Posts Tagged Redo plastic surgery
Here we have images of a woman I first saw a few years ago. She had had two breast implant operations before and noted after her second (an enlargement with full lift) that her left breast progressively dropped (over about a year). I recommended re-operation to re-set the lift and downsize her implants. She agreed to the lift but not the implant size decrease. Smaller implants do not weigh as much so the rate of recurrent sag should have been less. As these were silicone gel implants this is particularly important. They weigh more than saline-filled implants.
The After image was taken at 1 month. She moved Out of State, but I predict that the sag probably recurred at least to some extent.
(1) Large implants are hard to keep up. Plan on smaller implants or more surgery later if you select larger implants. Large silicone implants also harden (capsular contracture) more frequently/severely than smaller implants or saline implants. This also contributes to a higher redo rate.
John Di Saia MD
Originally posted 2007-05-15 07:30:21.
Low Maintenance Breast Implant
Surgery – Is this achievable?
I am looking into getting breast implants but want to keep redo surgeries to a minimum. Some of my friends have had 2-3 boob jobs in ten years, so I am not going to their doctor. I saw a few of your patients online saying that the implants you put in they kept for ten years. I want to get a worry-free boob job?
Thanks for the compliment.
There are several things you can do to reduce your risk for the need/desire for re-operation after breast implant surgery:
(1) Have surgery by a good qualified surgeon. In my book, that means a good ABPS board-certified plastic surgeon.
(2) Request guidance from your surgeon regarding the volume to which you can go safely. The leading cause of poor outcomes with implants that I see is the placement of implants too large for a woman’s available soft tissue coverage. Good surgeons know this although many fear “losing the case” if they share their concerns.
(3) Choose saline-filled implants and have them placed beneath your pectoral muscles. Silicone gel is another option but I feel the breast hardening rate (capsular contracture} is higher with them. Capsular contracture is also higher in some other cases that you may want to review before surgery.
(4) If you have any degree of breast sag, talk about breast lift surgery as an option before you have your operation.
John Di Saia MD
Originally posted 2011-04-22 07:30:34.
Heidi Montag was back in the OR again not so long ago for ten hours of surgery. Taking anything said or done by a reality television starlet entirely at face value is a bit much. Her “ten procedure/ten hour” trip to the OR is certainly not typical of the average cosmetic surgery patient, but it keeps her in the headlines which might have been a major part of the idea.
I liked the change from her first operation in 2007 (nose and breasts) as it seemed to improve, but not erase too much of her identity visually. The change from her second set of operations moved her in the direction of Jordan (Katie Price) making her appear kinda “overdone.” This is a personal opinion of course and a matter of philosophy. Plastic surgeons differ in philosophy as we have discussed here before.
Reality television showcases the extreme and unusual. Heidi certainly qualifies.
John Di Saia MD
Originally posted 2010-01-18 07:30:54.
Kelly Smith’s attempt to go up a bra size when her 15-year-old leaky saline implant needed a repair this winter left has her in a self-imposed house arrest.
Smith said her new size-D implants looked “fantastic” for eight weeks. But then a quarter-sized “bubble” appeared between her breasts.
Sounds like this could be symmastia, an unusual complication in which the breasts appear to have no cleavage. It might also be a tear in the muscular cover of the implant. Complications can be difficult to fix. We can’t be sure of course as the story doesn’t really give these particulars.
We also are not given much info on the doctor. Was she a trained and/or certified plastic surgeon? I am not sure the case is a “mistake,” but poor outcomes should be fixed if possible. Poor outcomes more commonly come from the work of poorly trained or inexperienced surgeons. Did the patient have “much larger implants” placed at her second operation? Maybe she didn’t have the tissue to cover them and this lead to the problems.
Hopefully this lady will have her problem properly addressed.
Reader Laura Adds:
Since plastic surgery seems to be becoming more mainstream, have you seen an increase in patients needing rework done? Have there been more patients with unrealistic expectations?
When patients get into the hands of novice surgeons, problems are more common and redos are as well. Some patients do think they can have anything they want and go to the doctors who promise this leading to more problems. This lady might be just such a case.
John Di Saia MD
I have never really known what to think about testimonial stuff, but a patient of mine did this one for me regarding the work I did for her. I think for what it is it turned out pretty well. Give me your feedback if you wish. Civil comments will be allowed.
John Di Saia, M.D.