Corrective Breast Surgery – Many patients who have breast augmentation, mastopexy or breast reduction have unsatisfactory outcomes. Some of the complications that can occur after “failed” breast surgery necessitate secondary or revision surgery. These types of operations are Dr. Handel’s “specialty.” He has extensive experience in secondary or revision breast surgery for a variety of problems. Common problems that may occur after breast implant surgery and can be successfully corrected by revision surgery include removal and replacement of ruptured or leaking breast implants, correction of capsular contracture, correction of waviness, rippling and irregularities of the breasts, correction of asymmetry and correction of inappropriate breast size. There are other rarer complications, including synmastia and the “double bubble deformity” as well as a variety of different types of implant malposition that can also be effectively treated.
Patients who have undergone reduction mammaplasty (breast reduction surgery) may have complications related to wound healing, including undesirable scarring, loss of part of the nipple and areola and the formation of firm nodules from fat necrosis. All of these conditions can be improved by corrective surgery. Patients who have undergone prior breast uplift (mastopexy) may also have problems with wound healing, circulatory problems to the nipple and areola resulting in loss of tissue, persistent breast asymmetry and unsatisfactory correction of their breast drooping. Most of these problems can also be corrected effectively by revision surgery performed by Dr. Handel.
One common complication that sometimes occurs after breast implant surgery is “capsular contracture.” This refers to the phenomenon where the scar tissue lining that forms around the implant begins to contract or shrink causing the breast to feel too firm and even to become distorted, painful and tender. Capsular contracture is a problem that can always be repaired but usually requires reoperation. In most cases, the tightened scar tissue capsule is “released” or removed altogether, and a brand new breast implant is inserted.
A number of adjunctive measures can be undertaken by Dr. Handel to try to reduce the risk of recurrent capsular contracture. This can involve things like pocket “conversion” where a subglandular implant is converted to the subpectoral position or, conversely, a subpectoral implant is converted to the subglandular position. There are also new surface textured breast implants that seem to have a lower risk of capsular contracture. There are adjunctive measures such as pocket irrigation with antibiotics, iodine solution and chlorhexidine that may also reduce the risk of capsular contracture. Dr. Handel is careful with his surgical technique to do everything possible to avoid capsular contracture and to prevent it from recurring in patients who already have the complication.
Another problem that may be seen in association with breast implants is implant “malposition.” Breast implants can be malpositioned in a variety of different directions. Implants can be too high (often seen in conjunction with capsular contracture), they can also be too low (a condition sometimes known as “bottoming out”), they can be too far off to the side or they can be too close to the midline (a condition known as synmastia). Implant malposition is something with which Dr. Handel has had extensive experience. He has performed hundreds of corrective procedures for all types of implant malposition and customizes the operation to employ the appropriate methodology and implant to best ensure a successful outcome and to reduce the risk of recurrence of the deformity. If you suffer from implant malposition, Dr. Handel will be happy to provide you with all of the details about exactly what procedure he feels worked best in your situation.