complications like capsular contracture may be suitable candidates. Consulting with a board-certified plastic surgeon is crucial to assess candidacy and discuss available options.

Benefits and Risks of Breast Augmentation

Breast augmentation, like any surgical procedure, carries both benefits and risks. The benefits often include improved self-confidence, enhanced body proportions, and achieving desired aesthetic goals. Risks such as infection, implant rupture, scarring, and changes in sensation and breastfeeding should be carefully considered before undergoing any surgery, including breast implant revision.

When to Do Breast Implant Revision

Determining the right time for breast implant revision depends on various factors. Changes in the appearance of breasts, discomfort, complications, or shifts in personal preferences can prompt individuals to consider revision. Additionally, aging effects and lifestyle changes may influence one’s decision regarding revision timing.

Preparing for Your Breast Revision Procedure

Preparation for breast implant revision surgery involves several steps. Patients should discuss their medical history, current medications, and expectations with their plastic surgeon. Pre-operative instructions, such as avoiding certain medications and arranging for post-operative care, will be provided. Ensuring a supportive recovery environment is essential for a smooth healing process.

How Do I Schedule a Consultation?

Scheduling a consultation with a qualified plastic surgeon specializing in breast revision is the initial step toward understanding the process and exploring available options. Researching potential surgeons, checking their credentials, viewing before-and-after images, and discussing concerns during the consultation will help in making an informed decision about moving forward with the procedure.

Request a consultation today!

December 28, 2023
Can Breast Implants Be Removed and Replaced at the Same Time?

Breast augmentation with implants is a popular cosmetic procedure that can enhance one’s appearance. However, over time, individuals may consider removing or replacing their implants due to various reasons, including complications, a new aesthetic or aging. If you are contemplating breast implant removal and replacement, understanding the process, timing, and considerations involved is a great place to start.

Choosing the Right Time for Implant Replacement

Deciding when to replace breast implants involves several factors. Implants are not intended to last a lifetime, and over the years, they might require replacement due to issues such as rupture, capsular contracture, or changes in personal aesthetic preferences. A consultation with a board-certified plastic surgeon can help determine the optimal timing for replacement based on individual circumstances.

Understanding Implant Options: Size, Shape, and Material

When opting for breast implant replacement, individuals often reassess their choices regarding implant size, shape, and material. This allows them to align their preferences with their current lifestyle and aesthetic goals. Consulting with a qualified plastic surgeon can provide insights into available options, helping individuals make informed decisions.

Recovery and Postoperative Care

Postoperative care after breast implant removal and replacement is essential for a smooth recovery. The recovery process varies for each individual but generally involves following the surgeon’s instructions, avoiding strenuous activities, and attending follow-up appointments. A plastic surgeon will offer guidance to ensure proper healing and minimize potential complications.

Consultation and Planning: What to Expect

A consultation with a board-certified plastic surgeon is the initial step towards breast implant removal or replacement. During this consultation, the surgeon will evaluate the current condition, discuss concerns, and develop a personalized treatment plan. Understanding the procedure, potential risks, and expected outcomes is integral to informed decision-making.

How Do I Schedule a Consultation?

To schedule a consultation for breast implant removal and replacement, it is crucial to find a qualified and experienced plastic surgeon. Look for professionals certified by reputable organizations such as the American Board of Plastic Surgery and membership with the American Society of Plastic Surgeons. Research their expertise, patient reviews, before/afters and overall approach.

Breast implant removal and replacement is a significant decision that requires careful consideration and guidance from a skilled professional. Whether motivated by implant complications, personal preferences, or health concerns such as breast cancer or scar tissue, working closely with a trusted plastic surgeon ensures a safe and satisfactory outcome.

November 23, 2023
Implant Rupture: Understanding, Symptoms, and Actions to Take

Breast augmentation, a common plastic surgical procedure utilizing silicone gel or saline implants, can significantly enhance one’s confidence and appearance. However, like any medical device, there can be complications necessitating awareness of signs, immediate steps to take, and subsequent treatment options. Here we will discuss general information about implant ruptures, the differences between silicone and saline implant ruptures, treatment options, and long-term outlook.

Is Implant Rupture an Emergency?

While not always an immediate emergency, an implant rupture warrants prompt attention. Breast implant ruptures can occur due to trauma, age, or manufacturer defects, potentially leading to discomfort or changes in breast appearance. Understanding the signs and symptoms is crucial to address the issue early and adequately.

Signs and Symptoms of Implant Rupture

Detecting an implant rupture can be tricky as symptoms may vary between individuals. For silicone implant ruptures, the gel is cohesive and might remain confined within the breast capsule, causing a “silent rupture” without noticeable aesthetic changes. On the other hand, saline implant ruptures usually result in a rapid deflation, leading to a clearly drastic visible change in breast size. Some general symptoms of implant rupture may include pain, swelling, redness, or changes in breast size/shape/texture.

Immediate Steps to Take

If you suspect an implant rupture, consult with a board-certified plastic surgeon promptly. Regardless of symptoms, regular check-ups, and imaging scans aid in detecting silent ruptures. Magnetic resonance imaging (MRI) is the method for diagnosis of silicone implant ruptures, as they might not cause visible changes. Other imaging techniques like ultrasound or mammography can help detect breast implant ruptures, but are not confirmatory.

Silicone Implant Rupture vs. Saline Implant Rupture

Differentiating between the two types of breast implant ruptures is crucial. Silicone implant ruptures can be more challenging to detect due to the nature of silent ruptures, requiring specialized imaging for diagnosis. Conversely, saline implants tend to deflate noticeably and rapidly, making the rupture more visibly apparent.

Treatment Options

Upon diagnosis, surgical removal of the ruptured implant is often recommended. While it may not be an emergency, most plastic surgeons will advise a window of several months for removal. In the case of silicone implants, the gel may need to be removed from the breast capsule. The procedure aims to restore the natural shape of the breast and address any complications, such as capsular contracture or the involvement of surrounding tissues. Some patients will opt for total breast implant removal while others may opt for breast implant exchange and/or mastopexy. This decision will be based on the patient’s anatomy, goals, and what their plastic surgeon advises is reasonable and best for their specific set of circumstances.

Prevention and Long-term Care

Choosing an FDA-approved implant manufacturer and discussing the risks with your plastic surgeon before breast augmentation is crucial. Regular check-ups, self-examinations, and imaging facilitate early detection of ruptures. Additionally, staying informed about advancements in implant technology and consulting your surgeon regarding proper post-operative protocols and long-term follow-up after breast augmentation surgery can minimize risks.

How Do I Schedule a Consultation?

Should you notice any signs of a possible implant rupture or desire routine check-ups, scheduling a consultation with a board-certified plastic surgeon is imperative. They can perform examinations, discuss concerns, and recommend the best course of action.

Breast augmentation using implants is a personal choice that can positively impact self-esteem. However, being aware of potential risks like implant ruptures is crucial for long-term satisfaction. By staying informed, regularly monitoring your implants, and seeking immediate medical attention if any issues arise, you can ensure optimal outcomes from your breast augmentation surgery.

While implant ruptures can pose concerns, timely intervention and expert care from a skilled plastic surgeon can effectively address these issues.

November 9, 2023
Pregnancy and Breast Implants: What You Need to Know

Breast Implants and Pregnancy: Common Concerns

When it comes to the intersection of breast implants and pregnancy, there are many common concerns that women may have. The journey through pregnancy is a transformative experience for any woman, and those who have had breast augmentation may wonder how it will impact their body, their ability to breastfeed, and the health of their baby. In this blog post, we’ll explore the key aspects of pregnancy and breast implants to help you make informed decisions and address your concerns.

Can You Get Breast Implants While Pregnant?

First and foremost, it’s crucial to understand that undergoing breast implant surgery during pregnancy is not recommended. Plastic surgeons generally advise against any elective surgical procedures during pregnancy due to potential risks to both the mother and the baby. Pregnancy is a time when your body undergoes significant changes, including weight gain and hormonal fluctuations, which can affect the outcome and safety of the surgery.

Pregnancy and Existing Breast Implants

If you already have breast implants and become pregnant, you may have questions about how your implants will be affected. Rest assured; pregnancy alone does not necessarily ruin breast implants. However, certain changes may occur in your breasts during and after pregnancy that can impact the appearance of your augmented breasts.

One common change is weight gain during pregnancy. As your body naturally gains weight to support the growth of your baby, your breasts may also increase in size. This can put added pressure on the skin and breast tissue, potentially affecting the shape of the breasts and the position of the implants. After giving birth and experiencing post-pregnancy weight loss, some women may notice changes in the shape and position of their breast implants.

Breastfeeding with Breast Implants

A significant concern for many women with breast implants is their ability to breastfeed. The good news is that most women with breast implants can still breastfeed successfully. Breast implants are typically placed beneath the breast tissue or the chest muscle, leaving the milk ducts and the glands responsible for milk production intact. As a result, the presence of breast implants should not inherently interfere with your ability to breastfeed.

However, it’s essential to discuss your desire to breastfeed with your plastic surgeon during your consultation. They can provide guidance on the placement of the implants and how it may affect breastfeeding. In some cases, certain incision types or implant placements may be recommended to minimize any potential interference with milk production or breastfeeding.

Consulting with a Plastic Surgeon

Before becoming pregnant or if you are already pregnant and considering breast augmentation, it’s crucial to consult with a board-certified plastic surgeon who specializes in breast implant surgery. Plastic surgeons have the expertise to assess your unique situation, discuss your goals, and address any concerns you may have about the impact of breast implants on your pregnancy and breastfeeding journey.

During your consultation, be sure to communicate your intentions regarding pregnancy and breastfeeding. Your plastic surgeon can provide recommendations tailored to your specific needs and concerns, such as the size and shape of the implants, the type of implants used, and the timing of your surgery in relation to your pregnancy plans.

October 5, 2023
How Long is the Recovery For Breast Implant Revision Surgery
Day One

Upon waking from surgery, you will have a surgical bra in place with gauze pads on your chest covering the incisions. Typically, you will have tape or glue under the gauze, directly covering the incision sites. Your surgeon will tell you what to do with these dressings, like when to change them and when you can shower. The surgical compression bra should be worn 24 hours a day, except to shower and assess your breasts. In general, the first week after surgery you will have moderate pain in your breasts and around the sides of your chest. Most people describe the pain after surgery as muscle soreness. This pain should be easily controlled by your doctor’s prescribed medications and will get a little better each day.

There may be minor drainage from the incision lines, like blood or clear fluid. You may even have drains to help manage any expected drainage. This will lessen over the first few days. You should expect to rest the first 24 hours after surgery with intermittent periods of light walking around your home to the bathroom and to get food. Starting the day following your surgery, you will be permitted to go outside for brief 10–15-minute walks up to 3 times per day.

Week One

You should expect to return to your surgeon’s office at least 1 to 2 times during the first week after surgery. This will include monitoring and management of any dressings, sutures, and drains. At your first week’s postoperative visit, you will receive a new compression bra that further expedites the resolution of swelling after surgery, while providing necessary support as you heal. At about one week you should expect any bruising to begin resolving, which may turn a yellowish hue. It is normal to still experience some slight soreness and inflammation. After one week you may start sleeping in a modified sideways position and briefly showering fully, including your breasts and the incision sites. By this time, returning to a sedentary work environment is expected. All medications should be discontinued by 1-week post-op.

Month One

One month after surgery, you will be feeling very well. Other than some minor swelling and numbness, life pretty much returns to normal. You will be cleared by your doctor to return to full workouts, including cardio and high-impact exercises. You will be transitioned from your surgical compression bra into something more “normal” like a sports bra for daily wear. There will be no more care of the surgical site other than keeping the healing incisions clean/dry. Your surgeon by one month will likely advise beginning a topical scar therapy regimen consisting of silicone gels to minimize their appearance for the next 3 months.

How to Speed Up Your Recovery
1. Follow instructions: Your plastic surgeon’s specific aftercare instructions will include guidelines on things such as which medications and supplements are okay to take and which are not, when and how long to wear a compression garment, how to properly clean incisions and when to reintroduce your body to exercise. Your instructions will depend on your procedure and other factors specific to your unique situation, so follow your plastic surgeon’s instructions.
2. Move: Getting up and moving in the early phase after surgery will help restore blood flow to your tissues following a period of immobility. This ultimately helps reduce swelling with gravity and reduces the risk of postoperative constipation. It is important not to be overly active and to follow your surgeon’s guidance.
3. Don’t smoke: Smoking decreases circulation and oxygenation of the tissues, which is harmful to surgical recovery. Most plastic surgical procedures will require you to abstain from smoking for 2-4 weeks before and after.
4. Healthy eating/hydration: Be sure to follow a high-protein, nutrient-rich diet during the period after surgery. This is important for proper wound healing. You should prepare to drink more than the normal amount of water for the first 1-3 days after surgery. This will help restore any fluid volume lost with blood during surgery and helps to prevent postoperative constipation. Avoiding alcohol and salty foods will also improve your recovery.
How Do I Schedule a Consultation?

The first step to scheduling a consultation would be doing thorough research. There are many ways to find a plastic surgeon. Arguably the best way would be to receive a referral from another physician, such as an internist, dermatologist, or OB-GYN. These providers often see multiple patients with good results and can attest to those by referring their own patients somewhere. Friends are a secondarily good referral source, especially if they are patients themselves. When it comes to advertising, the most essential consideration is the plastic surgeon’s education, board certification ONLY by the American Board of Plastic Surgery, and before/after gallery. If those components match your desired outcome, then they would be a good source of information to seek in consultation. You will often come across taglines such as “no downtime surgery” or “no anesthesia required”. If it seems too good to be true, it probably is. There are no shortcuts to SAFE plastic surgery.

The next step would be contacting the office of a board-certified plastic surgeon to find a time to meet them. First impressions last a lifetime, so pay attention when speaking to the receptionist upon calling. Should you decide to have surgery, this is the team you will be dealing with multiple times per month for at least a year. The administrative team is a direct reflection of the surgeon’s ways of working. Another thing to clarify would be a potential timeline for surgery. This is sometimes best done before reaching out to qualified providers because they are booked one to six months out, on average. Knowing well enough in advance will give you adequate time to interview surgeons, get any preoperative lab work done, and feel confident moving forward with your scheduled procedure.
March 29, 2023
What To Do After Your Plastic Surgery Consultation

Reflect

The most important thing to do after a consultation for plastic surgery is to reflect on what you learned through the process. Firstly, you should evaluate how your experience compared to other consultations if you have been on multiples. Everything from the appointment scheduling process to your treatment by the members of the surgeon’s staff and the environment that the consultation took place matters. Secondly, it is likely you will have been presented with a lot of information about your cosmetic concern, what treatments the surgeon has recommended for you, and why. If there is anything still unclear, you should plan to return to the office for another visit or have a call with the surgeon/ clinical staff member to reinforce information from the consultation.

Make a Decision

Based on your reflection, you will potentially decide which surgeon best suits your needs. It is possible you may decide not to have surgery at all. If you are still unsure, it may be worth requesting to speak with a consenting patient from a surgeon you are considering to hear their first-person perspective of what the experience was like. This may be a deciding factor in your ultimate decision. Another large factor in the decision-making process is cost. Every surgeon will quote a different amount based on their experience and the type of practice they run. While cost is important, you should weigh it against everything you learned during the consultation process before deciding.

Schedule Surgery

Once you have decided who will perform your surgery, the next step is to reach out to their coordinator and select a date. Many surgeons have specific operative days of the week and book these days out well in advance. You can expect to wait 1-6 months on average from the time of your consultation to the date of surgery. Not only are the surgeon’s schedules restrictive, but there are items you will need to complete on your own before the surgery takes place. These are detailed below.

Pre-operative Requirements

Each surgeon and each unique surgery may have preoperative requirements that you will be responsible for prior to your surgery appointment. Breast surgery, for example, may require mammography to establish a baseline. Most surgeries requiring general anesthesia will require a visit to your primary care doctor for bloodwork and an EKG to ensure you are at minimal risk for complications. If you have any significant contributory medical/surgical history, you may also be required to see a specialist before surgery. Any required pre-op visit will produce a report that your doctor will need to review to make sure you are cleared. You can speak with your surgeon’s coordinator at the time of your consultation to get a better idea of any requirements prior to determining an ideal date so that you are well prepared.

February 7, 2023
What Happens After an Implant Rupture
Detecting A Rupture

A saline implant rupture often requires no imaging to detect. A simple clinical evaluation demonstrating volume loss is sufficient. If mammography imaging is obtained, then the implant will often demonstrate a wrinkled appearance.

An intracapsular silicone implant rupture is very difficult to see on mammography. Ultrasound lacks sufficient sensitivity to show intracapsular ruptures. MRI is the most sensitive at detecting silicone implant rupture. Extracapsular rupture can often be seen with mammography and ultrasound, showing the silicone in the surrounding tissues or even axillary lymph nodes.

Common Signs of Implant Rupture
- Pertinent physical examination findings include:
- Breast shape and symmetry
- New breast masses
- Associated lymph node pain
- The texture of the breast implant in question versus the contralateral breast implant
- Skin changes in the affected breast versus the contralateral breast
- Nipple discharge
Can A New Implant Be Put in Immediately to Replace a Ruptured Implant?

The empty shell of a ruptured saline implant should be removed. A ruptured silicone implant should be removed because of the possible interaction with surrounding tissue and possible spread to local lymph nodes. Asymptomatic patients may be reluctant to undergo this procedure, but overall long-term safety is a priority. If an intracapsular rupture occurs, then a capsulectomy can be performed. If all silicone has been cleaned the surgeon may not remove the fibrous capsule. If there is a doubt about silicone persistence, the surgeon may attempt to remove the entire fibrous capsule that has been infiltrated by silicone. If the rupture is extracapsular, then it is possible that the patient will need several surgeries to retrieve all the silicone gel, with a delayed replacement of the implant to restore normal breast contour.

Consulting with A Plastic Surgeon

The first step to scheduling a consultation would be doing thorough research. There are many ways to find a plastic surgeon. Arguably the best way would be to receive a referral from another physician, such as primary care, dermatologist, or OB-GYN. These providers often see multiple patients with good results and can attest to those by referring their own patients somewhere. Friends are a secondarily good referral source, especially if they are patients themselves. When it comes to advertising, the most essential consideration is the plastic surgeon’s education, board certification ONLY by the American Board of Plastic Surgery, and before/after gallery. If those components match your desired outcome, then they would be a good source of information to seek in consultation. You will often come across taglines such as “no downtime surgery” or “no anesthesia required”. If it seems too good to be true, it probably is. There are no shortcuts to SAFE plastic surgery.

The next step would be contacting the office of a board-certified plastic surgeon to find a time to meet them. First impressions last a lifetime, so pay attention when speaking to the receptionist upon calling. Should you decide to have surgery, this is the team you will be dealing with multiple times per month for at least a year. The administrative team is a direct reflection of the surgeon’s ways of working. Another thing to clarify would be a potential timeline for surgery. This is sometimes best done before reaching out to qualified providers because they are booked one to six months out, on average. Knowing well enough in advance will give you adequate time to interview surgeons, get any preoperative lab work done, and feel confident moving forward with your scheduled procedure.
January 27, 2023
Will I Need a Breast Lift After Implant Removal?

Common Reasons for Breast Implant Removal

Your breast implants are causing pain or discomfort

Painful or uncomfortable implants can indicate several issues that require a breast implant revision, including capsular contracture, damaged lymph nodes, a developing seroma, pinched nerves or poor implant placement. If you have silicone implants, pain may be a sign your implant has ruptured or is leaking.

Even if there is no serious issue causing pain, some patients find implants are uncomfortable enough to disrupt their daily lives, especially if the implant used was too large or poorly placed.

Regardless of the cause, persistent pain or irritation is not a normal result of breast augmentation surgery. Patients who are experiencing either should schedule an appointment with their surgeon.

Your breast implant has ruptured

Implant rupture can be caused by abrupt or intense physical pressure (like in a car accident) or through the aging and weakening of the implant shell.

A rupture in a saline implant causes a nearly immediate deflation of the affected breast, making it easy to diagnose. The saline solution inside the implant is the same as IV solution and is easily absorbed by the body.

By contrast, ruptures in silicone implants cannot be diagnosed without an ultrasound or an MRI because the viscous silicone gel inside the implant leaks out slowly.

While the rupture of a breast implant is not a life-threatening emergency, it is important to have the damaged implant removed to prevent infection or the development of excessive internal scar tissue.

Your breast implant has bottomed out

If the skin and tissue cannot adequately support the breast implant, it is possible for the implant to gradually fall below the breast crease, or “bottom out.” This condition is more common with large or heavy implants, but post-surgery pregnancies or skin laxity due to age can also cause an implant to bottom out.

Drooping breasts are not uncommon. But unlike breasts that naturally fall over time, where nipples fall with the breast tissue, bottomed-out implants cause nipples to move upward as the implants fall lower. It is also common for patients to be able to feel and see the outline of a bottomed-out implant.

Your breast implant is moving or rotating

It is normal for breast implants to settle into a slightly different position over time. It is not normal for implants to move to a dramatically different location on the chest wall. This is called implant displacement, and there are several ways an implant can shift.

Lateral displacement of implants (implants moving too far away from the midline of the chest) can occur when the implant pocket is too large. Symmastia, or implants merging in the middle of the chest, is a rare complication caused when too much tissue is removed near the breastbone, which in turn causes the muscle between the breasts to detach.

An overly large implant pocket can also result in implant rotation. Patients may not be able to tell if a round implant has rotated, but a rotation of teardrop implants yields a top-heavy, unnatural appearance of the breast.

Your breast implant has changed shape

Implant shape can change if the implant ruptures, shifts, rotates, bottoms out, or becomes otherwise displaced.

Changes in implant shape usually occur asymmetrically, meaning in one breast or the other. Even if both implants change shape, they may not change in the same way. This asymmetry is not medically risky, but it can cause patients significant emotional distress and make it very difficult to find bras and clothing that fit properly.

Your breast implant is causing capsular contracture

The formation of scar tissue is a normal part of the healing process after placing any kind of medical or plastic surgery implant. Usually, this process is a good thing because the capsule of scar tissue helps support the implant, keeping it from slipping.

In some cases, however, the body mistakes the implant for a dangerous foreign object and creates excessive amounts of scar tissue to isolate it. Known as capsular contracture, this overproduction of dense, hard tissue around the breast implant can affect the success of the augmentation procedure.

There are four grades of capsular contracture, ranging from normal to severe. Grade one is asymptomatic and doesn’t interfere with the results of the implant. Grade two capsular contracture has only minor cosmetic symptoms, leaving the breast normal in shape but firmer to the touch.

Capsular contracture of grades three and four causes hard, misshapen, and overly round breasts that look and feel unnatural. Grade four contracture also often results in breast pain. Patients with either grade three or four capsular contractures usually require a breast implant revision.

You are unhappy with your breast size

While most patients are happy with the results of their breast augmentation, some patients find they wish they had gotten a different size implant – larger or smaller.

If you want to change the size of your implants, most doctors will recommend waiting about a year after your initial surgery before proceeding. Not only will this waiting period allow your body to fully heal, but it will also give your implants time to settle into their final position before you make this major decision.

Will My Breasts Sag After an Implant Removal?

When you have breast implants, your skin stretches to accommodate the size of your breasts. After implant removal, your breasts may sag, droop, or appear misshapen.

Many people choose to have implant removal with a breast lift (mastopexy). During a breast lift, your surgeon removes excess skin and reshapes your breast tissue. If needed, the surgeon can also reposition the nipple and areola. The result is firmer, more elevated breasts.

Factors to Consider

It is important to note that there are no scientific studies proving that breast implants cause systemic issues. As such, one cannot guarantee that removing your implants will improve your health for any reason. Be sure you have seen your primary care doctor first to rule out any diagnosable causes for symptoms, such as Lyme disease. If you cannot find an answer, removing your implants is an option to consider, knowing that implant removal may or may not have any effect. This includes the possibility of adverse outcomes such as bleeding, seroma formation, and/ or poor cosmetic outcome with limited options for additional surgery.

Schedule a Consultation with Dr. Maman

The first step to scheduling a consultation would be doing thorough research. There are many ways to find a plastic surgeon. Arguably the best way would be to receive a referral from another physician, such as primary care, dermatologist, or OB-GYN. These providers often see multiple patients with good results and can attest to those by referring their own patients somewhere. Friends are a secondarily good referral source, especially if they are patients themselves. When it comes to advertising, the most essential consideration is the plastic surgeon’s education, board certification ONLY by the American Board of Plastic Surgery, and before/after gallery. If those components match your desired outcome, then they would be a good source of information to seek in consultation. You will often come across taglines such as “no downtime surgery” or “no anesthesia required”. If it seems too good to be true, it probably is. There are no shortcuts to SAFE plastic surgery.

The next step would be contacting the office of a board-certified plastic surgeon to find a time to meet them. First impressions last a lifetime, so pay attention when speaking to the receptionist upon calling. Should you decide to have surgery, this is the team you will be dealing with multiple times per month for at least a year. The administrative team is a direct reflection of the surgeon’s ways of working. Another thing to clarify would be a potential timeline for surgery. This is sometimes best done before reaching out to qualified providers because they are booked one to six months out, on average. Knowing well enough in advance will give you adequate time to interview surgeons, get any preoperative lab work done, and feel confident moving forward with your scheduled procedure.

December 6, 2022