The Breast Expert
Breast Augmentation Patient
Breast Augmentation Patient
Breast Augmentation Patient
Breast Augmentation Patient

Dr. Corbin's Patient Mala

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augmentation risks Potential Breast Augmentation Risk and complications

Potential Breast Augmentation Risk and complications
With any surgical procedure there are risks. Though complications are rare they are always a possibility. Some of these risks can be avoided by choosing a qualified, experienced and board certified plastic surgeon with hospital privileges to perform breast surgery. Some complications are caused by surgeons or surgery and others are a result of the patients bodies own natural ability to heal.

Dr. Corbin regularly performs revision surgery on breast surgery patients whose surgeries were initially performed by other surgeons. Complications can occur to any surgeon and they are not always a result of surgeon error. Experience and expertise are very important in managing a patient’s revision surgery or complication. Not only is Dr. Corbin dealing with a difficult complication physically he is also dealing with the emotional needs of these patients.

Potential risks associated with breast surgery

Changes in sensation of the nipple and or breast: Feeling in the nipples and or breasts can increase or decrease after breast implant surgery. Generally, this is temporary and the normal feeling and response to touch comes back. It is also common for patients to experience differences in sensation between the two breasts. One nipple or breast may be more or less sensitive than the other. Usually any changes are temporary and normal sensation returns after adequate healing. Though rare, in extreme cases permanent loss of sensation or dulled sensation may occur.

Hematoma (bleeding): A hematoma is a collection of blood around the implant or around the incision. Swelling, pain and bruising may occur with a hematoma. If a hematoma occurs, it usually happens soon after surgery. Not all hematomas require surgery. Sometimes, small hematomas are absorbed by the body, but large ones may have to be drained surgically for proper healing. Hematomas are not common, but can occur. They can occur in one or both breasts. A hematoma can also happen at any time following an injury to the breast. If a breast implant patient receives any type of injury to the breast they should be evaluated by a doctor.

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This patient vomited after surgery which may have potentially caused bleeding. This photo was taken 4 days after breast surgery. The dark area on the right breast is a hematoma. The patient was taken back to surgery and the hematoma (extra blood) was evacuated. The patients breasts are both soft and she has not experienced any other complications.

Delayed wound healing and or Breast Implant Exposure: In an extreme case, the breast implants stretches the breast skin abnormally allowing the implants to push out through the skin. This complication is rare and requires additional surgery. In some other cases a patient may tear their suture line apart and require additional wound care. Smokers may be prone to heal slower than other patients due to their compromised blood supply caused by smoking.

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Necrosis: Most commonly seen with breast lift patients, nipple necrosis leading to loss of a nipple or nipples and or areolar is a rare but serious complication. Necrosis is caused by impaired blood flow to the nipple and areola after breast surgery . This complication is higher in smokers because smoking decreases oxygen in the blood supply. Dr. Corbin has successfully treated patients with this form of poor wound healing. After the wound has totally healed nipple reconstruction may involve, skin grafts and or tattooing to create a new nipple and or areolar complex.

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Infection: Infection can occur with any surgery. How often infections following breast implant surgery occur is not really known. Generally, infections after surgery appear within a days to weeks after the operation. However, infection is possible at any time after surgery. Infections with foreign objects present (such as breast implants) are more difficult to treat than infections in cases where no implants are present. If an infection does not respond to antibiotics, the implants will have to be removed. Usually, after the infection is treated and the patient has healed another surgery can be performed with new breast implants. Infections are usually rare, but it is a known risk of surgery.

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1st Breast Augmentation
Infection 4 months post op
removal of implants then redo

Aggressive scarring: A surgeon can never guarantee how a patient will heal or how they will scar. Most patients heal well and form small flat scars that fad in time. In very rare individuals they may form keloid scars where their incision is. This is rare, but can occur in individual who have a history of forming keloids.

Breast Implant Rupture: Silicone: Breast Implant ruptures can happen for a number of different reasons. Over time the body can break the implant down and weaken it, a car accident, a fall, or any hard blow to the chest area can cause an implant rupture. To confirm an implant rupture Dr. Corbin recommends patients get an MRI (magnetic resonance imaging) .Ruptures in the older silicone implants often stays inside or close to the capsule that has formed around the breast implant. If the surgeon removes the capsule and ruptured breast implant generally they will look for the any residual gel like substance and remove it at the same time. With the new generation of silicone gel breast implants the silicone gel is more cohesive and forms a unit instead of a runny liquid. Some people compare the texture to a gummy bear candy. If the new cohesive gel breast implants are cut in two they hold their shape and the silicone stay in the outer shell. The silicone does not migrate if ruptured. In addition the new implants have an improved stronger outer shell to help protect the implant and avoid ruptures.

Saline: The most common implants ruptures are seen in Siltex saline breast implants. (Textured Saline Implants). If a saline breast implant ruptures it can deflate quickly like a flat tire or it can have a slow leak that deflates over time. If a saline implant ruptures the sterile saline solution is absorbed by the body. If an implant ruptures Dr. Corbin recommends replacing it soon so that the breast pocket does not scar back down. Both American breast implant manufactures, Mentor and Inamed warranty their product for a lifetime. They will replace the breast implants free of charge if they rupture. Go to www.Mentorcorp.com to see their breast implant warranty.

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unilateral rupture

Symastia: This complication of surgery or natural breast deformity can occur when the skin or muscle is separated from the sternum. If the surgeon crosses over the mid line they can create a uniboob. Symastia can also be caused by breast implants that are too large and pull the skin and or muscle from the chest wall. If the muscles are overdisescted or tear from the weight and size of big breast implants this too can cause Symastia. Symastia is a difficult problem to correct, but Dr. Corbin has been featured on television for his surgery success with symastia patients. Dr. Corbin has never created symastia in a patient, but he has reconstructed patients who had this breast deformity. He has corrected symastia in bilateral (both breasts) situations as well as unilateral (one breast) symastia. He has also repaired a patient who had symastia naturally. Natural symastia is rare, but can occur and can be corrected with surgery. Generally, Dr. Corbin has to try and repair some of the damage done to the muscle. He may also put in smaller breast implants. And in some cases depending on the extent of the damage done to the breast muscle he may put the new implants in front of the muscle. The revision surgery technique varies from patient to patient depending on their specific needs.

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Bilateral Symastia
Bilateral Symastia
Bilateral Symastia

Rippling: Sometimes in very thin patients, patients with little breast tissue or patients with thin skin, they can see or feel small ripples from the breast implants. Generally what causes the ripple is the edge of the breast implant. Also as the breast ages and becomes ptotic ripples may occur or become more noticeable as the skin looses its elasticity and firmness. Rippling generally occurs more with saline breast implants than in silicone breast implants. With the new firmer silicone breast implants ripples are almost non existent. Some basic ways Dr. Corbin corrects rippling is to use alloderm to reinforce the areas where the skin is thin and ripples many be, injecting free fat into the breast (difficult in the presence of implants) or switching the patients breast implants from saline to silicone. Some things that may help prevent rippling are: smaller breast implants, putting the breast implants behind the pectoral major muscular, as well as filling saline breast implants slightly more than the minimum specified by the implant manufacture. If you look at a saline breast implant like a water balloon, you want to fill it just enough to get the wrinkles out yet keep it soft and not too firm.

Double Bubble: There are basically two different breast shape deformities in which the term "double bubble" would describe.

The first description of a double bubble look is an obvious deformity of the breast shape in which the part with the implant sits at the normal level for a breast, and the natural breast tissue and nipple have sagged downward. This double bubble look can occur immediately following surgery or over time because of pregnancy weight loss or gravity.

Basically, there are four indications for the double bubble to be present in the breasts.

1. The breast itself has drooped downward and slid off the breast implant.
2. The implants are sub-muscular.
3. The breast pocket or tissue is not sutured down correctly.
4. There may be capsular contracture.

This type of double bubble is more common with under the muscle breast implants, but can also be seen in both sub-muscular and over the muscle breast augmentation. This look of a double bubble can be caused the patients natural crease is very sharp, indented or constricted, and produces an obvious groove partway between the nipple and the new post surgical lower crease, separating a bulge above from a bulge below. In some cases, this condition gradually clears up if the breast tissue at the groove stretches out, however if it does not, a revision operation may be needed to suture the skin and breast tissue down to correct the double bubble look.

A surgical revision of this type of double bubble deformity requires a breast lift (mastopexy) or pocket revision. Dr. Corbin has never given a patient a double bubble, but he has corrected many patients done elsewhere who have had this breast deformity either bilateral double bubbles or unilateral double bubbles.

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Bilateral Double bubble
Unilateral double bubble redo

Bottoming out: Breast implant bottoming out can be seen when the implants are placed too low on the chest. Generally the breast shape lacks fullness on the top of the breast and most of the breast fullness is at the bottom. This causes an odd shaped breast. The position of the nipples looks too high relative to the shape of the breast mound. This undesirable breast shape can occur because of over dissection of the pocket. Bottoming out can also be seen in some patients with skin laxity if the breast implants are placed in front of the pectoral major muscle instead of below it. Bottoming out is not seen with breast implants that are truly submuscular like with an axillary breast augmentation. This breast deformity can be fixed by suturing the pocket back down and placing the implants higher on the chest wall so that the nipple is centered more in the middle of the breast mound. In some patients switching the breast implants from a sub mammary position to a sub muscular placement may also improve the appearance of breasts that have bottoming out. If bottoming out is not corrected it only gets worse over time as the skin ages and becomes more lax. Dr. Corbin has corrected many cases of breast implant bottoming out this is one of the reasons he prefers to place the breast implants sub muscular vs. sub mammary.

Capsular Contracture: This occurs when the patient forms an aggressive scar around the breast implant or implants. There are different levels of capsular contracture graded by the Bakers classification system. It grades the firmness of the breast I thru IV. Bakers class I describes a soft breast , Bakers class II describes a normal breast with slight firmness, Bakers class III describes a firmer than natural breast and Bakers class IV describes a hard, painful and distorted shaped breast Capsular contracture can occur either bilateral or unilateral. The incidents of capsular contracture is higher in patients who have their breast implants placed submammary (in front of the pectoral major muscle). Some things done to help reduce capsular contracture are placing the implants submuscular, using textured implants if the implants are placed infront of the muscle and having patients take Accolate after breast surgery. Accolate or Singular is believed to reduce the incidents of capsular contracture.

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Bilateral capsular contracture
Unilateral capsular contracture
Bilateral open capsulotomy with removal of implants

Breast implant shifting: Sometimes implants may shift from their original position. This shift may change the appearance of the breasts, giving them an unusual look. (especially the pre-shaped anatomical breast implants) Implant shifting can occur for a number of different reasons: Injury to the breast implants, pregnancy, weight gain, weight loss or if the implant is not securely positioned in the breast pocket. Breast implant shifting is unusual, but can be corrected with surgery. Dr. Corbin has corrected patients with implants that have shifted. He just fixed a woman’s breasts after she had already undergone 3 previous breast surgeries with another plastic surgeon. When the surgeon initially took out the patient’s large breast implants and replaced them with the pre shaped anatomical breast implants the surgeon did not tighten the pocket around the new smaller implants. After a while the implants both flipped and gave the breasts a very distorted shape. Dr. Corbin revised her pockets and replaced the anatomical (teardrop) shaped implants with round silicone gel.

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Anatomical breast implant shift

Additional breast implant surgeries: Breast implants do not last a lifetime. There are many patients who have breast implants for years, but eventually for one reason or another they decide to change implants and or improve the appearance of their breasts. Some reasons patients need additional surgery are; breast implant deflation, capsular contracture, infection, implant shifting, aging breasts, childbirth, weight loss, weight gain, natural changes in the breasts appearance or calcium deposits in the breasts. Whatever the reason for additional breast surgery the key to surgery success is to have a plastic surgeon like Dr. Corbin with extensive surgical experience in the area of breast revisions performing the corrective procedure.

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Breast Reconstruction patient
Breast Redo patient

 

 

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Breast Redo patient
Breast Redo patient