Even under ideal conditions, the results of breast surgery can change over time. Common problems may include visible rippling or rupture of the implant, loss of the natural architecture of the breast, scarring of the breast implant (i.e. capsular contracture) or ”bottoming-out” of the implant. Common causes of these changes can be attributed to your surgeon’s original choice of implant, the choice of the pocket for the implant or the use of implants too large for a particular body frame. Although unforeseen circumstances can develop, Dr. Pacella can assist patients with creating a revised surgical strategy to prevent these deformities in the long term.
It is important to realize that when the results of a breast augmentation or reconstruction are not ideal, there is often an underlying reason. Correcting the cause of the deformity requires a strategic surgical plan that is often not as simple as the original surgery. For example, if an implant appears deformed after breast augmentation, the correction is often not as simple as just “changing the implant”. The implant pocket may be deformed and may require placement of the implant in a new pocket. Overlying skin may be too thin, often requiring fat transfer or readjustment of internal tissue to prevent contour deformity. In addition, implants which appear too low or bottomed-out will often require support from the inside with an “internal-bra”. In these instances, specifically engineered biologic mesh (Alloderm® and Strattice™) may be required required to support the implant. Finally, if the nipple is out of position, a breast lift or mastopexy may be required.
Dr. Pacella is a board-certified San Diego plastic surgeon who has a special interest in breast revision surgeries. Because of his dedication to reconstruction following breast cancer, he often adopts reconstructive techniques to correct deformities resulting from cosmetic breast surgery in patients referred to him from all over Southern California including San Diego, Riverside, Orange and Los Angeles Counties.