Board Certified
Plastic Surgeon
Since 1989

Recurrent problems with breast augmentation

Q: In June 2016, I replaced my original implants from 1999. One was leaking. Everything went well. In October 2016, I had a folded implant and got it replaced with surgery #2. Today, Dec 2017, I have yet another leakage and am at a loss for what to do—fearing this is a pattern. Over the muscle, saline, 300cc. Do I change doctors? Now I have more costs to pay, due to no fault of my own! So frustrated.

Three strikes and you are out! If all 3 problems occurred with the same surgeon, then it might be smart to try another surgeon with a different technique or handling of the implants.

Another caveat is that it might be worth considering converting the subglandular pocket into the submuscular pocket for better coverage of the implants and more natural feel.

I have been in practice for over 30 years, and almost exclusively use saline implants under the muscles. Many of my patients are mothers and daughters, and it is in inconceivable that a mother would refer her daughter to me if she was happy with the outcome!

The good news with your situation is that you are a little over a year from your last surgery. In your case, the manufacturer will replace the implant for free and cover anesthesia and operating room costs. Unfortunately, the surgeon’s cost will not be covered and will be your responsibility (unless the surgeon agrees to wave it), since it is not the surgeon’s fault.

Always consult with experienced, board-certified plastic surgeons who operate in an accredited surgery center for your safety. Most importantly, check the before and after pictures in the photo gallery, to make sure that they are numerous, consistent, and attractive, with nice cleavage, perkiness, symmetry, and natural looks.

Replace Saline Implants With Silicone Implants

Q: I’m switching from Mentor saline implant under muscle to Allergan Natrelle Inspira under muscle. My existing saline implant is 375, overfilled to 425. I’m looking for the same (or maybe slightly bigger) size, with natrelle Inspira gel implant under the muscle. What size do I need? Is it true that when switching from saline to silicone, you need to go a little larger?

It would have been very helpful to see your front and side view pictures. I am curious to know why you want to change your saline implants to silicone implants, since, in my opinion, saline implants are superior to silicone implants.

I have been in practice for over 30 years, and performed breasts augmentation surgery on thousands of patients, using almost exclusively smooth, round, moderate profile saline implants made by Mentor. Many of these patients were mothers and daughters, and it is inconceivable that a mother would refer her daughter to me if she was unhappy with the saline implants.

One of the many disadvantages of silicone implants is that you will get long incision in the submammary crease, which is not scar friendly. Saline implants require only a small scar along the inferior sub areola line, which is very scar friendly.

If you insist on silicone implants, you do not have to change the size of the implants if you are happy with your current breasts cup size. Implants’ size is the same for silicone and saline implants.

Always, consult with experienced, board-certified plastic surgeons who operate in accredited surgery center for your safety. Most importantly, check the before and after pictures of “redo” breast augmentation in the photo gallery; make sure that they are numerous, consistent, and attractive, with nice cleavage, perkiness, symmetry, and look natural.

Redo Breast Augmentation With Mini Lift

Q: I desperately need help! My mother forced me to get a breast augmentation. I’ve been living a nightmare for the past ten years. My breasts are just two masses that have left me feeling empty. Are there any compassionate New York surgeons who can look the photos over and help me with this burden? I’ve been to several consultations, but this has been time-consuming and costly with no results.

Thanks for posting your pictures. It would have been helpful to see your breasts fully from a little further distance.  From observing your pictures, you appear to have capsule contracture (at least at the superior margin), and your areolas are large, not round, loose, and slightly droopy.

The corrective procedure is not difficult! But you need to consult with experienced, board-certified plastic surgeons who have performed numerous breasts augmentation with mini-lift procedures. So, check the before and after pictures in the photo gallery, make sure that they are numerous, consistent, and attractive, with perk, round, and symmetrical areolas.

Redo Breast Augmentation

Q: My breast augmentation was just 15 months ago. The right breast never seemed to fully “drop”, however, and I’ve been told I need revision. The original doctor said he would go in and cut/release the muscle to let implant drop. A 2nd opinion said it is contracture and should score the tissue instead. Are these two ways to get same result? Are these diagnoses very different? I cannot tell and don’t know what to do.

Thanks for posting your pictures. From observing your pictures, you have significant problems on both sides:

  1. Left side: medial capsule contracture creating wide cleavage and lateral displacement of the implant. The corrective procedures are medial capsulotomy (scar release) and lateral capsulorrhaphy (internal bra).

  2. Right side: severe capsule contracture and smaller breast. If the breast is very hard, you will need capsulectomy (scar excision) and replacement of implant due to ‘biofilm’. If it is not very hard, just capsulotomy will suffice. The implant should be replaced anyhow, for size symmetry.

The procedures on both breasts should be done through sub areola incisions, which make the maneuvers and the dissections easier and more predictable, since they are done under direct vision and feel. Submammary or axillary approach is too far for comfort and consistency.

As you can see from your own experience, not all results are the same. Experience, technical skills, and aesthetic eye are critical for good outcome. So, do your due diligence carefully and choose your surgeon wisely.

Always, consult with experienced, board-certified plastic surgeons who operate in an accredited surgery center for your safety. Most importantly, check the before and after pictures of redo breasts augmentation in the photo gallery, to make sure that they are numerous, consistent, and attractive, with nice cleavage, perkiness, symmetry, and natural looks.

*Individual results are not guaranteed and may vary from person to person. Images may contain models.