Breast Augmentation Revision Los Angeles, CA
Dr. Hughes has a great deal of experience in breast augmentation revisions, and he has authored numerous articles and chapters on these subjects (see the multitude of links below). There are a wide variety of deformities that can result from a previous surgery. Dr. Hughes can fix a wide variety of deformities. Before you give up on your breasts, come to Hughes Plastic Surgery. You will be glad that you did. Please see the breast augmentation revision and deformity correction pages to find before and after photos.
Dr. Kenneth Hughes, MD in Los Angeles has performed thousands of breast augmentations and hundreds of breast augmentation revisions. Dr. Hughes’s cosmetic fellowship in plastic surgery at Harvard Medical School’s Beth Israel Deaconess Hospital involved a great number of breast augmentation revisions referred to the Harvard Hospitals as a result of it being the preferred tertiary care center in the area.
What Types of Breast Augmentation Revisions Does Dr. Hughes Perform?
Dr. Hughes fixes a wide array of issues including implant malposition due to lateralization of the implant or the high riding implant, double bubble deformity, bottoming out, symmastia, capsular contracture, implant rippling, animation deformity, and the list goes on and on.
Implant Malposition and the High-Riding Implant
Breast implants can be placed and positioned in many ways. The most common malposition issues encountered by Dr. Kenneth Hughes, MD in Los Angeles, CA include lateralization of the breast implant and inadequate dissection of the inferior or inferomedial pole, leading to an implant “riding high.” The lateralized implant is easily corrected with capsulorrhaphy sutures to repair the pocket and block the implant from migrating laterally. The implant that is riding high can be corrected with additional dissection of the inferior or inferomedial portions of the muscle.
Double Bubble and Bottoming Out
Double bubble and bottoming out are variants on a theme and may result from overdissection of the pocket below the inframammary fold.
Double bubble describes the condition in which the breast implant becomes visible below the natural breast fold, thus giving the appearance of two breast folds. This double bubble can be corrected by repairing the inferior aspect of the pocket with capsulorrhaphy sutures to bring the implant up to the original inframammary fold. Sometimes, an acellular dermal matrix like Alloderm or Strattice may be necessary to reinforce the repair. In cases of constricted breasts or tubular breasts or tuberous breasts, the fold must frequently be lowered to get an adequate result, and the double bubble may be an inevitable outcome or require correction by other means. Sometimes a breast lift may be appropriate to bring sagging tissue up to reduce the appearance of the second fold. Sometimes the old fold remodels without further intervention. Sometimes the old fold can be altered in other means such as fat grafting.
Bottoming out involves the implant moving below the inframammary fold over time without causing two distinct folds. Sometimes this is the result of weak patient tissues, too large an implant, or a combination of both. The repair involves suturing the pocket with capsulorrhaphy sutures and possibly adding an acellular dermal matrix for reinforcement (Alloderm, Strattice). The implant size may need to be reduced as well.
Symmastia and Its Repair
Symmastia or (uniboob) results when the implants meet in the center of the chest due to overdissection of the medial pectoral fibers. The treatment is very difficult and involves suturing the pectoral fibers back to the chest wall with or without acellular dermal matrices such as Alloderm or Strattice. The implant size will likely need to be reduced as well to eliminate pressure on the repair.
Capsular contracture occurs when the normal capsular tissue which surrounds the breast implant begins to deform the surrounding breast and can lead to pain as well. Capsular contracture occurs in 3 to 5% of primary breast augmentations. Capsular contracture is corrected surgically by removing the capsule (anterior and posterior capsulectomy) and the implant is changed as a minimum treatment for first time capsular contracture formers. When patients form more than one capsule, acellular dermal matrices can be considered to reduce the risk of recurrent contracture in addition to capsulectomy and more form stable implants. Occasionally, the implants must be removed in severe cases or multiple recurrences that have been optimally addressed.
Dr. Hughes has performed hundreds of these difficult capsulectomy and capsular contracture revision cases and he will give your best outcome.
Implant rippling occurs with time as the tissues are thinned by the implant in usually thinner patients. Implant rippling can be reduced with more form stable implants. In some patients, a change of implants may be appropriate as can fat grafting or acellular dermal matrix placement.
This animation deformity can occur when scar tissue causes tethering of breast tissue, skin or fat to the gliding muscle plane as it moves over the implant. The treatment can involve scar release with interposition graft or matrix, change of planes for the implant, or repair of the pocket or muscle to prevent a contraction deformity.
Dr. Kenneth Hughes, MD Voted Best Breast Doctor in Beverly Hills and Los Angeles
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Breast Augmentation Revision
BEFORE & AFTER GALLERY
Dr. Hughes has a great deal of experience in breast augmentation revisions, and he has authored numerous articles and chapters on these subjects.
Links to Additional Beverly Hills and Los Angeles Breast Augmentation Articles at Hughes Plastic Surgery:
Article 1: The History of Breast Augmentation in the US
Article 2: The Evolution of Saline and Textured Implants
Article 3: Silicone Implants and Implant Controversies
Article 4: Evaluation of the Breast Augmentation Surgery Patient
Article 5: Determining Implant Size and Incisions in Breast Augmentation: Inframammary and Infraareolar
Article 6: Incisions and Approaches to Breast Augmentation: Transaxillary and Transumbilical
Article 7: Capsular Contracture in Breast Augmentation
Article 8: Complications of Breast AugmentationContinue on to Dermal Matrices in Breast Augmentation Articles available:
Part I: Types of Dermal Matrices in Breast Augmentation
Part II: Dermal Matrices in Breast Augmentation
Part III: Complications of Dermal Matrices in Breast Augmentation
Part IV: Dermal Matrices in Breast Reconstruction
Part V: Dermal Matrices in Breast Augmentation Summary
View Other Scholarly Articles by Dr. Hughes Related to Breast Augmentation