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Before general anesthesia is given, your breasts and chest are carefully outlined using a surgical marking pen. This acts as a “roadmap” during surgery and allows Dr. Delgado to make adjustments for the gravitational changes that take place in the position of the breasts as the body moves from a lying to a sitting position.
Breast revisional surgery is, most often, performed under general anesthesia. At Marin Cosmetic Surgery Center, anesthesia is administered only by a physician who is board certified in anesthesia.
The surgery takes place at Marin Cosmetic Surgery Center, Dr. Delgado’s private surgery suite, located in his Marin County office on the Sutter Marin County Community Hospital campus. This allows Dr. Delgado to offer his patients private, concierge medical care, while providing the extra measure of safety and reassurance afforded by the surgery center’s contiguous location to the hospital.
Revisional breast surgery requires an extra degree of surgical skill and experienced decision-making. The following are some of the most common scenarios with revisional breast surgery.
Capsular contraction. The procedure is focused on the excision of the scar tissue around the implant. After the incision is made, the dissection is carried down to the scar tissue capsule. The capsule and implant are dissected together as one piece, especially if we suspect a silicone implant rupture. Once the capsule is freed, both the breast implant and capsule are removed from the pocket. The new breast implant is placed in a virgin tissue pocket. If required, a breast lift is done. A drain is usually placed to remove excess fluid.
Deflation or ruptured breast implant. The breast implant is removed and replaced. If the silicone breast implant is ruptured, the silicone material is meticulously removed. If the silicone migrates outside the breast capsule, this process can be more difficult. Once the breast pocket is mechanically cleaned and pharmaceutically sterilized with antibiotic solution, a new breast implant can be placed. If a lift is required, it would be done at this time.
The skin of the breast is loose and, therefore, the breast shape has changed. This often occurs after childbirth or weight loss. The goal is to recapture a youthful breast shape. If the skin is loose due to pregnancy or aging, a breast lift or mastopexy is required. The breast lift section will explain the various lifts. The breast implants are usually replaced if a significant amount of time has elapsed since the initial surgery. If the breasts do not require a lift, sometimes the “dual-plane” technique is used for re-augmentation. This technique provides improved shape and appearance of the breasts.
These are the most common scenarios in revisional or secondary breast surgery.
Once the implants are in position, the patient is raised to a sitting position to evaluate the breast symmetry. This step allows the surgeon to evaluate the changes that occur when the body moves from a lying to a sitting position. Adjustments are made as needed and then the incisions are meticulously closed.
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SAN FRANCISCO OFFICE
450 Sutter Suite 2433
San Francisco, CA 94108
165 Rowland Way Suite 300
Novato, CA 94945