Coming out of Breast Augmentation, there is much care taken for you to have the best results possible. A lot of complications can be avoided by putting yourself in expert hands. I’m triple board certified and specialize in Breast Augmentation, revision and reconstruction. You have the best chances for the best outcome with us.

One of the complications of Breast Augmentation that we strive to avoid is breast implant malposition. This is when the implants move out of their correct position, either immediately or over time. It isn’t extremely common, but when it does happen, there are usually a few reasons and options for correction. If you’re aware of them, you can help avoid or identify them as early as possible for correction with Breast Revision surgery.

Here is a guide for the possible reasons for implant malposition:

1. Not allowing yourself to properly heal. With the pressures to return to work and daily activities, especially for mothers, you’re faced with the difficulty of allowing your body enough time to heal. Everyone heals at different rates. This can take from 3 to 6 months, up to a year to completely recover. Taking proper care of yourself during healing and wearing the correct bra support is crucial. Usually breast implants are positioned high with the intention of them dropping, or “settling” into the proper place as they heal. Wearing underwire or push up bras during this time can prevent them from doing this properly and they could stay unnaturally high. This “riding high” malposition is usually a tell tale sign of Breast Augmentation and can also cause nipples to appear irregularly low or pointed downward.
2. Your body shape, particularly if the ribs are more prominent or uneven, they could push the implant into a different position even if the implant pocket is positioned correctly. Ribcage prominence and scoliosis are some things surgeon should take note of and make accommodations for in surgery.
3. If breast tissue is not strong, implant size can sometimes contribute to a low malposition where the implant seems to be falling out of the breast pocket. This isn’t the only reason low malposition occurs, but there is a higher risk of this with larger implants because the extra pressure can thin out the bottom of the breast pocket. The inferior position or “bottoming out” of an implant empties out the top of the breast of any fullness and often points the nipple too high.
4. Capsular contracture is the most common reason for implant malposition. This occurs when the tissue surrounding the pocket containing the breast implant hardens. This constricts the implant and pushes it into a variety of ways that can look abnormal and be uncomfortable:
   1. This could be one of the reasons the implant would be pushed upward.
   2. Implants squeezed laterally into the armpits will look unusually far apart.
   3. When implants are pushed inwardly toward the center of the body this is called synmastia. The breast could be positioned inward or the implant could slide out of the pocket and bubble under the skin to look like a “uniboob.”
   4. Capsular contracture could also squeeze the implant into an irregular shape with unnatural curves or indentions.

If you are experiencing any of these unfortunate malpositions, in the correct expert hands, Breast Revision surgery can restore your hope, confidence and your breasts to a beautiful, natural appearance. Let’s talk about how I can help you. Visit www.davinciplastic.com to schedule a consultation.

Steven Davison M.D.

Board Certified Plastic Surgeon

These days my patients are quite informed about the procedures they are requesting from me. They’re reliant on my professional advice on the details and implementation of their goals, but most Breast Augmentation patients have an idea about what the procedure entails. The lesser known sister of Breast Augmentation is Breast Revision surgery. There are a variety of reasons someone might need this “surgery after the surgery,” and I’ll cover those here.

Breast Revision surgery is for someone who’s already had a Breast Augmentation and needs a change that requires another surgery to the breast area at any point in time near or distant from the original Breast Augmentation. The majority of women love their new breasts with no complications and often experience satisfaction for many years.

However, a Breast Revision surgery is a great option for a variety of reasons, such as:

1. Address the natural effects of aging and gravity on the breasts. The breasts with the implant still will sag over time and so a Breast Lift could help restore perkiness and placement.
2. Breasts change as a result of pregnancy, weight loss or gain. If the Breast Augmentation occurred before these events, a Revision can be intended to restore your breasts to their former stature.
3. Change the implant size with a Breast Implant Exchange to go smaller or larger. Fortunately, the Breast Implant Exchange is less intense of a surgery than the original augmentation. The space or pocket for the implant has already been created so there’s not the stretching discomfort experienced during the initial surgery. Also, the recovery time is usually shorter.
4. Repair breast implant malposition. The implant didn’t settle where it should be and has caused the breasts to look unnatural.
5. Correct capsular contracture where the tissue surrounding the implant contracts and squeezes the implant into an awkward and uncomfortable position. In this case, the constricting tissue would be removed and the implant replaced.
6. Change the implant type. Some women who got saline implants and experience rippling or wrinkling, prefer to exchange them for the consistency of a silicone gel. This is particularly common for women who got a Breast Augmentation when the silicone option was off the market from 1993 to 2006.
7. Breast Implant Exchange for prevention or in the case of leakage. Implants do not have a lifetime guarantee to not leak. It is recommended to exchange for a new implant every 10 years. If a saline implant is leaking, it’s easy to detect because the breast will appear deflated. However, in most cases, a silicone implant leak would require an MRI to detect leakage, so regular checks are recommended.
8. Breast cancer treatments may require the implant to be removed. This is a decision that should be made along with your medical support team.

In conjunction with considering the need for a Breast Revision surgery, I can’t emphasize enough the importance of choosing an experienced plastic surgeon to perform it. Maintaining aesthetics of the breasts while navigating prior surgery effects is an art that requires much technical skill and expertise. To discuss the possibility of putting yourself in the hands of a triple board certified surgeon, such as myself, you can schedule a consultation at www.davinciplastic.com.

Steven Davison M.D.

Board Certified Plastic Surgeon