Correction of Breast Implant Complications
Dr. Hilton Becker is a recognized expert on Breast Implants. He has developed several adjustable breast implants and published numerous articles and book chapters on breast implant complications and how to treat them.
Breast Implant Complications May Be Related To:
- The Implant
- The Surgical Procedure
- The Patient
2. Capsular Contracture (hardening of the tissues around the implant)
3. Rippling (more common with saline and textured implants)
4. Abnormal Muscle Movement (causing distortion of implant)
5. Bottoming Out (implant in abnormally low position)
6. Sagging (of breast over implant; of implant)
– Size of Implant
– Symmastia (Implants touching in the middle)
Many patients who have undergone breast augmentation or breast reconstruction in the past have developed a variety of complications, many of these as a result of older techniques and implants.
Fortunately many advances have been made in this area that have greatly improved the result of revisional surgery. These include
- Newer implants – Smooth round cohesive gel implants
- Adjustable saline implants.
- Improved surgical techniques
- Use of the sub-fascial plane
- External expansion— Brava
- Micro fat injections (stromal derived stem cells).
- PRP – Platelet Rich Plasma
- biological scaffolds
Patient with sub-muscular breast implants and sagging
Following replacement of implants in sub-glandular position and ‘scarless’ breast lift
Dr. Becker is a recognized expert in both reconstructive and cosmetic breast surgery. He is therefore confident with all the techniques and makes them available to his patients.
Complications related to Saline implants
Although results with saline implants are generally good, the complications seen with saline implants may include:
- Rippling and thinning of the tissues
- Excessive sagging – if saline implants were placed above the muscle
- Distortion and excessive muscle movement if they were placed beneath the muscle
- Stretching of the areola
Fortunately, now that Silicone Gel Implants have been approved by the FDA, they offer a viable solution to many of the problems that were caused by saline implants.
“Our patients who have had problems with saline implants are delighted by the feel and shape of the new gel implants. By replacing gel implants above the muscle under the Fascia, abnormal movement is eliminated and a more natural shape and feel is restored.”
Complications following saline breast implant surgery are often related to the physical characteristics of saline verses that of breast tissue. Saline is heavier than breast tissue, and when confined to a flexible silicone bag it has more of a tendency to ripple, compared to a silicone gel implant. Saline implants therefore have a greater tendency to become ptotic (sag), especially when placed above the muscle.
Abnormal Muscle Movement Related to Submuscular Placement
Patient with abnormal muscle contraction corrected with subfascial placement
In certain patients, particularly muscular athletic patients, submuscular implant placement results in elevation and abnormal movement of the muscle.
We have achieved very successful results by re-positioning those implants in the subfascial position. When the fascia is thin it is enhanced with a mesh matrix (an absorbable synthetic mesh)
Bottoming out is the term used to describe a breast where the implant is sitting in a lower than normal position.
This may result from:
- Over dissection of the breast pocket
- Stretching of the breast pocket where there is insufficient support eg. pre-pectoral implant placement where the skin is thin.
- Release of the muscle inferiorly allowing the implant to herniate out of the pocket.
- It is also more common with large implants and saline implants.
- Re-enforcement of the thin tissue and recreation of the fold with sutures or mesh.
- Replacement with smaller implants.
There are several treatment options available for capsular contracture:
- Massage and ultrasound.
- Open capsulotomy – release of the scar tissue.
- Open capsulectomy – excision of calcified or thickened scar tissue.
- Capsulotomy with expansion – using adjustable implants.
- Insertion of acellular dermal or synthetic mesh matrix.
- Insertion of adjustable implant and post operative expansion.
Click here to learn about an affordable, safe, non-surgical therapeutic option for the treatment of Capsular Contracture.
Dissatisfaction with size, symmetry and shape
The availability of the New Cohesive Gel (MemoryGel – Gummy bear) implants, and mesh (biologic and synthetic), provide new options that are highly successful in treating these complications.
Use of Adjustable Implants to Treat Breast Implant Complications
The implant is adjustable after surgery by means of a small injection dome that allows the inner saline compartment to be increased or decreased.
Currently only the smooth adjustable implant is available (spectrum) in the USA . The adjustable gel implant is available outside of the USA
- Post-operative adjustability
- Ability to stretch scar tissue
- Ability to modify the shape after surgery
- Ability to change the size of the implant after surgery to the size desired by the patient and to more accurately match the size of the opposite breast in case of asymmetry
- More natural feel
- More elasticity of shell
- Less rippling
Replacement of Saline Implants with Silicone Gel Implants
Now that silicone gel implants have been approved for use by the FDA, women have the option of having the most natural form of breast enlargement available.
When Silicone gel implants were not available in the United States, woman had only two options available to them:
- Use saline implants placed above the muscle – Due to the weight of the saline implant they would tend to sag excessively, resulting in an abnormal shape, commonly known as Rock-In-The-Sock. Rippling was also problematic.
- Place the saline implant under the muscle. Although this technique reduced sagging, muscle contracture resulted in abnormal distortion of the implant.
Patients, who have previously had saline implants and are dissatisfied with their results, can now have their saline implants replaced with the New Cohesive Gel (MemoryGel – Gummy bear) implants.
It is of my opinion that the most beautiful and natural results in breast augmentation are seen with Silicone Gel implants, placed above the muscle in the Sub-Fascial position.
Our patients who have received these implants are happier than ever.
The Blunt SeromaCath® was developed by Dr. Becker
The blunt SeromaCath® was developed by Dr. Becker. It is used to drain Seromas after breast implant surgery. Should an infection be suspected after surgery, the Seroma Cath is highly beneficial in treatment.
- The catheter is inserted into the pocket around the implant and fluid is aspirated.
- The fluid is sent for culture before antibiotics are started.
- The pocket can be irrigated with antibiotic solution and then attached to a drainage bulb.
- This avoids the surgical practice to insert a drain.
Greer Medical, Inc. is proud to introduce the NEW BLUNT SeromaCath® specifically designed for treatment of postoperative seromas surrounding breast implants.
Developed from concepts originally conceived by Hilton Becker, MD, Greer Medical is pleased to bring you the first BLUNT SeromaCath® designed to treat seromas surrounding breast implants without the risk of perforating the implant.
The rounded blunt tip allows for an easy and safe entry into the pericapsular space following breast reconstruction and augmentation.
Greer Medical’s BLUNT SeromaCath® is the newest in a family of three SeromaCatl® catheters specifically designed to meet your clinical needs.
For further information on the BLUNT ScromaCath’s® or to place an order, please call toll free 1 800 424 2155 or visit our Web site at www.greer-medical.com Grer MEDICAL, INC.