Breast Implant Revision


3d Animated Procedures


Breast enhancement with the placement of saline or gel filled silicone implants is the most frequently performed plastic surgical operation. Breast implants are often used simply to enlarge a breast considered too small or deflated, but they are also placed in concert with skin envelope reduction and nipple areolar repositioning to correct loss of support of these tissues (referred to as a mastopexy).

There are many causes of the “bad result” in breast implant surgery. Some of these such as capsular contracture which can create pain, deformity, and malposition of the breast are unfortunate maloccurances which are an accepted risk because they cannot be eliminated. Others such as overly large implant selection which can damage the support structures of the breast as well as cause nipple malposition and ” snoopy dog breast” shape are avoidable.

I have always been an advocate for NATURAL BREAST ENHANCEMENT and have refused to create the showgirl breast due to the damage likely to occur over time. This goal of natural and feminine breast shape has given me a busy and extensive experience in the correction of the Bad Result. Some of the problems that I have solved Included excessive implant size, significant asymmetry, snoopy dog or double bubble deformity, recurrent capsular contracture, saline and gel implant rupture, synmastia or unibreast, implant malposition and nipple areolar malposition.

I authored one of the first papers in the plastic surgical literature regarding breast implant rupture diagnosis by ultrasound examination, as well as published strategy advice to treat implant malposition. I invented an instrument essential to safe implant placement manufactured by ASSI surgical.

Breast revisional surgery is more complicated than the first procedure but there are many solutions available to solve these problems. Amongst these is a procedure that I published called Presurgical Percutaneous Implant Deflation which is performed in my office. Other techniques include the removal of implants with skin tightening, breast reshaping, and nipple repositioning (mastopexy). When a ruptured or malpositioned implant is replaced , I prefer a sub pectoral position for the final implant. With severe recurrent capsular contracture I often use Acellular Dermal Matrix as a spacer. A mastopexy may be done internally by suturing the old capsule or externally involving the skin envelope as necessary to tailor the breast to the new implants. These procedures require general anesthesia.

*Individual Results may vary

Richard Levine, MD, DDS, FACS
4499 Medical Drive, Suite 316
San Antonio, TX 78229
Phone: 210-614-2747
Fax: (210) 614-6221
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