Women seeking breast implant revision surgery in Miami may be understandably confused with the amount of conflicting information on the subject. Problems with implants develop in about 10% of women ranging from implant rupture to capsular contracture. Some women are simply unhappy with the cosmetic result of their surgery, wishing they had gone larger or smaller. Breast implant problems do have solutions. There is no reason to suffer with painful or cosmetically unsatisfactory implants. In some cases, insurance may cover the cost.
Dr. Joshua Lampert, board certified plastic surgeon, has spent thousands of hours performing revision surgery. He notes that while implants do have a lifespan which will eventually require replacement, ideally this should not be the issue for at least 10 to 15 years.
Unfortunately, some women naturally develop conditions that cannot be predicted or prevented which can cause early problems. When this is the case, Dr. Lampert finds that revision surgery is usually indicated.
Four Main Issues
There are four main breast implant issues:
- Capsular Contracture
- Breast Implant Rupture
- Implant Movement or “Malposition” of the implant related to the shape of the breast
- Incorrect Implant Size
It is caused by the natural response of the body to encapsulate any foreign material with scar tissue. This condition can occur as early as 6 weeks post surgery. The scar tissue, also called a capsule, can remain soft throughout the life of the implant and cause no problem. For some patients, the scar tissue around the implant contracts which causes the breast to feel hard, sometimes painful and eventually to become displaced. With enough time, almost every patient gets some degree of capsular contracture. Older implants and capsules over 20 years old can calcify and become very firm.
Before & Afters
All plastic surgeons should be judged on the aesthetic merits of their work. Review Dr. Lampert’s before and after gallery to see what he has accomplished.
There are two types of implants: those filled with saline and those filled with silicone gel. All implants are contained within a silicone elastomer shell.
When saline implants rupture, the deflation is usually immediately obvious due to the saline solution leaking into the chest. Saline solution is safely absorbed into the body so that this is not a health concern. However any implant, once ruptured must be removed and replaced, if desired. Sometimes a slow leak leads to a slowly deflating saline implant.
Silicone gel implants have greatly improved over the last 20 years. They rarely spontaneously leak and rupture rates are very low. Ruptures can occur due to outside forces such as:
- Trauma such as in a car accident
- Mammogram pressure
- Accidental puncture during biopsy or other surgical procedures
The newer cohesive gel implants (or “gummy bear implants”) have a fill that remains in the implant shell after a leak. With silicone implants, it may not be immediately obvious that there is a problem. The FDA recommends that women with silicone gel implants should commit to having an MRI every 3 years after their initial surgery and then every 2 years after that to detect any possible rupture that may be present. Additionally, any silicone gel that escapes the shell is usually contained within the scar capsule naturally formed around the implant. In the past there was considerable fear surrounding silicone gel leaking into the body. However, extensive research has shown safety with the use of both silicone and saline breast implants for breast augmentation.
An MRI can usually detect an implant rupture, which is the only way that many leaking silicone implants are detected. In the case of a leaking saline implants, the affected breast will appear smaller—usually immediately unless there is a very slow leak. PIP breast implants, which were never allowed in the US but were popular in France, had a very high incidence of rupture and have since been removed from the market. Patients with these implants should have them removed as soon as possible.
Poorly Positioned Implants (Implant Malposition)
Poor implant placement, or implant malposition is a mistake that Dr. Lampert corrects in breast revision patients that seek him out to remedy this problem. Miami is a hub for plastic surgery procedures. Unfortunately, not all work done will stand the test of time.
This condition is similar to Symmastia. Implants can move to locations that are too high (superior malposition), to low (inferior malposition), away from the middle of the chest (lateral malposition) or too close to the middle of the chest (symmastia). When the breast implant falls below the natural fold where the breast meets the chest wall, a ‘bottomed out’ or “stargazer” effect occurs.
Incorrectly placed implants can migrate within the breast leaving a very undesirable cosmetic effect. In cases where the implant migrates toward the armpit (or axilla), it can not only look bad but restrict downward arm movement.
There are several procedures that Dr. Lampert uses when correcting implant displacement. The implant will usually need to be removed and replaced no matter what method is used. Simply trying to anchor the implant to a better location using sutures is usually not a permanent solution. Dr. Lampert will employ a technique which creates a permanent pocket in the right location so that the implant stays in place. At the same time, Dr. Lampert often creates an internal structure, or sling, to support the implant in the desired position.
Incorrect Implant Size
In this case, Dr. Lampert can employ different correction methods depending on the type of implant used, shape of the breast, and prior scars. Dr. Lampert can usually remove and replace the implants using the original incision sites, to minimize scarring. If scarring is a problem, a scar revision can be done during implant replacement.
Many women change their mind regarding implant size as they get older and opt to downsize. Some women are disappointed to find out that there really hasn’t been enough of a change in their appearance and they want to go a little larger. Whatever the breast issues or problems may be, Dr. Lampert is dedicated to help his patients achieve their personal image goals and desires.
This is a condition in which the left and right implants move toward each other too close together, eliminating definition between the two sides. The two implants can even touch each other or nearly touch. The breast implant pocket was likely dissected too far in the cleavage area. The skin over the sternum (or chest breast bone) stretches, creating a web like structure. The effect is to blend the two sides creating a ‘bread loaf’ deformity. Repair of symmastia requires surgical skill and the best breast revision Miami has available.
Some patients develop visible rippling of the skin over the implant. It is more common with saline devices than silicone implants. Implants that have been placed under the muscle are less likely to cause this problem.
Muscle Flex Deformity
Implants that are placed submuscular, or under the pectoralis muscle, must have sufficient room to remain unaffected when this muscle is flexed. If preparation of the site has been inadequate and not enough muscle has been released, patients will notice the implants moving abnormally when working out or lifting heavy objects.