Secondary Breast Operations

Specialist in breast implants, breast augmentation, and breast implant exchange for Northern Virginia, West Virginia, Maryland, & Washington DC

Subglandular Malposition

This sounds like a big phrase and sometimes it is a big problem. Breast implants placed above the muscle are only covered by a woman’s natural breast tissue and her skin. This position is also called ‘below the breast gland’ or ‘sub glandular’. Over time, in some patients, the breast mound with the breast implant can develop skin stretch. This is a suboptimal situation. This stretch will lead to an increase in breast implant visibility. The subglandular positioned implant is easier to feel and may cause more skin stretch problems than the below the muscle position.

These breast implant problems can be very distressing to some women. It is in these patients, that Dr. Brown has found some of the happiest people after correcting their problem. The best solution for correcting subglandular malposition is to remove the old breast implants and all of the scar tissue and replace the breast implants below the muscle. The old breast implants may be reused if the woman’s skin envelop is not too stretched out. If the breast skin envelop is large, new larger breast implants than the original breast augmentation will be needed and this may make her appear larger than before. The solution may also require a breast lift if the woman also wants to be smaller than she was after the first breast augmentation surgery. As with any plastic surgery, there are risks associated with breast implant exchanges and scar tissue removal.

Capsular Contracture

The human body heals by forming scar tissue. This is a normal response to an injury and scar tissue forms from both external injuries and internal injuries. A scar tissue layer forms around the breast implant. This scar tissue layer is called the breast implant capsule. This scar tissue layer can either be directly around the breast implant or it may form somewhat away from the breast implant. The size of the breast implant capsule and whether it restricts the breast implants mobility is determined at the time of breast augmentation surgery and shortly thereafter. If the pocket size is small, then the breast implant will not move much and the breast will appear rounder and feel firmer.

Sometimes after breast augmentation, the breast mound can become firm secondary to this scar tissue formation. This may occur within a few months after the breast implants have been placed but will usually take years to develop. This scar tissue occurrence is not as common as it used to be and even less common with the breast implants placed under the muscle. The scar tissue is attached to the breast tissue and the implant, and as the scaring gets worse; the mound can become firm and distorted. This is called a capsular contracture. In the most severe cases, it can even cause pain.

Breast Implant Exchange

Aside from the occasional patient who also presents with some breast shape irregularities caused by breast implants, the breast implant exchange surgery is one of the more straightforward operations. Despite this, it is often performed too cavalierly without the 'attention to detail' it deserves. The details of a breast implant exchange involve the removing the older breast implants and perhaps the surrounding breast scar tissue. The older breast implants may be silicone gel breast implants or saline filled breast implants. Other details center on creating a larger breast mound when necessary, but also in creating more aesthetically pleasing breast shapes. Depending on how much larger a woman wants her breast implants to be, dictates how well the breast implant exchange operation will go and how quickly she will recover. Usually to the woman's surprise, it does not hurt as much as their initial breast augmentation; if her original breast implants where below the muscle. These women are usually ready to go out soon afterwards with very little down time. Despite this description, there are risks involved with the breast implant exchange.

Breast Implant Removal

Some women for various personal reasons will request that their breast implants be removed permanently. Depending on how long they have had their breast implants in, how much overlying breast tissue and skin they have, as well as how much of their breast mound was made up of breast implant, will dictate how many complexities their 'customized' operation will have. Some women after their breast implants have been removed will need no other breast surgeries, while others may require a breast lift. Some breast lifts may be extensive while others may be very limited. The women that require breast lifts will be left with scars on the outside of their breasts.
Informed-consent documents are not intended to define or serve as the standard of medical care. Standards of medical care are determined on the basis of all of the facts involved in an individual case and are subject to change as scientific knowledge and technology advance and as practice patterns evolve.

To learn more about breast augmentation surgery, click to review more of an overview of breast augmentation. To learn about breast anatomy and breast implant positioning you may want to start here.

For more information click on the icon above or to see the actual breast augmentation surgery video be performed on a live person, visit one of Dr. Brown's breast specific web sites.

Prior to any surgical procedure, it is imperative that you have read and understand the consent forms required for a plastic surgical procedure.