Breast Augmentation Revision Surgery – SF Bay Area

Posted September 02, 2019 in Breast Asymmetry, Breast Augmentation, Breast Augmentation Lift, Breast Implant Removal, Breast Implant Revision Surgery, Breast Lift (Mastopexy), Capsular Contracture, Home

Breast Implant Revision Surgery is performed when there is a problem with the breast implants. Some problems are subjective, for example when the implants are judged to be too small or too large. Other problems are objective, such as issues with the breasts’ shape, firmness, symmetry or position. These are commonly associated with Capsular Contracture and breast implant malposition. A third group of breast implant problems require urgent attention, like infections or exposure of the breast implants.

Today’s post reviews Breast Revision Surgery and the treatment for some of the more common Breast Augmentation Problems.

Capsular Contracture Correction

Capsular Contracture occurs when the normal pocket that holds the breast implant in place becomes tight. It can be tight all around the implant causing firmness and a reduction in the apparent size of the implant(s), or it can be along one side, pushing the implant out of position, usually upward.

Breast Implant Revision for Capsular Contracture Before and After Pictures - Front View

These breast augmentation revision before and after pictures show grade III/IV capsular contracture of the right breast preoperatively, and the result of removing the tight capsule (capsulectomy) thus lowering the breast mound to match the left side. (Click image for uncensored view.)

In the Breast Implant Revision Before and After Pictures above, the right breast mound is significantly higher, and harder, than the normal appearing left breast mound (Grade III Capsular Contracture). This is a problem for the patient both in and out of clothing, and with time, the right breast has become tender (Grade IV Capsular Contracture).

This Breast Implant Malposition was treated with a complete capsulectomy, removal of the tight scar. The result is a softer breast, that is lowered back to its normal and symmetrical position. The areolae are also more symmetrical postoperatively. To see the nipple position, click or touch the picture above and the censoring will be removed. Tap again to replace it.

Symmastia Correction for Uniboob

Symmastia is a specific type of Breast Implant Malposition where the implant(s) move toward the midline. It is more common in women with tighter skin and larger, high profile breast implants. Just like raising the towers on the Golden Gate Bridge would raise the bridge’s cables across the mouth of the San Francisco Bay, the high profile breast implants have raised the skin across the sternum causing a Uniboob Deformity or “Bread Loafing”. In addition, this patient has “bottoming-out” of her breast implants, greater on her right side.

Breast Implant Revision for Symastia or Uniboob Before and After Pictures - Front View

These breast augmentation revision before and after pictures show symmastia of the breasts and bottoming out (right greater than left) preoperatively. The after photo shows the result of symmastia repair and breast implant replacement with smaller breast implants and raising of the inframammary folds (IMFs) thus getting rid of the uniboob bread-loafing of the implants in the midline. (Click image for uncensored view.)

The Symmastia Deformity was corrected by both repairing the damage and addressing the original problem to prevent recurrence. The damage was repaired by closing the original capsule medially, forming a pseudoneopocket in the correct anatomical position and reinforcing the repair. Since the original cause was breast implants too large for the chest, they were replaced with smaller implants. The after picture shows that the breasts have been elevated and separated into two separate breast mounds. Breast symmetry is improved and the reduction in breast implant size should help to maintain the superior cosmetic result.

Stage 1 – Breast Implant Removal for Impending Exposure

Breast Implant Exposure and Breast Implant Infections are emergencies, and require prompt surgical intervention. In the picture below, the square area at the base of her left breast is the lower edge of the breast implant which is about to erode through the breast skin. Once exposed, infection is inevitable, so the implant was removed promptly to prevent this eventuality.

Breast Implant Removal for impending breast implant exposure Before and After Pictures - Front View

These breast augmentation revision before and after pictures show stage one of treatment for breast implant exposure. Once an implant is exposed, it requires removal to prevent infection and sepsis. The after photo reveals that the left breast was smaller before breast augmentation, confirmed by the removal of a larger breast implant during surgery. (Click image for uncensored view.)

An inframammary incision was used to remove the breast implant, and the damaged skin at the base of the breast was also removed to allow for a secure closure. Her left breast implant was larger than the right, because her left breast was smaller than her right breast before Breast Augmentation. The size discrepancy is apparent in the after picture

Stage 2 – Breast Implant Replacement after Exposure

After breast implant infection or exposure, a minimum of three months is allowed to pass before replacing the breast implant. This is to reduce the risk of another infection. After three months, the patient returned to the operating room for delayed Breast Implant Replacement.

Breast Implant Replacement after breast implant exposure Before and After Pictures - Front View

These breast augmentation revision before and after pictures show stage two of treatment for breast implant exposure. After the breast implant is removed, and the site heals for several months, the breast implant can be replaced. The after photo shows the restoration of symmetrical breast mounds after Asymmetrical Breast Augmentation. (Click image for uncensored view.)

The before and after pictures above show the results of the second stage of reconstruction. The breast implants were replaced without complications, and the patient was happy to have her figure back.

Breast Augmentation Revision Consultations

If you are considering Breast Augmentation Revision be certain to consult with an experienced and Board Certified Plastic Surgeon in your area.

If you are in the San Francisco Bay Area, call (925) 943-6353, to schedule a private consultation appointment in my Walnut Creek, CA, plastic surgery office.

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Breast Implant Removal in the San Francisco Bay Area

Posted August 26, 2019 in Breast Implant Removal, Breast Implant Revision Surgery, Home

Breast Implant Removal is performed for about 1% of all Breast Augmentation patients. It is not a common procedure. Often it is elective, but sometimes it is as necessary as it is unwanted.

Breast Implant Removal Before and After Pictures - Side View

These breast implant removal before and after pictures show the result of removing moderate sized breast implants from a woman with young, elastic skin. No lift was needed. (Click image for uncensored view.)

Why Breast Implants Are Removed

Breast Implant Removal is chosen for many reasons ranging from completely elective to emergency situations. Elective reasons include the desire to have smaller breast, anticipating pregnancy and breast feeding and even a desire to exchange the current breast implants for larger ones. Urgent situations include exposure and infection of the implants.

How Are Breast Implants Removed?

Breast Implant Removal With Breast Lift Before and After Pictures - Side View

These breast implant removal before and after pictures show the result of removing ptotic, “bottomed-out” breast implants with a Breast Lift performed at the same time. (Click image for uncensored view.)

Breast Implants are often removed during a relatively short outpatient procedure through the same incisions originally used to place them.

For Saline Breast Implants, after a small incision is made the implants are deflated and then removed. The empty shell allows removal through a smaller incision.

Silicone Breast Implants are not deflated prior to removal to avoid leaving silicone inside the breasts. If silicone breast implants are already ruptured, the capsule is often removed to contain the extravasated silicone and to prevent gel migration.

Breast Implant Removal Recovery

Breast Implant Removal Before and After Pictures - Side View

These breast implant removal before and after pictures show the result of removing large breast implants from breasts with less elastic skin. No lift was performed, so the skin sags after the loss of support previously provided by the breast implants. (Click image for uncensored view.)

Recovery after Elective Breast Implant Removal is normally just a few days. If a capsulectomy is performed, a drain is often placed, and it may take longer for the swelling to subside. Aesthetically, the appearance of the breasts continues to improve for several months as the skin recoils postoperatively.

BioCell® Textured Breast Implants

Since the recall of BioCell® Textured Breast Implants a few weeks ago, I have received several phone inquiries regarding breast implant removal. This textured surface is associated with a small risk of developing BIA-ALCL; however, the FDA’s current recommendation is to leave the implants in place and follow them clinically for signs and symptoms including enlargement due to fluid collections around the implants and swelling.

Despite the FDA’s current recommendations, some patients feel more comfortable having their BioCell® textured breast implants removed or replaced. Allergan® will provide smooth replacement implants at not charge (until July 24, 2021). Since the FDA does not recommend removal, there is no financial support available for the elective surgical removal of BioCell® textured breast implants.

Breast Implant Removal Consultations

If you are considering elective Breast Implant Removal, be certain to consult with an experienced and Board Certified Plastic Surgeon. In cases with larger implants and skin laxity, a Breast Lift may be recommended, either at the time of breast implant removal or staged after recovery.

An experienced plastic surgeon can discuss these and other options with you and offer personalized guidance during an in-person consultation appointment. To schedule a private consultation in our Walnut Creek plastic surgery office call (925) 943-6353.

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Breast Implant Revision Before and After Pictures – Capsular Contracture SF Bay Area

Posted July 22, 2019 in Breast Asymmetry, Breast Augmentation, Breast Implant Removal, Breast Implant Revision Surgery, Home

Breast Augmentation Revision for Capsular Contracture

Breast Augmentation Revision for Capsular Contracture. Notice the decreased volume, increased hardness and irritated red color in the before picture on the left. After release, the breast are softened and expanded. (To view uncensored before and after photos, click on the image.)

There are many different reasons for Breast Implant Revision Surgery. Possible causes include:

  • Capsular Contracture
  • Breast Implant Malposition:
    • Too high
    • Too Low (Bottoming out)
    • Too close (Symmastia, Uniboob, Bread loafing)
    • Too far apart (in the armpits)
  • Breast Implant Deflation
  • Breasts sagging off implants (Waterfall deformity)

Capsular Contracture

One of the most common reasons for Breast Implant Revision Surgery is Capsular Contracture. So what is the capsule and what is contracture?

When you have Breast Augmentation, a pocket is created for the breast implant behind the native breast tissue. As this pocket matures, your body creates a thin layer of scar around the breast implant. This scar pocket is called the capsule, and it is very important because the capsule holds the breast implant in place, preventing it from migrating. Capsular Contracture occurs when the scar lining the breast implant pocket contracts, squeezing and distorting the breast implant.

Breast Augmentation Revision for Capsular Contracture Unilateral

Capsular contracture often affects just one side. In the case above, the right breast implant is higher and tighter than the left before surgery. After surgery symmetry is restored.
(To view uncensored before and after photos, click on the image.)

The above patient has mild capsular contracture affecting only her right breast. She was able to compensate for the difference in upper pole fullness by tightening her left bra strap. During the Breast Augmentation Revision, a capsulotomy was performed to expand the right breast capsule and lower the right breast implant.

Grades of Capsular Contracture

A scar around the breast implant is normal. Without the scar pocket, the breast implant will bottom out and move to the sides. On the other hand, too much scar causes problems with implants riding too high or becoming too hard.

Capsular Contracture is normally classified into four grades (I-IV), but I like to add grade zero for malposition problems caused by not enough scar support.

  • Grade 0 – not enough support causing breast implant malposition
  • Grade I – normal soft
  • Grade II – firm but no visible distortion of breast shape
  • Grade III – hard causing visible distortion of the breast shape
  • Grade IV – like grade III but is also painful

Breast Augmentation Revision for Capsular Contracture Unilateral

Severe unilateral capsular contracture – The right breast so high that it would be hard to disguise in clothing. After treatment for capsular contracture, the breasts are much more even.
(To view uncensored before and after photos, click on the image.)

The patient above has severe contracture of the right breast, which was noticeable both in and out of clothing. A capsulectomy was performed to remove the previous capsule, expand the pocket, lower the breast implant and reset the formation of a new capsule. Now both her breasts are soft and even.

Breast Implant Revision

If you have Breast Implants but are unhappy with their size, placement or firmness, Breast Implant Revision is worth considering. To schedule a private consultation, call (925) 943-6353, today. Breast Implants have changed in the last few years, and there are new options available.

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Mommy Makeovers After Children (Video) | SF Bay Area

Posted April 08, 2019 in Breast Augmentation, Breast Lift (Mastopexy), Breast Reduction, Home, Liposuction, Mini Tummy Tuck (Mini Abdominoplasty), Mommy Makeover, Tummy Tuck (Abdominoplasty), Videos

Mommy Makeovers include breast and belly enhancement in one surgery.

Mommy Makeovers include breast and belly enhancement in one surgery.

No matter what shape you are in before childbirth, the postpartum physique is rarely an improvement. Pregnancy can wreak havoc on a woman’s body. Cosmetic Surgery Repairs after having children are done so frequently, there’s a name for it: Mommy Makeover. Today’s video is all about the Mommy Makeover, and its many variations.

Breast Augmentation and Tummy Tuck Video (Mommy Makeover)

This Mommy Makeover Video is from my Body Beautiful television show broadcasted on the San Francisco Bay Area’s News Station, KRON 4. It reviews the techniques and options available for different types of Mommy Makeovers.

What Is A Mommy Makeover?

The Mommy Makeover has two goals: to enhance the shape of the breasts and to flatten the belly. With pregnancy, the breasts enlarge and then often shrink and collapse. Breast Augmentation and Breast Lifting are used to enlarge and lift the breasts. On the other hand, if the breast remain too large after pregnancy, a Breast Reduction can be substituted to improve breast and body proportions. The differences and options for Breast Augmentation and Breast Lifts are discussed further here: Breast Augmentation or Breast Lift?

For the belly, a Tummy Tuck is the workhorse that dramatically improves the appearance of the abdomen by tightening the abdominal muscles and skin, and by removing excess fat. When abdominal laxity is confined to the area below the belly button, a Mini Tummy Tuck may be the procedure of choice to restore a pre-baby toned belly. Lastly, if the skin and muscle tone are good, but disproportionate fat is bothersome, Liposuction alone may be the answer. The differences between the procedures are discussed here: Liposuction or Tummy Tuck?

Mommy Makeover Consultations

If you are considering a Mommy Makeover, or its component cosmetic procedures, Breast Augmentation or Tummy Tuck, be certain to consult with an experienced, Board Certified Plastic Surgeon. In the San Francisco Bay Area, call (925) 943-6353, and schedule a personal and private consultation appointment today.

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Saline Breast Implants – SF Bay Area Breast Aug Surgery

Posted February 11, 2019 in Breast Augmentation, Breast Implant Revision Surgery, Home

All breast Implants create larger breasts. While Silicone Breast Implants are more widely used, Saline Breast Implants still have a role to fill.

All breast Implants create larger breasts. While Silicone Breast Implants are more widely used, Saline Breast Implants still have a role to fill.

Over 90% of today’s Breast Augmentation patients choose Silicone Gel Breast Implants, but Saline Breast Implants still play a role in selected situations. Today, I review the pros and cons of Breast Augmentation with Saline Breast Implants.

Saline Breast Implant Cost Less

Saline Breast Implants cost less than Silicone Breast Implants. Since saline breast implants are easier to manufacture, they cost less. Also, saline breast implants are not pre-filled. The saline is actually inserted during surgery by your surgeon.

Saline Breast Implant Leak Detection

Saline is water with a little salt added to make it as salty as we are, about 0.9% NaCl.

Saline is water with a little salt added to make it as salty as we are, about 0.9% NaCl.

With Saline Breast Implants, leak detection is simple. When they leak, the slightly salty water inside escapes and is quickly absorbed by the body. The result is noticeable deflation, usually occurring overnight. Unlike Silicone Breast Implants, expensive diagnostic imaging, MRI is not needed. Saline Breast Implants are also easier to replace, because only the shell needs to be removed.

Saline Breast Implant Projection

Until recently, Saline Breast Implants provided more projection than silicone breast implants. When saline implants are filled, they become firmer and have more projection. For the same volume, Saline Breast Implants have about 10% more projection. Additionally, Silicone Breast Implants are flat on the back side, while Saline Breast Implants are convex.

Saline Breast Implants are convex on the back, so they give more projection than the flat-backed Silicone Breast Implants for the same volume.

Saline Breast Implants are convex on the back, so they give more projection than the flat-backed Silicone Breast Implants for the same volume.

Saline Breast Implant Incision Size

Saline Breast Implants are inserted empty, so the surgical incision is small. They can be collapsed and then filled after they are inserted by way of a filling tube. On the other hand, Silicone Breast Implants come pre-filled, thus they are bigger and require a larger incision for placement.

Saline Breast Implant Drawbacks

Saline Breast Implants feel firmer, tend to ripple (wrinkle) more and move differently than Silicone Breast Implants. For women going up one cup size, there may be enough native breast tissue to disguise the implant. However, for those going from an A-cup to a D-cup, the implant is more palpable, even when the Breast Implant is placed behind the muscle.

Breast Augmentation Consultation

The difference between Saline and Silicone Breast Implants is just one consideration before Breast Augmentation surgery. While the Internet can provide general information, consulting with an experienced, Board Certified Plastic Surgeon will help you translate which options will work best for you.

If you are in the San Francisco Bay Area, call (925) 943-6353 today, and schedule a private Breast Augmentation Consultation.

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Silicone Breast Implant Warranty Comparisons

Posted January 28, 2019 in Breast Augmentation, Breast Augmentation Lift, Breast Implant Revision Surgery, Breast Reconstruction, Home, Patient Safety

Breast Implant Warranty Coverage

Every few years, the US FDA approved breast implant manufacturers update their Breast Implant Warranties. While implant deflation has been covered for a long time, the warranties now include extended coverage for breast implant replacement and enhanced coverage for specific situations that may occur after Breast Augmentation with Silicone Gel Filled Breast Implants. Expanded coverage now includes Capsular Contracture, late seroma formation, double capsule formation and BIA-ALCL.

Below, I compare warranties offered by the three US breast implant brands: Allergan, Sientra and Mentor, in the three major areas of coverage: Capsular Contracture, Rupture and Seroma Formation. It is important to state that these are the current offerings, and that they may change without notification. You should check with the manufacturer directly for the latest warranty information. Additionally, newer coverage is limited to newer implants, so you need to know the manufacturer, type of implant and the date of your surgery in order to determine which warranty applies to your implants.

Capsular Contracture Coverage

The most common reason for Breast Augmentation Revision Surgery is Capsular Contracture. In the breast implant 10-year follow-up studies, occurrence rates ranged from 12% to 19% for the primary breast augmentation cohort. Breast Implant manufacturers have begun to include Capsular Contracture in their warranty programs.

Capsular Contracture is tightening of the scar pocket that holds the breast implant in place. In the left before-photo, Capsular Contracture elevates this patient's right breast implant and causes severe asymmetry. The right after-photo shows correction after capsule surgery and breast implant revision surgery. Now, Capsular Contracture is covered by all three US FDA approved manufacturers' warranties.

Capsular Contracture is tightening of the scar pocket that holds the breast implant in place. In the left before-photo, Capsular Contracture elevates this patient’s right breast implant and causes severe asymmetry. The right after-photo shows correction after capsule surgery and breast implant revision surgery. Capsular Contracture is now covered by all three US FDA approved manufacturers’ warranties.

Sientra currently offers the best free warranty for Capsular Contracture (grade III or IV). The latest Sientra Platinum20 Warranty offers twenty years of free implant replacement during surgery for Capsular Contracture along with $2000 of financial assistance if capsular contracture occurs in the first two years after surgery.

The Allergan ConfidencePlus Warranty was just updated and is a close second with ten years of free implant replacement during surgery for Capsular Contracture along with $2000 of financial assistance if capsular contracture occurs in the first two years after surgery.

The MentorPromise Warranty offers ten years of free implant replacement during surgery for Capsular Contracture, but no financial assistance. However, Mentor does offer an enhanced warranty. You need to pay $300 to Mentor at the time of your surgery to obtain the MentorPromise Enhanced Warranty. This includes ten years of free implant replacement during surgery for Capsular Contracture and $3500 of financial assistance but limits coverage to primary augmentation or primary reconstruction unless MemoryShape breast implants are utilized. Mentor currently lags, especially when comparing the free warranties; however, Mentor may update their warranty to more closely match their competitors as Allergan did when Sientra announced enhanced free coverage for capsular contracture.

Rupture Coverage

Breast Implant Rupture was the original coverage benefit for Breast Implant Warranties. It is a close second to Capsular Contracture as the reason for Breast Augmentation Revision Surgery. In the 10-year follow-up studies, rupture (deflation) rates range from 8% to 25%.

These Breast Implant Rupture Before and After photos illustrate a common case of Breast Implant Revision Surgery. The coverage is variable and depends on the manufacturer.

These Breast Implant Rupture Before and After photos illustrate a common case of Breast Implant Revision Surgery. The coverage is variable and depends on the manufacturer.

All three manufacturers provide free lifetime breast implant replacement on both sides and financial assistance for the revision surgery. Recently, Sientra increased the financial assistance offered, and it remains to be seen if the other manufactures will match them, as they often do.

The Sientra Platinum20 Warranty offers $5000 in financial assistance toward replacing the breast implants for up to 20 years after the original surgery. This is a recent change and is currently the best in the industry.

The Allergan ConfidencePlus Warranty offers $3500 in financial assistance toward replacing the breast implants for up to 10 years after the original surgery.

The MentorPromise Warranty also offers $3500 in financial assistance toward replacing the breast implants for up to 10 years after the original surgery. This is not increased in the MentorPromise Enhanced Warranty.

Late Seroma Coverage

As shaped implants became more popular, so did the problems associated with them. Shaped implants can rotate and “change” shape. To reduce this problem, shaped implants are textured. This can help prevent rotation and may also reduce the risk of capsular contracture; however, Textured Breast Implants also have unique problems: seromas (collections of fluid around implants), double capsules and possibly BIA-ALCL. Manufacturers have responded with late seroma coverage along with coverage for double capsules and BIA-ALCL diagnostic testing in their latest Breast Implant Warranties.

Seromas are collections of fluid. Small amounts of fluid around the breast implants is normal the first few days after surgery and resolves spontaneously. Seromas that appear years after surgery are not normal or common. The fluid will enlarge the effected breast, making it appear larger than its sister breast. It may present as the picture above shows, with the right breasts appearing larger than the left. There are many causes, most of them benign; however, all should be checked by your plastic surgeon. Breast implant warranties are starting to include testing and treatment for late seromas.

Seromas are collections of fluid. Small amounts of fluid around the breast implants is normal the first few days after surgery and resolves spontaneously. Seromas that appear years after surgery are not normal or common. The fluid will enlarge the effected breast, making it appear larger than its sister breast. It may present as the picture above shows, with the right breasts appearing larger than the left. There are many causes, most of them benign; however, all should be checked by your plastic surgeon. Breast implant warranties are starting to include testing and treatment for late seromas.

The Sientra Platinum20 Warranty provides twenty year coverage for breast implant replacement and $2000 in financial assistance should a double capsule or seroma form in the two years after surgery. They also provide CD30 panel testing for BIA-ALCL evaluation of late seroma fluid.

The Allergan ConfidencePlus Warranty also was recently updated to provide twenty year coverage for breast implant replacement and $2000 in financial assistance should a double capsule or seroma form in the two years after surgery. They also provide up to $7500 in financial assistance and implant replacement in cases of BIA-ALCL.

The MentorPromise Warranty offers ten year coverage for breast implant replacement and no financial assistance in cases of double capsule and seroma formation. However, Mentor does offer an enhanced warranty. You need to pay $300 to Mentor at the time of your surgery to obtain the MentorPromise Enhanced Warranty. This includes ten years of free implant replacement during surgery for Capsular Contracture and $3500 of financial assistance in the ten years after surgery. Like the Mentor Capsular contracture coverage, coverage is limited to primary augmentation or primary reconstruction unless MemoryShape breast implants are utilized. There is currently no coverage for BIA-ALCL testing.

Breast Augmentation and Breast Augmentation Revision

If you are considering Breast Augmentation or Breast Augmentation Revision, be certain to ask your Board Certified Plastic Surgeon about breast implant warranties. For revision surgery, bring as much information as possible about your current implants to your consultation appointment. The breast implant card given to you after surgery is very helpful as it provides the manufacturer, size, type of implant, and date of implantation.

There is much to know about Breast Implants and the procedures used to place and maintain them. It helps to have an experienced guide to answer your questions and provide expert guidance. For Breast Augmentation and Breast Augmentation Revision in the greater San Francisco Bay Area, call (925) 943-6353 today, to schedule a private consultation.

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Breast Implant Revision SF Bay Area

Posted September 25, 2017 in Breast Asymmetry, Breast Augmentation, Breast Augmentation Lift, Breast Implant Revision Surgery, Home, Videos

Breast Augmentation with Breast Implants remains the most popular cosmetic plastic surgery. Three to four-hundred-thousand women have Breast Augmentation each year in the US alone. It is the safest and most effective means of enlarging the breasts available, but even FDA approved devices, like Breast Implants, need touch-ups from time-to-time.

Do I Need Breast Implant Revision Surgery?

The following Breast Implant Revision Surgery Video originally aired on the San Francisco Bay Area‘s news Station, KRON 4. It reviews Breast Augmentation Revision Options and describes some of the most common breast augmentation revisions. Multiple before and after pictures are included as examples.

Breast Augmentation Revision Surgery Video

Breast Implant Deflation

The introductory photo for the video above shows deflation of this patient’s left breast implant. For Saline Breast Implants, loss of the breast implant’s shell integrity results in complete deflation and loss of breast augmentation. Replacement of a deflated breast implant can be done with minimal downtime. It is also a good time to consider if your breast implants are the right size, profile or style (saline vs silicone), as there is no better time to replace both implants. In situations like the above, it is extremely helpful if you know what type and size of breast implants you have.

Breast Implant Revision – Bigger

The most common reason for Breast Augmentation Revisions is to go bigger. This is especially common after pregnancy with preexisting breast implants as shown above.

The most common reason for Breast Augmentation Revisions is to go bigger. This is especially common after pregnancy with preexisting breast implants as shown above.

The above Breast Implant Revision Before and After Pictures show two common reasons for revision. The first, and the most common, is to go larger. The second, and often seen after pregnancy with preexisting breast implants, is to correct breast tissue sagging off the breast implants.

This patient has already had a Breast Augmentation Mastopexy, also known as a breast lift, using breast implants for additional volume. The larger the preexisting breast tissue volume, the more likely the breast is to sag. This is true with or without breast implants. She desired larger breasts and a perkier appearance. A larger Breast Implant provides both additional volume and support for her breasts.

Breast Implant Revision – Smaller

The above Breast Augmentation Revision pictures demonstrate the correction of bottoming out.

The above Breast Augmentation Revision pictures demonstrate the correction of bottoming out.

Sometimes, the breast implants are too large to be supported. The before picture, in the above Breast Augmentation Revision Before and After Pictures, demonstrates what happens when breast implants are too large, even with a breast lift. Over time, the Breast Implants have over-stretched the skin of the lower breast and moved down the chest. The previous breast lift (mastopexy) scar is red and irritated, and the nipple is riding high. This patient presented with a desire for correction of the shape of her breasts, and also wanted to be smaller.

The after photo shows the results after the mastopexy was revised and the breast implants were replaced with smaller, lower profile, Breast Implants. The mastopexy scar looks less irritated. The distance between the nipples and the bottom of the breast is reduced to normal. The new breast implants are smaller, but maintain the width of the breast to preserve cleavage.

Breast Implant Revision Surgery Consultations

With the popularity of Breast Implants it is not surprising that Breast Augmentation Revision Surgery has become its own specialty. If you have breast implants which are:

  • too small
  • too large
  • too high
  • too low
  • too close together
  • too far apart
  • too hard
  • deflated or leaking
  • not supporting your breast tissue

then give my San Francisco Bay Area Plastic Surgery Clinic a call at (925) 943-6353. With 20 years of experience, I will give you up-to-date options that are personalized to your unique situation. Previous operative reports and your before and after pictures help, so bring them with you, too.

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New Body Beautiful From Head to Tummy

Posted September 09, 2017 in Breast Augmentation, Breast Implant Revision Surgery, Breast Reduction, Breast Reduction (Men), Capsular Contracture, Ear Pinning, Ear Shaping (Otoplasty), Home, Tummy Tuck (Abdominoplasty)

Dr. Mele discusses Cosmetic Plastic Surgery on Body Beautiful - September 12, 2017, at Noon.

Dr. Mele discusses Cosmetic Plastic Surgery on Body Beautiful – September 12, 2017, at Noon.

Hey San Francisco Bay Area. Body Beautiful will be broadcast this Tuesday, September 12, at noon. You may not have noticed, but KRON 4 was acquired by Nexstar. The good news is that they have decided to continue Body Beautiful, so I’ve got new Plastic Surgery News to share with you.

Body Beautiful on KRON 4

KRON 4's Body Beautiful with Vicki Liviakis and yours truly on the San Francisco Bay Area's News Station.

KRON 4’s Body Beautiful with Vicki Liviakis and yours truly on the San Francisco Bay Area’s News Station.

I have been doing Body Beautiful live for the last 10 years. The original show was with host Vicki Liviakis, and we would take viewer calls live, on the air. It certainly added excitement. Since we were on the air live, even the “unusual” questions had to be answered.

The latest version of Body Beautiful with host Janelle Marie.

The latest version of Body Beautiful with host Janelle Marie.

Now Janelle Marie is the host, but the format remains the same. This week’s show was taped last week. Maybe KRON’s new management was a little nervous about an amateur, me, on the air live. But don’t worry, you can still submit questions for the show via email or the contact form here in the margin.

This Week’s Body Beautiful Discussion

This week’s show is dedicated to four Cosmetic Plastic Surgery Procedures:

The links above will take to more detailed information about these procedures.

Body Beautiful Airs Tuesday At Noon

Body Beautiful will be broadcast this Tuesday, September 12, at noon. Be sure to tune in or set your DVR. I you miss it, don’t worry. I will be posting the segments from the show here, and the San Francisco Plastic Surgery Blog and on my YouTube channel.

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Breast Implant Warranties – SF Bay Area

Posted July 30, 2017 in Breast Augmentation, Breast Implant Revision Surgery, Home

If you have Breast Implants, here's some peace of mind to help you chill this summer.

If you have Breast Implants, here’s some peace of mind to help you chill this summer.

Did you know your Breast Implants come with a manufacturer’s warranty? It’s true. All FDA approved Breast Implants in the US come with a Breast Implant Warranty automatically. The details of coverage have changed throughout the years, but here are the latest details for the summer of 2017.

The Big Three Breast Implant Manufacturers

In the US, there are currently three FDA approved Breast Implant manufacturers:

  • Natrelle® (Allergan)
  • Mentor (Johnson & Johnson)
  • Sientra

Below are the latest details. These have been fairly consistent over the last two decades; however, contact your breast implant’s manufacturer directly for the latest information.

Allergan Natrelle® ConfidencePlus® Warranty

Natrelle breast implants are manufactured by Allergen.

Natrelle breast implants are manufactured by Allergan.

The following applies to Breast Augmentation using Natrelle® breast implants performed on or after November 1, 2014.

Enrollment:

  • For Natrelle® Silicone Gel Breast Implants:
    • Automatic and Free
  • For Natrelle® Saline Breast Implants:
    • Standard Warranty: Automatic and Free
    • ConfidencePlus® Premier: Enroll within 45 days and pay $200

Coverage:

  • Natrelle® Silicone Gel Breast Implant coverage:
    • Lifetime FREE breast implant replacement for rupture
    • 10-year FREE breast implant replacement for grade III or IV capsular contracture
    • 10-year up to $3500 surgery cost assistance for rupture
  • Natrelle® Saline Breast Implant coverage:
    • Standard Natrelle® Saline Breast Implant coverage:
      • Lifetime FREE breast implant replacement for rupture (deflation)
    • Premier Natrelle® Saline Breast Implant coverage:
      • Lifetime FREE breast implant replacement for rupture
      • 10-year up to $2400 surgery cost assistance for rupture

Mentor® MentorPromise Warranty

Mentor breast implants are manufactured by Johnson & Johnson.

Mentor breast implants are manufactured by Johnson & Johnson.

The following applies to Breast Augmentation using Mentor® breast implants performed on or after May 1, 2017.

Enrollment:

  • For Mentor® Silicone Gel Breast Implants:
    • Basic warranty: Automatic and Free
    • Enhanced warranty: Enroll within 45 days and pay $300
  • For Mentor ® Saline Breast Implants:
    • Basic Warranty: Automatic and Free
    • Enhanced warranty: Enroll within 45 days and pay $200

Coverage:

  • Mentor ® Silicone Gel Breast Implant coverage:
    • Basic Mentor® Silicone Gel Breast Implant coverage:
      • Lifetime FREE breast implant replacement for rupture
      • 10-year up to $3500 surgery cost assistance for rupture
    • Enhanced Mentor® Silicone Gel Breast Implant coverage:
      • Lifetime FREE breast implant replacement for rupture
      • 10-year up to $3500 surgery cost assistance for rupture, grade III or IV capsular contracture, double bubble or late seroma
  • Mentor ® Saline Breast Implant coverage:
    • Basic Mentor® Saline Breast Implant coverage:
      • Lifetime FREE breast implant replacement for rupture (deflation)
    • Enhanced Mentor® Saline Breast Implant coverage:
      • Lifetime FREE breast implant replacement for rupture
      • 10-year up to $2400 surgery cost assistance for rupture

Sientra® Warranty

Sientra manufactures only silicone breast implants for use in the US.

Sientra manufactures only silicone breast implants for use in the US.

Sientra® offers the following Breast Implant Warranty on all their breast implants.

Enrollment:

  • For Sientra ® Silicone Gel Breast Implants:
    • Sientra warranty: Automatic and Free

Coverage:

  • For Sientra ® Silicone Gel Breast Implants:
    • Lifetime FREE breast implant replacement for rupture
    • 10-year up to $3600 surgery cost assistance for rupture
    • 5-year FREE breast implant replacement for grade III or IV capsular contracture

Breast Implant Warranty Updates

Breast Implant Manufacturers are constantly updating their warranties. Be certain to check with your Board Certified Plastic Surgeon and your Breast Implant’s manufacturer for the latest details.

If you are considering Breast Augmentation or Breast Implant Revision Surgery, give my San Francisco Bay Area Plastic Surgery Clinic a call today at (925) 943-6353.

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San Francisco Breast 2.0 Enhancement (Augmentation, Lift and Reduction)

Posted July 09, 2017 in Areolar Reduction, Breast Asymmetry, Breast Augmentation, Breast Augmentation Lift, Breast Implant Options, Breast Implant Revision Surgery, Breast Lift (Mastopexy), Breast Reduction, Breast Reduction (Men), Breast Reduction (Women), Capsular Contracture, Home, Inverted Nipples, Nipple Reduction, Tubular Breasts

New Breast Enhancement Content

SanFranciscoBreast.com has been completely updated. This update includes new content, and it is artfully illustrated with new breast enhancement videos and more before and after pictures. In addition, the fresh content is wrapped in a new skin, improving navigation for the small screen and the desktop alike.

New Breast Augmentation Information

The site includes new pages featuring the most requested Breast Enhancement Procedures. For example, the Breast Augmentation Information has been exploded into a dozen detailed pages including:

  • Breast Augmentation
  • Breast Implant Options
  • Breast Augmentation Incisions
  • Breast Implant Placement
  • Today’s Breast Implants
  • History of Breast Implants
  • Breast Implant Warranties
  • Breast Implant Care
  • Breast Augmentation Lift
  • Breast Augmentation Revision
  • An Expanded Breast Augmentation Photo Gallery
  • And Hours of Breast Augmentation Videos

Breast Implant Revision Surgery

The Breast Augmentation Revision Section includes pages devoted to specific problems like:

  • Capsular Contracture
  • Breast Implant Deflation
  • Breast Implant Infection
  • Breast Implant Malposition
  • Breast Implant Removal
  • Breast Implant Rippling
  • Breast Implant Scar Revision
  • Breast Implant Replacement
  • Breast Lifts (Mastopexy)

    The Breast Lift section includes details about five main options for Mastopexy. There are also pages dedicated to the combination of Breast Lift using Breast Implants and Areola Reduction.

    Breast Reduction for Women and Men

    Options for Breast Reduction for Women are also reviewed, as several techniques have evolved during the 20+ years I have been in practice. Breast Reduction for Men, also known as Gynecomastia Reduction, is covered with attention paid to the causes and the most current treatments available.

    Specialty Breast Procedures

    A section on the often overlooked details of Breast Enhancement is also included. San Francisco Breast’s Specialty Breast Pages include:

    • Inverted Nipple Correction
    • Areola Reduction
    • Nipple Reduction
    • Tubular Breasts
    • Poland Syndrome
    • Other Congenital Breast Abnormalities
    • Areola Reconstruction
    • Nipple Reconstruction

    A Plastic Surgery Web Site Dedicated to Breast Enhancement

    I have tried to create an all inclusive Breast Enhancement site designed to provide detailed information about the many Plastic Surgery options available for Breast Enhancement, whether that be Breast Enlargement, Breast Reduction or Breast Reshaping.

    While the San Francisco Breast web site in meant to provide information, it is just a starting point. The Internet cannot take the place of a thoughtful, in-person consultation with a qualified Board Certified Plastic Surgeon. If you would like to schedule a private, personalized consultation appointment call (925) 943-6353 today. My San Francisco Bay Area Plastic Surgery clinic specializes in helping you obtain the best possible results.

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