Dr. Becker is uniquely qualified to treat Breast Implant Complications as he is highly experienced in Reconstructive & Cosmetic Surgery
Dr. Hilton Becker is a recognized authority 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 correctly.
The patient underwent bilateral sub muscular breast augmentation. She exercises frequently and is very uncomfortable with the tension placed by muscle especially on contraction. The right implant has become firm and elevates excessively on muscle contraction.
A corrective procedure was performed by removing the gel implants. The muscle was returned to its original position, and a new subfascial pocket created. Moderate plus silicone gel implants were placed in the new pocket The patient feels much more comfortable and has no abnormal muscle contracture.
Breast Implant Complications May Be Related To:
- Implant failure
- Surgical procedure or errors
- The patient’s physiology
- Size of Implant
- Symmastia (Implants touching in the middle)
- Capsular Contracture (hardening of the tissues around the implant)
- Rippling (more common with saline and textured implants)
- Abnormal Muscle Movement, animation deformity (causing distortion of implant) see video
- Bottoming Out (implant in abnormally low position)
- Sagging (of breast over implant; of implant itself)
- Unsightly scarring
Many patients who have undergone breast augmentation or breast reconstruction in the past have developed a variety of complications, many of these have come about 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 with our breast revision in Boca Raton. These include
Advances in Breast Implants and Breast Augmentation Surgery in Boca Raton
Fortunately, many advances have been made in breast implants and breast implant surgery that have greatly improved the results 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 had previous breast augmentation with submuscular implants.
After images following replacement with pre pectoral implants and breastlift.
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 positive, complications seen with saline implants can 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
Patient with previous sub-glandular saline implants, replaced with sub-fascial silicone gel
Fortunately, with modern silicone gel implants achieving FDA approval after extensive research into consumer safety, these latest generation implants provide a viable solution to many of the problems that commonly occur with 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 correction 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.
Capsular contraction is a result of the body’s reaction to the implant, this results in tightening of the tissues around the implant. Read Article
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.
Correction of implant rippling
Although implant placement above the muscle has many advantages, rippling is one of the most common complications
Predisposing factors include:
- Type of implant. More common with textured, low profile or high profile and saline implants.
- Overlying skin flap. Thin skin flap or excess skin
Correction of this condition includes:
- Replacement with Implants filled to the volume of the shell eg. smooth round moderate profile plus X silicone gel.
- Thicken skin flap with fat grafting
- Acellular dermal matrix
- Capsular tightening—radiofrequency
- Skin flap reduction with dermal flaps or contraction
Dissatisfaction with size, symmetry and shape
Dr. Becker has authored a chapter in the text book – Surgery of the Breast. Read Article.
The adjustable breast implant developed by Dr.Becker enables the size of the breast to be changed after surgery. Read Article.
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.
Dr. Becker’s response to questions on realself.com
Click here for Dr. Becker’s response to questions on realself.com
Breast Implant Removal
Following your breast implant removal, there may be sagging of the breast and hollowiness where the implant was . Fortunately , options available to improve the shape and even the size of the remaining breast
- Removal,of the implant, removal of the capsule when necessary
- Breast lift
- Internal tissue tightening lifting and tissue advancement with mesh suspension
- External expansion
- Fat grafting
Although breast implants are designed to be durable, they are not intended to last forever. The shell of the implant may tear or break, allowing the saline or silicone to leak out of the implant. There are a number of possible reasons for implant rupture, including:
- Pressure or trauma to the chest
- Folding or wrinkling of the implant shell
- Damage when the implant is placed, or a biopsy performed
- Aging implant
- Manufacturing defects
Saline implants deflate when they rupture, making the problem obvious. With silicone implants, MRI or other diagnostic testing may be required to detect a leak. In either case, the solution is to surgically remove and replace the ruptured implant.
Capsular Contracture Treatment
As stated in an article in the Archives of Plastic Surgery (APS) published by the National Institutes of Health (NIH), capsular contracture is the most common complication of breast implant surgery, with an overall incidence of 10.6%. This painful condition, in which the breast becomes hard and misshapen, is one of the most common reasons for revision breast surgery.
What Is Capsular Contracture?
Capsular contracture is a breast implant complication that occurs when the scar tissue capsule that forms around the implant becomes tight and constricting. The capsule squeezes the implant, causing it to become hard and distorted. The breast may feel stiff and painful and develop a misshapen, unattractive appearance.
What Causes Capsular Contracture?
Capsular contracture results from an excessive fibrotic reaction (formation of fibrous connective tissue) to a foreign body implanted in the breast, the precise cause of which is still unknown. However, the risk of developing this breast implant complication has been shown to be related to:
- Bacterial contamination
- Unknown predisposition
How Is Capsular Contracture Treated?
- Placement of the implant in a new pocket
- Antibiotic irrigation of the pocket
Options for CorrectingBreast Asymmetry
Breasts can be uneven in a number of different ways, and therefore, there are several surgical methods to correct asymmetry:
Breast augmentation with implants: If one breast is significantly larger than the other, breast implant surgery can help create uniformity in size. However, if you have an implant placed in the smaller breast, you will probably need an implant in the larger breast as well to create symmetry in both breasts. The adjustable breast implant developed by Dr. Becker is particularly helpful in correcting breast asymmetry. To learn more, click here.
Breast reduction: In some cases, the best way to achieve symmetry when one breast is larger than the other is to reduce the size of the larger breast. This can be achieved with breast reduction surgery. Nipple and areola asymmetry can also be corrected in this procedure.
Breast lift: Asymmetry can involve sagging and differences in the shape of the breasts. Breast reduction surgery can lift the breasts, improve their shape, and make them more symmetrical in appearance. The nipples can be repositioned and the areolas reduced in this surgery.