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San Francisco Revision Breast Surgery

Revision Breast Surgery

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Revisional, or secondary, breast surgery, is nearly as popular as primary breast augmentation. As discussed in the breast augmentation section, maintenance involving surgery on augmented breasts is common. When a woman chooses to improve the appearance of her breasts with breast implants, she is also assuming a lifelong endeavor to sustain the quality of her enhanced profile.

If you take 100 women with breast augmentation and follow them for thirty or forty years, you will find that majority of these women will have had one or more additional surgeries on their breasts. Therefore, it is highly likely that breast augmentation patients will need a revisional surgery during their lifetime.


Women who have had previous breast augmentation surgery and have issues with their breasts are candidates for revisional breast surgery, assuming they are healthy enough to undergo the proposed procedure.

There are many reasons or conditions to have revisional breast surgery. The most common ones are the following:

  • Breast contraction: when the breast implant is inserted into the body, the body’s response is to recognize the implant as foreign material. In response, it can form a scar capsule that encases the implant and walls it off from the body. An inflammatory process occurs which causes the scar tissue to thicken and constrict around the implant making it unnaturally hard. Though theories exist, it is not known exactly what triggers this response, nor why it happens to some people and not to others.
  • Deflation or rupture of the breast implant.
  • Laxity of the skin and the resulting changes in breast shape, as part of the normal aging process.
  • Stretching of the skin and changes in breast shape caused by pregnancy and breastfeeding.
  • Infection or bleeding in the early postoperative period, while uncommon, may occur in 1%-2% of patients nationwide.

In general, there is no reason to change implants unless there is a significant issue.

Revisional breast surgery, which is surgery that is done to correct a problem, often takes more skill, precision and artistic ability than the primary breast augmentation surgery.

The various options for revision may be:

  • Removal of the scar capsule and replacement of the implants, with the same size, larger or smaller.
  • Breast lift, with or without changing out the breast implants.
  • Remove the breast implants all together. (This option is rarely chosen by patients.)

Each case requires careful study of a patient’s needs and a personalized treatment plan in order to achieve the best outcome.

One advantage to secondary surgery is you can switch from saline implants to silicone, or vice versa. You can also change your implant size to larger or smaller ones.

With the benefit of his extensive experience and expertise with this type of surgery, Dr. Delgado will guide you through the various decisions that will customize your new look.

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There is no ‘perfect’ breast implant. All implants have their advantages and disadvantages. There are essentially two breast implants used today: saline-filled and silicone-filled breast implants. Both types of breast implants have an outer pliable envelope, or shell, which is made of silicone. The contents of the shell are either saline (saltwater) or silicone gel. For saline breast implants, the silicone shell is filled with saline at the time of surgery. Saline breast implants have been used for decades. They are safe and effective.

The advantages of saline implants are:

  • If a leak does occur, the saltwater is safely absorbed
  • Saline implants are filled after insertion, therefore, more adjustments can be made for volume discrepancies
  • In general, smaller incisions can be used
  • Saline implants are less expensive

The disadvantages of saline implants:

  • Slightly firmer than silicone breast implants
  • Mild rippling or scalloping (of the bottom edge of the breast implant)
  • Not ideal for implantation over the muscle in thin women, due to the increased likelihood that a rippled edge will be noticeable

Silicone breast implants have been approved for general usage since November of 2006. The FDA (Food and Drug Administration) restriction is that you must be at least 22 years of age. In addition, the FDA suggests an MRI at three years and then every two years thereafter to check for leakage. Though this is suggested, it is not required.

Silicone breast implants have evolved and improved over the years. They now have a thicker outer shell and contain a more cohesive gel. This means that the silicone has a more solid consistency and is less liquid. For example, if the breast implant is cut with a pair of scissors and squeezed, the silicone material will go out and then retract back into the silicone shell.

The advantages of silicone implants are:

  • A softer, more natural feel (the greatest advantage)
  • No wrinkled or scalloped edges and therefore, can be installed on top of the muscle, if desired

The disadvantages of silicone implants are:

  • A leak or rupture may occur unknowingly
  • Silicone implants are prefilled and, therefore, the size cannot be adjusted
  • An MRI may be required in the future
  • Silicone implants are more expensive

It is likely that a “gummy bear” silicone breast implant will soon be approved in the United States. These will contain an even more cohesive gel, much like the gummy bear candy.

As a general statement, women who have saline breast implants and change to silicone breast implants do prefer the silicone more for the natural feel. The breast implant companies now offer a variety of shapes and sizes to customize the fit to your body.

Based on your anatomical dimensions and your personal goals for your appearance, Dr. Delgado will expertly advise you on options for implant size, style and shape.

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