On April 12, 1961, Soviet cosmonaut, Yuri Gagarin, used a space capsule like this to become the first human in orbit. That same year, the first breast implant was developed by American plastic surgeons Thomas Cronin and Frank Gerow.
Breast implant capsules have a bad reputation. Normally, they are only discussed when they are causing problems like capsular contracture or breast implant malposition. However, like a space capsule, the breast implant capsule provides protection, and without breast implant capsules, there would be no breast augmentation.
What is a breast implant capsule?
Whenever a breast implant is used for breast augmentation, your body makes an encapsulating sheet of scar that lines the breast implant’s pocket. This normally thin, soft scar is called the “capsule”, and it is incredibly important in maintaining your breasts’ enhancement.
Have you ever wondered how breast implants stay in place?
The capsule is responsible for keeping the breast implants in the proper position beneath the breasts. It forms in just a few weeks after breast augmentation surgery and keeps the breast implants from freely sliding around. Optimal breast implant position is a combination of careful placement during surgery and a proper capsule. The capsule will quickly line the surgical pocket and provide a smooth, strong interface between the breast implant and the soft tissues of the chest. By reinforcing the pocket, the capsule helps to maintain optimal breast implant placement.
The capsule protects the breast implant.
Not only does the capsule help keep the breast implant in position, it also protects the implant. The interior of the capsule is smooth and allows for nearly frictionless movement within its boundaries. The outer layers of the capsule provide enhanced vascular circulation and helps protect the breast implant from infection.
When good capsules go bad.
So what can go wrong with breast implant capsules? The perfect capsule is firm enough to maintain proper breast implant positioning, but soft enough to not be felt. Problems occur at the extremes, so like Goldilocks the capsule needs to be just right, not too hard and not too soft.
Too soft
When the Breast Implant Capsule is too soft, it does not provide enough support for the implant. Gravity pulls the implants down when standing or to the side when laying down. The larger the breast implants, the greater the force. Stomach sleeping also pushes the implants apart. A healthy capsule can resist the tendency toward Breast Implant Malposition, but a good bra helps too.
Treatment for implant malposition can include a capsulorrhaphy, to tighten the capsule, and close off the areas where the implant should not be going. If an overly large breast implant in compounding the problem, a smaller implant can help reduce recurrence. The use of an acellular dermal matrix (ADM) has also become more popular as a way to line, reinforce and thicken the capsule.
Too hard
When the Breast Implant Capsule is too hard, it can compress the implants, and cause Capsular Contracture. Capsular contracture can also result in breast implant malposition. If the capsule is tight only on one side, it will push the breast implant toward the soft side. If the capsule is tight all the way around, it can make the implant feel hard.
Treatment for capsular contracture includes capsulectomy, removing the thickened capsule, and capsulotomy, incising the capsule to allow it to expand. Both these techniques are performed in the operating room. An older, non-operative technique called closed capsulotomy was a way to split the capsule without surgery by forcefully compressing the implant. This has been largely abandoned as it has less predictable results, may lead to uncontrolled bleeding or implant rupture, and violates most breast implant warranties.
Just Right
The most common types of capsules are grade I followed by grade II. Grade I capsules are soft on not detectable from the outside, Grade II capsules feel firmer, but are not tight enough to cause visual changes. Both usually provide adequate support to allow the breast to age naturally, securely on the chest. If you are considering breast augmentation, or you have breast implants and are considering breast implant revision surgery, give me a call at (925) 943-6353 or contact my Walnut Creek Plastic Surgery Office using the contact form in the left column.
Breast Implant Revision Surgery is performed to improve the results of Breast Augmentation. While Breast Augmentation is both safe and effective, our bodies continue to change as we age. Breasts naturally change size and shape over time. This occurs with or without breast augmentation. While most changes are gradual, changes can happen relatively quickly with pregnancy and changes in weight.
Breast Implant Replacement
Breast implants can wear out too, requiring a new implant to be placed. The major US breast implant companies, Allegan and Mentor, do provide Breast Implant Warranties.
What Are the Common Reasons for Breast Augmentation Revision Surgery?
The most common reasons for Breast Implant Revision Surgery are a desire for a change in size, deflation of the breast implant, capsular contracture and breast implant malposition. It is important to clearly identify what problem(s) are bothersome, and to seek a consultation with a Board Certified Plastic Surgeon.
Below is number four of four of my latest Breast Implant Revision Videos. They appeared on KRON4′s Body Beautiful. The series covers Breast Augmentation, Breast Implants and Breast Augmentation Maintenance. The television show was broadcast live, so viewers could call in during the broadcast to have their questions answered. The (415) number shown in the video was only for the show; however, if you have Breast Augmentation or Breast Implant Revision questions, please call our San Francisco Bay Area Plastic Surgery Office directly at (925) 943-6353. If you prefer, you may also use the contact form on the left.
San Francisco Bay Area Breast Implant & Breast Augmentation Revision Video
San Francisco Bay Area Breast Implant Revision Questions
This Breast Augmentation and Breast Implant Revision Surgery video includes:
The type of trauma most likely to cause breast implant deflation
Common reasons for breast implant revision surgery
Changing breast implant size
Breast implant leaks
Capsular Contracture
Breast Implant Malposition
Breast Augmentation and Breast Implants Revision Resources
You are viewing number three of four Breast Implants Revision Video segments from Dr. Mele’s recent Body Beautiful television appearance. Here are links to the other segments:
Breast Augmentation remains one of the procedures that I perform most frequently. Whether you’ve always had small breast and want them larger, or you had larger breast and want them back, Breast Augmentation can help you achieve your goals.
Breast Implant Revision Surgery is performed to improve the results of Breast Augmentation. While Breast Augmentation is both safe and effective, our bodies change as we age. Breasts naturally change size and shape over time, and this happens even after breast augmentation. Changes can certainly be exacerbate by pregnancy and changes in weight, but most of the time the changes are gradual and sneak-up on us.
What’s New in Breast Implants and Breast Augmentation?
If you are considering Breast Augmentation or Breast Implant Revision surgery, you should know that new breast implants are available and more are on the horizon. New techniques are also being developed to help make your Breast Enhancement simpler, safer, more predictable and easier overall. Be certain to seek a Board Certified Plastic Surgeon for all your Cosmetic Breast Surgery needs.
Below is part three of four of my Breast Implant Revision Video that appeared on KRON4′s Body Beautiful. Options in Breast Augmentation, Breast Implants and Breast Augmentation Maintenance are reviewed. The television show was broadcast live, so viewers could call in during the broadcast to have their questions answered. The (415) number shown in the video was only for the show; however, if you have Breast Augmentation or Breast Implant Revision questions, please call our San Francisco Bay Area Plastic Surgery Office directly at (925) 943-6353. If you prefer, you may also use the contact form on the left.
San Francisco Bay Area Breast Implant & Breast Augmentation Revision Video
San Francisco Bay Area Breast Implant Revision Questions
This Breast Augmentation, Breast Implant Revision Surgery video includes:
The Breast Implants currently available
Saline Breast Implants – Natrelle (Allergan) and Mentor (J&J)
Silicone Gel Breast Implants (Natrelle and Memory-Gel)
Soft-Solid Silicone Breast Implants (GummiBear Implants)
Natrelle 410′s*
Mentor Contour Profile Gel (CPG)*
*The 3 yr and 5 yr data for the 410′s and CPG breast implants surpasses that of the breast implants that are already approved in this country. Why are they not approved? Only your FDA knows for sure.
Breast implant deflation
What are the signs and symptoms associated with a leaking breast implant?
How to check for a breast implant leak
How long do Breast implants last?
How are breast augmentation and breast lifts combined?
Breast Augmentation and Breast Implants Revision Resources
You are viewing number three of four Breast Implants Revision Video segments from Dr. Mele’s recent Body Beautiful television appearance. Here are links to the other segments:
Breast Implant Revision Surgery is performed to improve the results of Breast Augmentation. Breast Augmentation Revision can help with Breast Implants are the wrong size, in the wrong position, have developed capsular contracture or when other cosmetic deformities require correction. Specific techniques have evolved for the correction of the most common problems that can occur with Breast Implants. Some recently developed new techniques have significantly improved the results of breast implant revision for problems that have been difficult in the recent past.
San Francisco Bay Area Breast Augmentation
This segment of Body Beautiful focuses on before and after results. Breast Augmentation is reviewed, as well as the correction of specific breast implant problems like capsular contracture and implant malposition (bottoming out and symmastia). The following Breast Implant Revision Video was broadcast on KRON4′s live Medical Monday show, Body Beautiful. The television show allows viewers to call in during the broadcast and have their questions answered. The (415) number shown in the video was only for the show, so if you have Breast Augmentation or Breast Implant Revision questions, please call our San Francisco Bay Area Plastic Surgery office directly at (925) 943-6353, or use the contact form on the left.
San Francisco Bay Area Breast Augmentation & Breast Implant Revision Video
San Francisco Bay Area Breast Implant Revision Questions
This Breast Augmentation, Breast Augmentation Revision Surgery video includes:
Before and After Pictures of Breast Augmentation
Before and After Pictures of Breast Augmentation Revision including:
Before and After Pictures of Breast Augmentation Revision for a Breast Implant that is too low and a poorly formed inframammary fold (IMF)
Before and After Pictures of Breast Augmentation Revision for Grade III Capsular Contracture causing the Breast Implant to be too high (Capsulotomy/Capsulectomy)
Before and After Pictures of Breast Augmentation Revision for Grade IV Capsular Contracture causing the implant to ride up and appear significantly smaller
Before and After Pictures of Breast Augmentation Revision for Breast Implants that are too close (as seen in symmastia) and too far from the midline (often causing a large gap between the breast implants) and rippling on the inside of the breast (medial rippling)
Before and After Pictures of Breast Augmentation Revision for severe bottoming out with internal capsulorrhaphy (though a breast lift is the most frequently selected option)
Breast Augmentation and Breast Implants Revision Resources
You are viewing part two of four Breast Implants Revision Video segments from Dr. Mele’s recent Body Beautiful television appearance. Here are links to the additional segments:
Breast Augmentation remains one of the most popular cosmetic plastic surgery procedures. While often the procedure lasts a lifetime, breast augmentation revision is quite common. Breast Implant Revision has emerged as a specialty unto itself. While many of the tenants that lead to excellent Breast Augmentation results will also apply to Breast Augmentation Revision, new and specific techniques have evolved for the correction of the common problems that can occur with Breast Implants.
The most frequent reasons for Breast Augmentation Revision Surgery include the desire to change the size of the breast, breast implant deflation, problems with the position of the breast implants and tightening of the scar that normally forms around the breast. The last listed is called capsular contracture.
San Francisco Bay Area Breast Augmentation
What follows is a Breast Implant Revision Video segment from KRON4′s live Medical Monday show, Body Beautiful. The television broadcast allows viewers to call in and have their questions answered live. The (415) number shown in the video was only for the show, so if you have Breast Augmentation or Breast Implant Revision questions, please call our San Francisco Bay Area Plastic Surgery office directly at (925) 943-6353, or use the contact form on the left.
San Francisco Bay Area Breast Augmentation & Breast Implant Revision Video
San Francisco Bay Area Breast Implant Questions
This Breast Augmentation, Breast Augmentation Revision Surgery video includes:
What to consider before having Breast Augmentation
Is “routine maintenance” for Breast Implants required?
If my Breast Implants are too high, can they be lowered?
If my Breast Implants are too low, can they be raised?
If my Breast Implants are too wide, can they be moved towards the middle?
If my Breast Implants are too close together, can they be separated?
What causes Breast Implants to fail?
Can I maintain my body proportions and have Breast Augmentation?
What are the problems associated with Breast Implants which are too big?
Breast Augmentation and Breast Implants Revision Resources
You are viewing one of four Breast Implants Revision Video segments from Dr. Mele’s recent Body Beautiful television appearance. Here are links to the additional segments:
Breast Augmentation and Breast Implant Revision San Francisco Bay Area – 1 of 4 (You Are Here)
Tubular breast deformity is a common, congenital breast abnormality found in both women and men. In men, the treatment is straight forward (see the bottom of this article). In women, however, additional aesthetic norms come into play, making the repair more complex.
Tubular Breast Deformity in Women
Tubular breast deformity is known by many names:
Tubular breast deformity
Tuberous breast deformity
Snoopy Nose or Snoopy’s Nose deformity
Constricted breast deformity
Women with mild constriction often come to see me to simply increase the size of their breast, not aware of the diagnosis. Women with more severe deformity, however, are often reluctant to show their breasts to others, and want to improve the size and the shape of their breasts. Correcting these types of problems is more challenging, but at the same time, quite rewarding.
Mild tubular breast deformity with constricted base was corrected with sub-pectoral breast augmentation (behind the muscle) and internal release (no lift needed)
Tubular Breast Abnormality is a Congenital Breast Deformity
While present at birth, the full extent of the tubular breast deformity is often not appreciated until puberty. This is when the breasts normally develop, and the full extend of abnormalities are revealed. While women with tubular breasts have smaller than average sized breasts, not all small breasts are tubular breasts. While the extent to which the deformities manifest can vary widely, several specific abnormalities are present.
Signs and Presentation of Tubular Breast Abnormality
Besides smaller size, the main components of the tubular breast are a constricted base and a tubular shape to the breast. This can be exacerbated by herniation of the breast tissue into the areola, causing “puffy nipples”. Technically, the nipple is not affected, but the areola, the colored skin around the nipple, may project out from the breast mound. The overall effect is an elongated or tubular shape to the breast. The true tubular shape is most noticeable in more severe cases.
The colloquial name for tuberous breasts is the Snoopy Nose or Snoopy’s Nose deformity. Snoopy is Charlie Brown’s white beagle of Peanuts fame. Picture the front of Snoopy’s muzzle. If you are not familiar with Snoopy click the link above. His white face represents the breast mound, his black nose sits like a ball on the end, and represents the herniated breast tissue filling the areola.
Treatment of the Tuberous Breasts
As mentioned above, tubular breasts tend to not fully develop. Often patients with tubular breasts desire breast augmentation to increase the size of their breasts. For mild tubular breast deformity, a breast implant may be sufficient treatment. When the breasts are more tubular, additional maneuvers are necessary to provide an enhanced result.
If the areola is overly full, a periareolar lift can reduce the puffy nipples, and prevent the breast tissue from herniating. Unlike for men, the breast tissue is not usually removed, just pushed back into its normal anatomical position. The constricted base seen with tuberous breasts also tends to shorten the distance between the areola and the base of the breast. The lift has the additional benefit of moving the areola higher on the breast, helping to center the nipple on the breast mound.
Moderate tubular breast deformity with constricted base, elongated breast and mild areolar breast tissue herniation, best seen in right breast (your left). Both size and shape were corrected with breast augmentation and peri-areolar lifts.
Traditionally, tubular breast were treated with breast implants placed in front of the muscle. With a periareolar lift, it usually possible to place the implant behind the muscle. This gives a more natural appearing breast mound, and makes it easier to perform mammography in the future. While silicone and saline breast implants can both give good looking results, for smaller breast, a silicone gel implant may give a better feeling result. It is important to discuss the pro’s and con’s of each option with your Board Certified Plastic Surgeon.
Tubular Breast Deformity in Men
In men, tubular breast deformity presents as an overly full areola or “puffy nipples”. Since men like flat chests, tuberous breasts are easily treated in with resection of the excess tissue. The procedure is similar to that used for Gynecomastia. A small “smiley-face” incision is made from 4 to 8 o’clock around the lower edge of the areola, and the excess glandular tissue is removed. The procedure provides a smoother contour, and a quick recovery.
Dr. Joseph Mele appears on KRON4's Body Beautiful.
To celebrate the debut of the new San Francisco Breast dot com (SanFranciscoBreast.com), a site dedicated to cosmetic breast surgery for the San Francisco Bay Area, I will be dedicating my appearance on Monday’s Body Beautiful on KRON4 to the breast. Breast augmentation, breast lifts, breast reductions, breast implant revisions, everything related to enhancing the breasts is open for discussion.
Body Beautiful is broadcast live at 11:00 AM on KRON4, so tune in and phone in with your breast questions. Whether you have had breast surgery, or are considering it, the show will cover a variety of topics. For a preview of what’s in store visit SanFranciscoBreast.com.
What’s new in Breast Enhancement Surgery?
The new web site is a comprehensive and authoritative review of the latest techniques in aesthetic breast surgery. Located in the San Francisco East Bay Area city of Walnut Creek, Plastic Surgeon, Joseph Mele, has lent his years of experience, and breast expertise, to this free patient education resource. The site is illustrated with graphics, videos and before and after pictures, and there is more to come. The list of topics covered is long and includes:
I look forward to hearing from you on Monday. If you will not be able to watch KRON4 at 11 AM on Monday, December 13, 2010, and you have a question you want answered, you can send your question via the contact form to the left. I will send you a personal response, and perhaps your question will be answered live during Body Beautiful.
San Francisco plastic surgery patients have an extensive new local resource encompassing all aspects of cosmetic breast enhancement surgery. I have consolidated my years of experience, and the common questions that my patients ask, to create a site that is both informative and understandable. If you are considering cosmetic breast surgery, SanFranciscoBreast.com is a comprehensive collection of consumer information.
The web site is illustrated with videos and before and after pictures. The list of topics covered is long and includes:
SanFranciscoBreast.com is a specialty site dedicated to all aspects cosmetic breast surgery. Since the site is focused only on the breast, it gives me the opportunity to describe each procedure in detail, and to provide you with specific information to help you make an informed decision.
Radiant Life – RLM Success Files features breast augmentation by Dr. Joseph A. Mele.
As seen in Radiant Life Magazine. (Click to enlarge.)
Radiant Life® Magazine is The Aesthetic Wellness Magazine, and is dedicated to innovations in cosmetic plastic surgery. The current issue of Radiant Life® features an article by Lindsay Haakenson on the latest innovations in Breast Augmentation entitled Breast Surgery 2.0.
Radiant Life Magazine approached me with a short deadline and the need for an example of modern breast augmentation. My staff contacted a few of our many satisfied patients. Jennifer was the first to respond, and she immediately agreed to both an interview with Radiant Life Magazine and the use of her pictures, and for that she gets my sincere thanks. This is a true testimonial* to how worthwhile breast augmentation surgery has been for her. Thanks goes out to my other happy patients who also graciously responded, and to Lindsay Haakenson for including me.
Jennifer first came into the office for a consultation after noticing her breast volume had decreased after pregnancy. She was interested in restoring what mother nature had both given and then taken away. She expressed a desire to maintain proportions with her body, and wanted a natural look that would be attractive, without being distracting.
The excerpt to the right is from the Breast Surgery 2.0. At the top are her breast augmentation before and after pictures. Before submuscular (subpectoral) breast augmentation, her breasts where asymmetrical, small, had a relatively low set nipple and a constricted base. The distance between the nipple and the inframammary fold was short, and the remaining breast tissue was firm. She had a mild form of what is sometimes referred to as a tubular breast.
The simplest way to correct a tubular breast is with a subglandular breast augmentation. Often a periareolar mastopexy is performed to lift and reshape a protruding nipple/areolar complex at the same time. Okay, that may not sound so simple, and in Jennifer’s case, the easiest way was not necessarily the best way.
Every patient requires careful thought and consideration. In Jennifer’s case, the tubular deformity was mild, and a periareolar breast lift was not needed. The lack of breast tissue higher on the chest meant that the upper pole of the implant was more likely to be seen. A saline implant was placed behind the muscle to help soften the upper pole of the implant, and to give a more teardrop shape. A periareolar incision was used, and this, as is usual, healed very well.
For a more pronounced tubular breast deformity, this approach may not work. Unlike the approach using a periareolar lift, it will not correct a bulging areola that is often seen in concert with the narrow constricted breast base. If you are considering breast augmentation, it is important to seek a qualified and experienced, board certified plastic surgeon, so that the safest and most predictable plan can be constructed.
I want to thank Jennifer for volunteering to share her results with you. The best part of my job is helping my patients. I am thrilled that Jennifer is happy with the results of her breast augmentation.
* As per the latest American Society of Plastic Surgeons Code of Ethics this is a true testimonial. I have not reimbursed my patient in any way for her kind words, and I have not paid Radiant Life Magazine to be included in this article. To read the entire Radiant Life Magazine article, click here. You need to be able to view pdf files in order to display the contents properly. To download the latest version of Adobe Reader for free click here.
Whether you are considering breast enhancement, or already have breast implants, this video discusses the most frequent reasons why corrective surgery is needed and includes before and after pictures and live viewer questions.
This is part two of two from an episode of KRON 4′s Body Beautiful with Vicki Liviakis that aired last month. This video discusses breast augmentation revision surgery, including before and after pictures and viewer questions.
Specific examples are shown. The first patient (shown below) had breast augmentation in her twenties. Years later, she had children and was not happy with the changes in her breast resulting from pregnancy and breast feeding. Before and after breast augmentation revision surgery pictures are shown. In her case a breast implant exchange and breast lift and were performed to adjust for lost volume and improve the shape of the sagging breasts.
A different patient had breast implant bottoming out. In her case the implants had fallen below the inframammary fold leaving the nipples high and flattening out the normal curve beneath the breast. Corrective beast augmentation surgery included breast implant implant exchange to adjust the volume, and the inframammary fold was reconstructed internally to raise the implant and form a distinct curve beneath the breast.
The caller in this video had a question about ruptured silicone gel implants that were placed in the 1970′s. If any breast implant has ruptured, it needs to be removed. Most frequently, a ruptured breast implant is replaced at the same operation. Silicone gel implants in particular should be removed sooner than later. A ruptured silicone gel implant, over time, can cause increased scarring and hardening of the breasts, as the body tries to wall off the free gel. If not treated promptly, this type of scarring can lead to further problems than may not be correctable.
Silicone gel filled implants placed before 1985 seem to have a higher deflation rate than the new silicone breast implants. In fact, the outer shell of silicone breast implants has changed twice since the 70′s. The first change, in the mid 80′s, was to decrease the rupture rate. The second change, in the mid 90′s, was to reduce gel bleed (the ability of the silicone gel to leak through outer shell without a rupture). Both US FDA approved breast implant manufactures, Allergan and Mentor, offer lifetime replacement of their implants should they fail, and often provide financial support should this occur within ten years of your breast augmentation procedure. For details of the Mentor and Allergan (Natrelle) Breast Implant Warranties click on the manufactures names. It is best to get the information direct from the manufacturer; however, the Mentor site has been going through some changes, perhaps with the merger with Johnson & Johnson, so if you can’t link there, JustBreastImplants.com also has information on breast implant warranties.
