Breast Augmentation Correction

Overview | Patient Specific Questions | Photo Gallery

1. What is Breast Augmentation Correction?
2. Am I a good candidate for Breast Augmentation Correction?
3. What can I expect at my initial Breast Augmentation Correction consultation?
4. What are the risks and complications of Breast Augmentation Correction procedure?
5. How is a Breast Augmentation Correction procedure performed?
6. What can I expect after Breast Augmentation Correction surgery?
7. Where are the incisions following a Breast Augmentation Correction surgery?
8. Will I have scars following a Breast Augmentation Correction procedure?
9. When will I be able to return home after a Breast Augmentation Correction procedure?

What is a Breast Augmentation Correction?

A Breast Augmentation Correction is a revision of prior breast augmentation surgery including correction of implant malposition, breast pocket lateralization, implant deflation, breast mound asymmetry, breast mound deformity, capsular contracture, and implant size alteration or saline to silicone exchange.

Am I a good candidate for Breast Augmentation Correction?

The best candidates for Breast Augmentation Correction surgery are women who are displeased with the appearance of their breasts mound appearance following primary breast augmentation surgery. Undesirable appearance of breast mound deformity may occur early due to surgical technical error or years following surgery due to the effects of gravity and implant aging.

What can I expect at my initial Breast Augmentation Correction consultation?

At your initial consultation, you and Dr. Mowlavi will discuss your concerns and goals regarding reversing undesirable breast deformity following breast augmentation. He will describe in detail what your Breast Augmentation Correction procedure will entail. Dr. Mowlavi will then perform a physical examination, after which you will decide together which specific surgical maneuvers are best suited for your situation. You will have the opportunity to review before and after photographs of patients that Dr. Mowlavi has corrected. Finally, a complimentary quote will be provided and explained in detail.

What are the risks and complications of Breast Augmentation Correction?

As with all surgical procedures, there are side effects and risks of surgery. Your Breast Augmentation Correction procedure may take anywhere between two to four hours of operative time to complete. In order to determine if you are a suitable candidate for this surgery, Dr. Mowlavi and our board Certified Anesthesiologist conduct a detailed review of your medical history, lab values, and if indicated, EKG results. If you are found to have any risk factors, Dr. Mowlavi may post-pone your surgery. Both Dr. Mowlavi and the Anesthesiologist participate in this process to determine if you are physically stable to proceed with the Breast Augmentation Correction surgery.

Side Effects: Side effects are events that may be experienced by patients as a result of your surgery and should not be considered adverse events. Our patients are counseled regarding these effects and if experienced they are tolerable and usually temporary in duration.

1. High riding implants: Patient’s frequently notice high riding implants in the early postoperative period. The implants will drop into their desired, aesthetically pleasing position within 2 to 4 weeks. The tendency for the implants to sit high is countered by wearing of a breast band, which will be provided by your plastic surgeon. The breast band will be worn for approximately 2 to 4 weeks until the implants fall into their desired space.
2. Numbness: Numbness can occur when sensory nerves are inadvertently traumatized during surgery, which involves creation of a pocket for the implants to sit in. Since these nerves are extremely small, they are not apparent to the naked eye and so unavoidable. Clinically, the peri-areolar incision has been associated with increased incidence of numbness since the dissection is closer to the nerves. Fortunately, numbness is an infrequent event and when present resolves itself over 2 to 3 months.
3. Capsule formation: Capsule formation refers to the normal formation of a scar around an implant. This scar should remain thin; but when thickened, it is termed capsular contracture and can result in distortion of the overlying breast. Capsular contracture is rarely observed with saline implants and has been minimally observed with the use of new generation silicone implants.
4. Hypertrophic scar: Hypertrophic scar refers to the development of a thickened scar in the skin. Since, most plastic surgeons use a similar technique for closure of their skin incisions, whether or not you are at risk for this depends on the healing capacity of your body. Contrary to common knowledge, the better healer you are the more likely that you may develop a thickened scar.
5. Mild asymmetry of breast size: Asymmetry of the breasts is considered only a side effect because most women have some degree of asymmetry. The surgeon must do his/her best to improve on any asymmetry. Any preoperative asymmetry should be improved upon to within a 5% difference in size between the two breasts.
6. Deflation: Deflation of the implants occurs at a rate of 1% per implant per year. So in 10 years there is a 10% chance of having an implant deflate.

Risks: Risks are unwanted events that may occur during or following surgery. These events are recognized as “complications” but their occurrence is minimized by appropriate patient selection, proper surgical decision making, effective surgical technique, and thorough preoperative and postoperative patient management.

1. Hematoma: Hematoma refers to the accumulation of blood in the early postoperative period, which pools into a surgical pocket. When the volume of accumulated blood is less than 10 % of the breast volume, the hematoma is left to resolve on its own. If larger than 10 % most surgeons will recommend a trip back to the operating room so that this hematoma can be removed.
2. Infection: An infection is one of the worse complications that can occur following breast augmentation surgery. An infection may require removal of your implant.
3. Asymmetry of breast shape: Asymmetry in shape is very different than asymmetry of size (described above) and occurs when the implant pockets have not been dissected accurately. If the breast pockets are dissected too medially, this can lead to the breast pockets connecting together resulting in a condition called symmastia.
4. Pneumothorax: A pneumothorax refers to the inadvertent puncturing of the lining that covers your lungs. This is a rare event but can occur since implants are placed under the pectoralis muscle. When dissecting under the muscle, only a few millimeters of tissue separate the breast pocket from the lung lining. If the lung lining is punctured, the surgeon will have to place a catheter into the lung cavity and seal the lung lining at the end of surgery. You will require overnight hospitalization and removal of the catheter the following day prior to going home.

How is a Breast Augmentation Correction procedure performed?

Since breast augmentation surgery will require general anesthesia, it may be performed in an operating room that is part of a hospital institution or outpatient surgery center. Frequently, patients may be operated on in an in-house office based operating room, but it is of utmost importance for patients to make sure that a surgical accreditation body such as AAAASF accredits the office facility.
The surgery involves placement of accurate preoperative markings including: the midline of the chest, the incision line (determined by the approach used), the inframammary crease (fold under the breast), as well as the pocket that is going to be dissected or repositioned to fit the implant. The pocket size and position is determined by the correction that you need. Following removal of your implants, breast pocket alteration, and implant replacement, Dr. Mowlavi will position you in several positions including sitting upright and all the way on your back to ensure that appropriate correction maneuvers have been performed. Dr. Mowlavi performs meticulous breast pocket adjustment including releasing areas that are tight(termed capsulotomy) and sewing down areas of the pocket that have loosened(termed capsulorrhaphy). When Dr. Mowlavi is satisfied with your new breast mound appearance and symmetry, he repairs your incisions in in multiple layers and using plastic surgery closure techniques to ensure protection of the implant and an aesthetically pleasing incision line.

What can I expect after Breast Augmentation Correction Surgery?

Patients will awaken from general anesthesia to find their breasts wrapped with Ace Wraps as well as a breast band. The Ace wraps are to support the implants in their newly created pocket. The breast band is to prevent the implants moving up on the chest wall or moving from their newly created position. Although this is not intuitive, for the first three weeks following surgery, breast implants tend to want to move up on the chest wall against gravity. The band counters this movement and ensures that the breast implant stay in the desired position. Patients will feel sore throughout the first 2 to 3 postoperative days. By placing long lasting local anesthetic solution in the breast pockets prior to closing the incisions, this soreness is minimized. Patients are asked to avoid lifting of weights greater than 15 pounds for the first two weeks. Incision lines will be sealed with special tape (steri-strips) for the first month. Showering should be delayed until the 2nd day following surgery. Finally, exercise should be limited for the first 4 weeks until the incisions and the breast pocket have completely healed.

Where are the incisions following a Breast Augmentation Correction procedure?

The various approaches to primary breast augmentation include:

1. Inframammary crease (in the breast fold): this approach provides the surgeon the best visualization of the breast pocket that he/she is dissecting thus ensuring breast symmetry following breast augmentation surgery. The most important advantage of this approach is that it provides the most direct access to the surgical pocket in the event that revision surgery is required.
2. Periareolar (around the areola): when this incision heals well, it can be very well camouflaged. However, this incision is associated with several disadvantages including: surgical trauma to the breast glands, increased potential for nipple numbness, and poor scarring in the event revision surgery is required. Since the incision is circular, if opened a second time, it tends to contract into a straight line when healed thus distorting the areola.
3. Transaxillary (in the armpit): This incision tends to hide well as long as you dont have to raise your arms as part of your occupation. However, it has several disadvantages including: more difficult dissection resulting in more difficulty obtaining symmetrical pockets, potential for arm numbness, potential for damaging large veins to the arm which if damaged could result in prolonged arm swelling, and a necessity to convert to another incision if a revision is necessary (revisions may include correcting asymmetry or to remove a thickened capsule scar). Breast implants using the armpit technique are usually placed under the pectoralis muscle.

Dr. Mowlavi performs all Breast Augmentation correction procedures through previous surgical incisions in order to avoid creation of further breast scars. He utilizes any peri-areolar or inframmammary crease incisions already present to gain access to your implant, to remove your implant, and to revise your breast pocket. Only when necessary, will Dr. Mowlavi extend these incisions in order to tuck/revise breast tissues that are redundant, droopy, and/or out of place.

Will I have scars following my Breast Augmentation Correction procedure?

Although surgical incision do look reddish and are evident at first, they progressively fade to pink and then blend to your natural color. Depending on the natural pigmentation of your skin, your incisions may fade and be nearly invisible. In general, Dr. Mowalvi’s surgical incisions should heal as fine lines. Dr. Mowlavi and his staff go to great lengths to ensure well healed incision lines utilizing an anti-scar topical silicone gel used for one month following surgery. In addition, Dr. Mowlavi may encourage several sessions of Intense Pulse Light Therapy (all complimentary) if he feels your incisions demonstrate prolonged redness.

When will I be able to return home after my Breast Augmentation Correction procedure?

Breast Augmentation Correction is an “Out Patient” surgery. You will be released to go home or to a facility of your choice after your surgery. We do offer “Recover Retreat” options, for patients who feel more comfortable having 24 hour post-operative nurturing by a registered nurse.