Category: Breast Surgery
Breast Revision Case Studies
Women seek breast revision surgery for a variety of reasons. Some want to switch from saline implants to silicone implants or go from a larger to a smaller size or vice versa. Others decide to have their implants removed and not replaced or their implants removed and their breasts lifted. In the event of a complication such as capsular contracture, which results in a misshapen, hard breasts from a build-up of thick scar tissue surrounding the implant. With saline implants, there is always the risk of deflation, which calls for revision surgery to replace the defective implant.
No matter the reason for revision surgery, Dr. Schlechter has encountered all of these situations during his 22-year career and has successfully corrected each of them. Below is a sampling of case studies of breast revision surgeries that Dr. Schlechter has performed.
Case One
Opting for Saline Implants then Switching to Larger Silicone Implants
This 43-year-old patient came to Dr. Schlechter for breast augmentation with saline implants. She did not want to have too much projection, just a fuller look. She was adamant that she did not want silicone implants because she was afraid of having a foreign substance implanted in her body. We discussed the differences between the two types of implants and tried to reassure her of the safety of silicone. With Dr. Schlechter’s guidance, ultimately she chose 270cc saline implants. During the actual procedure, Dr. Schlechter overfilled the 270cc implants to 290cc. Seeing that result and based on the patient’s concerns of not wanting too much projection, he removed 20cc so that the implants were the original 270cc.
Five months post op, this patient was completely unhappy with the size and feel of her saline implants and opted to have them removed and replaced with larger silicone implants. Dr. Schlechter removed the 270cc saline implants, adjusted the pockets to accommodate the high profile 350cc silicone implants. At two months post op, the patient was very pleased with the look and feel of the silicone implants.
Case Two
Saline Implant Removal and Breast Lift
This 40-year-old patient had breast augmentation with 360cc saline implants overfilled to 390cc performed by another area plastic surgeon. She was completely disheartened by the appearance of her breasts and suffered buyer’s remorse. She did not want to go back to the original surgeon because she did not like his reaction to her when she complained about her augmentation. She chose to come to Dr. Schlechter because of his stellar reputation and years of experience. Dr. Schlechter advised having a breast lift done immediately after removal of her implants. At four months post op, the patient was thrilled with her results and has since returned for BOTOX® Cosmetic, fillers, and other surgical procedures.
Case Three
Capsular Contracture and Deflation of 19-Year-Old Saline Implant Removal with Breast Lift
This 40-year-old patient’s case is unique in that her left implant was deflated and she suffered grade 4 capsular contracture. She had moved to our area from the south, and it was not feasible for her to return to her original plastic surgeon for her revision. She consulted with multiple plastic surgeons in our area and chose to come to Dr. Schlechter for her revision surgery. She needed the implants and capsules removed along with a breast lift but was unsure if she wanted to replace the implants. Since her implants were saline, she asked if Dr. Schlechter would deflate her implants to see how much natural breast tissue she had. Depending on that, she would decide whether or not to have her breasts re-augmented. Once her implants were completely deflated, she decided that she had enough breast tissue and opted for just the breast lift after the implant and capsule removal. At two months post op, she was really glad she opted for just the lift and not to have her breasts re-augmented.
Case Four
Capsular Contracture and Malposition of 450cc Silicone Implant Removal and Reaugmentation with 700cc Silicone Implants
This 27-year-old patient was very upset by the hardening of her breast and how her implant had moved so much. She told us that she was confiding in her college friend about her situation. Her friend, a patient of Dr. Schlechter’s, suggested that she make to drive from northern Pennsylvania to meet with Dr. Schlechter and he could revise her situation. The patient explained that not only did she need her implants removed, but that she also wanted a dramatic increase the size of her breasts. Dr. Schlechter removed her implants and the capsules and restructured the pockets to accommodate for the much larger sized implants. At one-month post op, she was in love with her new look.
Board-certified plastic surgeon Dr. Benjamin Schlechter frequently performs breast revision surgery to help his patients reach their aesthetic goals. To schedule your personal consultation with Dr. Schlechter, call us at (610) 624-7240 or fill out our online contact form today.
Common Reasons for Breast Revision
Even the safest surgical procedures are not without risk. While there are ways to avoid plastic surgery mishaps, procedures such as breast augmentation can lead to complications or dissatisfying results that require revisionary surgery.
If you experience the following complications or issues after your breast augmentation procedure, Dr. Schlechter can expertly perform breast revision to eliminate your concerns and improve your results.
Surgical Complications
While rare, surgical complications may unexpectedly occur after breast augmentation. Complications with breast implants are not uncommon despite the procedure being performed properly, but they can nonetheless occur with varying degrees of risk for any woman with breast implants.
Common complications that require breast revision surgery include:
- Capsular Contracture: The scar tissue constricts around the implant, causing the breast to become unnaturally firm, cold, and painful.
- Bottoming Out: The implant slips below the breast crease, causing the upper portion of the breast to collapse and the nipple to point upward.
- Double Bubble Deformity: The implant is pushed upward so that the breast tissue sags beneath it, or the implant slips downward so that the breast tissue appears to sit on top of it. Either situation leads to the appearance of two bubbles.
- Rupture or Deflation: The implant shell tears, causing the filling to spill out into the breast pocket. Implant rupture or deflation is usually noticeable with saline implants but may only be detected by an MRI in the case of silicone implants.
- Synmastia: The implant shifts toward the center, creating a “uniboob.” This issue is quite rare and is usually caused by poor technique on the part of the original surgeon.
- Implant Malposition or Shift: The implant is vertically or laterally displaced because it has shifted within the pocket. This complication usually produces noticeable breast asymmetry with an unnatural appearance or position of one or both breasts.
- Implant Rotation: An anatomical implant rotates within the breast pocket, creating an unnatural breast shape.
Some of these issues may compound, leading to an even greater need for surgical correction. Dr. Schlechter can correct each of these issues with breast revision surgery. The technique used for your breast revision may involve adjustment of the breast tissue and breast pocket, removal of scar tissue, and/or replacement of the implant(s).
Dr. Schlechter is known for having a remarkably low rate of capsular contracture (less than one percent in contrast to the national average of 15 percent), and he can significantly reduce your risk of recurrent complications.
Other Reasons for Breast Revision
Other reasons for breast revision are primarily elective and may include:
- Size Change: The implants may be exchanged for smaller or larger ones according to the patient’s preference. Implant size change may be desired shortly after surgery or many years afterward.
- Implant Type Change: The implants may be exchanged for implants of a different material or type according to the patient’s preference.
- Implant Removal: If desired, the implants may be permanently removed.
Adjustment of the breast pocket and breast tissue as well as accompanying breast lift surgery may be needed if breast revision is performed for these reasons. Unlike with surgical complications, breast revision surgery is not technically necessary unless the woman is unhappy with her results.
If you would like to improve your results after breast augmentation, Dr. Schlechter can perform breast revision surgery to help you achieve the results you desire.
Board-certified plastic surgeon Benjamin Schlechter, MD, FACS has over 28 years of experience in plastic surgery. If you are interested in breast revision surgery, Dr. Schlechter can help. To schedule your complimentary consultation, call (610) 678-9200 or contact us online today.
Advances in Breast Implant Technology
Breast Implant technology has improved immensely over the past few years. Recently, Allergan’s Natrelle® implants have been FDA approved with highly cohesive gel, which is the same silicone gel as in the Natrelle® 410 shaped implants that have been available for a few years. The Natrelle INSPIRA® line of implants has 30 percent more gel fill, which reduces the risk of rippling and also provides for potentially better projection of the implant.
Mentor®’s silicone gel implants are made in the United States at their plant in Texas, and the MemoryShape® Breast Implants have a cohesive gel fill that is quite natural filling. The use of shaped implants has gained popularity for primary breast augmentation. Implants now come in literally hundreds of sizes and shapes, which allows Dr. Schlechter to better tailor the implant to the patient and results in more accurately achieving the result the patient desires.
Saline implants continue to be available. The drawback with traditional saline implants is that the implants have a scalloped edge that can be noticeable at the side of the chest where the tissue is the thinnest over the implant. Saline implants also have an increased tendency for visible rippling, particularly in women who have smaller breasts and less soft tissue coverage of the implants.
Breast Augmentation is one of the most popular plastic surgery procedures performed. To find out more about breast augmentation surgery, contact Spring Ridge Plastic Surgery to schedule your consultation with our board-certified plastic surgeon Dr. Benjamin Schlechter. Call us today at (610) 678-9200 or fill out our online consultation form.
New Breast Implant Available: FDA Approves Natrelle INSPIRA® Cohesive Breast Implants
Advancements in plastic surgery have led to the development of new breast implants that can offer women even better results from breast surgeries. Each newly developed product must be approved by the U.S. Food and Drug Administration (FDA) so that patients can be assured of its safety for use. Natrelle INSPIRA® Cohesive breast implants have recently been approved by the FDA and are now being offered as an excellent option for breast implants here at
Natrelle INSPIRA® Cohesive Breast Implants
The new Natrelle INSPIRA® Cohesive breast implants are designed for a soft feel with the fullest roundness. Natrelle INSPIRA® Cohesive implants are filled with cohesive silicone gel and are available in multiple sizes and projections so that women can personalize their look. Due to their high gel-fill ratio and highly cohesive gel, Natrelle INSPIRA® Cohesive implants offer improved fullness and roundness to provide patients with more customizable options. These implants are also more likely to maintain their shape long-term and may reduce the risk of implant irregularities and rippling. The cohesive gel in Natrelle INSPIRA® Cohesive breast implants helps the implants resist tissue compression and minimizes distortion and gel migration in the unlikely event of implant rupture.
Now Available at Spring Ridge Plastic Surgery
Dr. Schlechter is now offering Natrelle INSPIRA® Cohesive implants to provide his breast augmentation, breast revision, and breast reconstruction patients with more options that can help them achieve the best possible results. Patients who are most likely to benefit from these new implants are those who desire a fuller and rounder look, patients with thin breast tissue who are at a higher risk of rippling, patients who need lower breast pole expansion, and patients who are undergoing breast reconstruction with implants. With Natrelle INSPIRA® Cohesive breast implants now approved by the FDA, many more women will be able to experience even better results and achieve their aesthetic goals with breast surgery.
To learn more about the newly approved Natrelle INSPIRA® Cohesive breast implants or other breast implant options available at Spring Ridge Plastic Surgery, schedule your personal consultation with our board-certified plastic surgeon, Benjamin Schlechter, MD, FACS. Please call us at (610) 678-9200 or complete our online contact form to request your consultation today.
INSPIRA™ Breast Implants
Allergan Corporation recently released the INSPIRA™ line of new silicone gel breast implants to complement their NATRELLE® Collection of gel-filled breast implants. The advantage of this new implant is that it is filled 95 percent volume with TruForm™ (cohesive) gel. The advantage to this is that the INSPIRA™ breast implant creates more fullness, particularly in the upper part of the breast, which leads to improved projection. This implant will also help to decrease deformities such as rippling or wrinkling. The implants are available featuring 400 different options for a more customized fit.
If you are considering breast augmentation and want more information regarding your breast implant choices, including the new INSPIRA™ breast implants, contact Spring Ridge Plastic Surgery to schedule your consultation. Dr. Benjamin Schlechter is a board-certified plastic surgeon with years of experience performing breast augmentation. To schedule your complimentary consultation, please call (610) 678-9200 or fill out our online contact form today. We look forward to helping you achieve the breast results you desire.
Breast Implant Warranties Improved for 2015
There is a lot of confusion among patients as to what their breast implant warranty covers following augmentation surgery. There is a distinction in warranties between saline and gel implants, and a slight difference among the various manufacturers; Allergan, Mentor and Sientra. Registration for the warranty varies between medical practices, but whenever there is a fee to the patient for an upgraded warranty, the patient is responsible for doing that themselves online within 45 days of their surgery. Beginning with saline implants, there is lifetime replacement coverage for a rupture, or deflation. In this situation the companies also provide a contralateral implant (for the non-affected implant) within a comparable size range. For the first ten years if something does happen to the implant the manufacturers may also provide financial assistance as well, to help cover the cost of the doctor replacing the defective implant. To obtain or increase the financial assistance there may be a fee of $200, this is often referred to as the enhanced warranty. It is important to understand that while the implant itself is covered by warranty for the lifetime, the financial assistance ends after ten years. It is highly recommended that all patients with saline implants purchase the enhanced warranty when available, as the standard plan may offer no financial assistance, and even if it does the standard financial assistance is not enough to cover the surgeon’s fees.
The warranty for gel or silicone implants is slightly better coverage. Again, the implants themselves are covered for life if a rupture or defect occurs. It is possible for the doctor to get a contralateral (other side), implant at no charge as well, within a comparable size range. The financial assistance for most companies is $3500 to help cover the surgeon’s fees, if there is an issue during the first ten years following surgery. The improvement in the warranty beginning in November 2014, is that the companies will not provide a replacement implant at no charge if the patient has a capsular contracture, which occurs in 15% of all implant patients according to the national data. The restriction is that it must be within the first 3, or 10 years depending on the manufacturer, and it must be what they refer to as Baker lll/lV, which means the severity of the contracture must be on the higher end. It does not cover a very mild case of capsular contracture. The grade is determined by the physician. Some companies also provide financial assistance for capsular contracture, others do not, so be sure to have an understanding after your consult of exactly what the warranty will cover regarding capsular contracture. To further complicate things for the consumer, one company does offer an enhanced version of the capsular contracture warranty, so that if an additional fee is paid by the patient after surgery, the warranty time period extends from 3 to 10 years of coverage. If an enhanced warranty is offered on the gel implants it is highly recommended that the patient purchase it. Always ask the doctor with whom you are consulting with how often he encounters these situations, as it can vary greatly. The staff at Spring Ridge Plastic Surgery is very thorough about reviewing the warranty coverage for the implants with each patient.
Breast Reconstruction: Closing the Loop on Breast Cancer
Breast Reconstruction After Breast Cancer
October is Breast Cancer Awareness month, which was organized to raise funds for research and raise awareness of this disease. While just about everyone knows that breast cancer exists, not as many people know the repercussions of breast cancer and steps that may help to prevent it.
Breast Cancer: Did You Know?
- One in eight women will be diagnosed with breast cancer in their lifetime
- Breast cancer is the second leading cause of death in women
- Breast cancer is the most common cancer among women worldwide
- Death rates from breast cancer have been declining since about 1990, partly due to better screening and early detection, increased awareness, and improved treatment options.
While the above facts are becoming more widely known, many women are unaware of the options available to them after their cancer has been treated with a mastectomy. Breast Reconstruction Awareness (BRA) Day was created to “close the loop on breast cancer” by informing women of their options for reconstructive breast surgery. BRA Day occurs annually on the third Wednesday of October (October 15th this year).
Breast Reconstruction: Did You Know?
- Since being enacted in 1998, the Women’s Health and Cancer Rights Act (WHCRA) requires any health plan or insurance company that offers coverage for breast cancer to also provide coverage for breast reconstruction and other post-mastectomy benefits.
- Eighty-nine percent of women want to see what breast reconstruction surgery results will look like before beginning cancer treatment.
- Less than 23 percent of women know the wide range of breast reconstruction options available.
- Only 22 percent of women are familiar with the quality of outcomes that can be expected.
- Only 19 percent of women understand that the timing of their treatment and the timing of their breast reconstruction greatly impacts their options and results.
After mastectomy, many women may feel an overwhelming sense of victory once their cancer has been treated, but many of them also miss what was once such a central part of their femininity. Breast reconstruction can restore a natural-looking breast appearance so that the battle with breast cancer does not have to end with something missing. At Spring Ridge Plastic Surgery, we have seen how rewarding breast reconstruction can be for women who want to look and feel whole again.
To learn more about your options with breast reconstruction surgery, please schedule a complimentary consultation at Spring Ridge Plastic Surgery by calling (610) 678-9200. For your convenience, you may also fill out our online contact form.
Breast Implant Exchange Myths
Breast Revision, Wyomissing, PA
Since breast implants are not lifetime devices, it is no surprise that several myths have surfaced about breast revision surgery and breast implant exchange. Whether you desire a different size, correction from a complication, or you simply no longer wish to have your implants, here are some of the most widely believed myths about breast implant exchange, debunked.
Myth 1: I must get my breast implants replaced after ten years.
Many women think that they must have their implants replaced after ten years, when, in fact, ten years is simply the average amount of time that passes before most women have them replaced. After ten years, the patient may have grown dissatisfied with the size she originally chose for her breast implants. Or, she may have gone through pregnancy or breastfeeding and her implants no longer provide the enhanced shape or volume they did when they were first placed.
The risk for developing complications from breast augmentation with implants also increases with time. If ten years have passed, there are no complications, and the patient is still happy with the way her breasts look, most surgeons see no need to replace them.
Myth 2: If I exchange my breast implants for a smaller size, I will have loose skin.
If you decide to replace large implants with smaller ones, there is a chance you will experience excess skin, but this is highly dependent on your unique situation. The most straightforward way for your surgeon to determine the amount of breast sagging is to simulate smaller breasts by deflating the implants. This procedure is done under local anesthetic while the patient is awake. Of course, this can only be done if the initial implants are saline filled. Excess skin may be easier to predict if you are choosing a significantly smaller size than your initial implants. Your surgeon may recommend a breast lift along with implant replacement when this is the case, as a breast lift will eliminate any loose skin.
Myth 3: Two surgeries are required for breast implant exchange.
Many women believe that if they have their implants removed, they must allow their breasts to heal for several months before receiving new implants in a secondary surgery. The majority of the time, breast implant exchange can be performed during one procedure, but this is dependent on the patient’s unique circumstances. If there is a significant amount of aesthetic correction to be made (e.g., the nipple must be adjusted significantly, or a breast lift must be performed), two surgeries may provide the best results. Two surgeries may likely be advised if the reason for implant replacement is due to an infection.
Myth 4: My breasts will look deflated if I choose to remove and not replace my implants.
If you have your implants removed but not replaced, you may experience sagging skin or other undesirable cosmetic changes to your natural breasts such as dimpling, wrinkling, puckering, or breast tissue loss. These issues can be avoided by combining breast implant removal with a breast lift. Dr. Schlechter also performs breast augmentation with fat transfer to provide natural-looking augmented breasts without the use of implants.
Dr. Benjamin Schlechter has been performing secondary breast augmentation for more than 20 years at his practice in Wyomissing, PA. If you are interested in this procedure, please schedule a consultation at Spring Ridge Plastic Surgery by calling (610) 678-9200 to schedule your appointment.
