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Breast Revision

Breast Revision McAllen

Revision Breast Augmentation

Breast augmentation remains hugely popular, and is one of the most frequently performed cosmetic surgery procedures. As a result, the demand for breast revision surgery is increasing. Reasons for breast revision procedures may include: patient dissatisfaction with lateral displacement or bottoming out of previously placed implants that simply migrated over time or were improperly placed at the initial procedure; visible rippling and sagging of implants that were placed in the subglandular position (above the muscle); complications such as symmastia (uniboob) caused by over dissection medially; residual breast ptosis (drooping) after implants because a breast lift was indicated; and many other reasons. Patients are often upset from their prior breast procedures, and patients must understand that secondary and especially tertiary revision breast procedures are much more complicated than simple first-time breast augmentation. Often, there are multiple issues that must be corrected that include nipple-areolar malposition, implant malpositition, and residual breast ptosis. Although every effort is made to correct all of these problems with a single, complex revision procedure, patients must understand that additional procedures may be necessary – especially in the setting of capsular contracture.

Dr. Rodriguez specializes in complex breast revision procedures (See Revision Breast Augmentation photo gallery). During his general plastic surgery fellowship training at UCLA he performed many breast reconstruction procedures for breast cancer patients after mastecromy using acellular dermal matrix, tissue expanders, and implants. Although he no longer performs breast reconstruction procedures for breast cancer, he applies his expertise to perform cosmetic breast reconstruction for revision breast augmentation patients.

As part of their revision breast procedure many patients require a revision breast lift as well as internal restructuring (capsulorrhapy). Often, revision breast augmentation patients also need additional internal support using advanced materials (such as Seri® Surgical Scaffold – See Below) to achieve their goals and maintain long-lasting results.

ADVANCED TECHNIQUES:

For select patients who do not require a breast lift, Dr. Rodriguez has applied his expertise as a cardiac surgeon at Stanford University and heart valve replacement surgery to create a modified parachute technique that allows him to perform complex breast repairs using the small, pre-existing scars from a patient’s prior surgery. This allows these patients the ability to avoid additional scarring on their breast. Dr. Rodriguez is recognized as a pioneer using this technique for cosmetic revision breast procedures, and has been invited to present at both the California Academy of Cosmetic Surgery annual meeting and the American Academy of Cosmetic Surgery national meeting about revision breast augmentation surgery.

Breast Revision

Case 3821

Complex Revision Breast Augmentation with Seri® Surgical Scaffold

ADVANCED MATERIALS:

Revision breast augmentation patients often need additional internal support using advanced materials to properly support the implant and provide a beautiful, long-lasting result. Acellular dermal matrix has proven effective in breast reconstructive surgery and has been successfully applied to complex cosmetic breast revision procedures. In particular, acellular dermal matrix provides important structural support for surgical repair of symmastia (uniboob), lateral displacement of implants, and recreation of the inframammary fold. The high cost of acellular dermal matrix, however, effectively creates a financial barrier that prevents its widespread application for self-pay cosmetic surgery patients. VICRYL™ (polyglactin 910) absorbable woven mesh (Ethicon US, LLC) is a well-known product, which has been successfully used for temporary wound and organ support in other surgical specialties, and is available at a fraction of the cost of acellular dermal matrix. It has been used successfully for breast reconstruction and revision surgery.

Seri® Surgical Scaffold (Allergan Inc., US), however, is a newer bioresorbable product that is FDA approved for use as a transitory scaffold for soft tissue support and repair to reinforce deficiencies where weakness or voids exist that require the addition of material to obtain the desired surgical outcome. Seri® Surgical Scaffold now provides patients an excellent, cost-effective alternative for their complex revision breast augmentation needs.

Seri® Surgical Scaffold is a silk-derived bioprotein with substantial bioreplacement over 24 months. Seri® Surgical Scaffold facilitates the generation of native, well-vascularized tissue that is almost twice the starting thickness of the scaffold alone at 24 months (based on research from Allergan Inc., US). This developmental research demonstrated that at 24 months, the bioreplaced tissue demonstrated nearly twice the average strength of ovine fascia. Hence, the Seri® Surgical Scaffold provides immediate and long-term support for complex repairs and larger implants.

An important application for Seri® Surgical Scaffold involves breast revision surgery to correct heavy, droopy breasts and visible rippling from previously placed subglandular implants (above the muscle). For these repairs, the Seri® Surgical Scaffold allows me to recreate the patient’s inframammary fold and support new implants in a subpectoral position. For many reasons, subpectoral placement of implants has emerged as the preferred placement for implants, and it is my preferred placement of implants for all breast surgery in most patients. Advantages of subpectoral placement (under the muscle, which is actually a dual-plane placement, with the upper 2/3 of implant covered by muscle and the lower 1/3 covered and supported by breast tissue, fat, and skin – See Figure) include, but are not limited to: decreased visible rippling; lower incidence of capsular contracture; enhanced visibility of breast tissue for mammograms; and increased support of the implant for longer lasting results.

Moving Forward

Making the decision to have revision breast augmentation is important. Throughout the country, few general plastic or cosmetic surgeons specialize in such complex procedures. Dr. Rodriguez is a double-board certified cosmetic surgeon, and he is one of the only cosmetic surgeons in the country with advanced fellowship training in cardiothoracic surgery, general plastic surgery, and cosmetic surgery. He has successfully corrected many breast augmentation complications from other surgeons in both the U.S. and Mexico. In addition to complex revision breast procedures, Dr. Rodriguez also specializes in advanced techniques for primary breast augmentation, such as transumbilical breast augmentation (TUBA, or Belly Button Boob Job®), and combined breast augmentation / breast lift techniques.

If you would like to find out more about revision breast augmentation, we encourage you to take the first step toward feeling more attractive, confident and desirable, and schedule a consultation with us.

Dr. Rodriguez Interview

A New Beginning (ENG)

Courtesy of Fox Rio 2

Un Comienzo Nuevo (SPA)

Courtesy of Fox Rio 2

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Edinburg, TX 78539

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Brownsville, TX 78526

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