Breast Implant Issues

Unfortunately, some women naturally develop conditions that cannot be predicted or prevented. When this is the case, Dr. Lampert finds that revision surgery is usually indicated.

Dark brown-haired woman looking out the window in black lingerie

Women seeking breast implant revision surgery in Miami may be understandably confused with the amount of conflicting information on the subject. Problems with implants develop in about 10% of women ranging from implant rupture to capsular contracture. Some women are simply unhappy with the cosmetic result of their surgery, wishing they had gone larger or smaller. Breast implant problems do have solutions. There is no reason to suffer with painful or cosmetically unsatisfactory implants. In some cases, insurance may cover the cost of the revision. Dr. Joshua Lampert, board-certified plastic surgeon, has spent thousands of hours performing revision surgery. He notes that while implants do have a lifespan, which will eventually require replacement, this should not be the issue for at least 10 to 15 years.

Four Main Issues

There are four main breast implant issues:

Capsular contracture
Breast implant rupture
Incorrect implant size
Implant movement or “malposition” of the implant related to the shape of the breast

Capsular Contracture

This condition is caused by the natural response of the body to encapsulating any foreign material with scar tissue. It can occur as early as 6 weeks post-surgery. The scar tissue, also called a capsule, can remain soft throughout the life of the implant and cause no problem. For some patients, however, the scar tissue around the implant contracts, which causes the breast to feel hard, sometimes painful, and eventually to become displaced. With enough time, almost every patient gets some degree of capsular contracture. Older implants and capsules over 20 years old can calcify and become very firm.

Ruptured Implants

There are two types of implants: those filled with saline and those filled with silicone gel. All implants are contained within a silicone elastomer shell. When saline implants rupture, the deflation is usually immediately obvious due to the saline solution leaking into the chest. Saline solution is safely absorbed into the body so that this is not a health concern. However, any implant, once ruptured, must be removed and replaced, if desired. Sometimes a slow leak leads to a slowly deflating saline implant.

Silicone gel implants have greatly improved over the last 20 years. They rarely spontaneously leak, and rupture rates are very low. Ruptures can occur due to outside forces such as:

Trauma, as in a car accident
Mammogram pressure
Accidental puncture during biopsy or other surgical procedures

The newer cohesive gel implants (or “gummy bear implants”) have a fill that remains in the implant shell after a leak. With silicone implants, it may not be immediately obvious that there is a problem. The FDA recommends that women with silicone gel implants should commit to having an MRI every 3 years after their initial surgery and then every 2 years after that to detect any possible rupture that may be present. Additionally, any silicone gel that escapes the shell is usually contained within the scar capsule naturally formed around the implant.

In the past, there was considerable fear surrounding silicone gel leaking into the body. However, extensive research has shown safety with the use of both silicone and saline breast implants for breast augmentation. An MRI can usually detect an implant rupture, which is the only way that many leaking silicone implants are detected. In the case of a leaking saline implant, the affected breast will appear smaller—usually immediately, unless there is a very slow leak. PIP breast implants, which were never allowed in the US but were popular in France, had a very high incidence of rupture and have since been removed from the market. Patients with these implants should have them removed as soon as possible.

Poorly Positioned Implants (Implant Malposition)

Poor implant placement, or implant malposition, is a mistake that Dr. Lampert corrects in breast revision patients that seek him out to remedy this problem. Miami is a hub for plastic surgery procedures. Unfortunately, not all work done will stand the test of time. This condition is similar to symmastia. Implants can move to locations that are too high (superior malposition), to low (inferior malposition), away from the middle of the chest (lateral malposition,) or too close to the middle of the chest (symmastia.) When the breast implant falls below the natural fold where the breast meets the chest wall, a ‘bottomed out’ or ‘stargazer’ effect occurs. Incorrectly placed implants can migrate within the breast, leaving a very undesirable cosmetic effect.

In cases where the implant migrates toward the armpit (or axilla), it can not only look bad but restrict downward arm movement. There are several procedures that Dr. Lampert uses when correcting implant displacement. The implant will usually need to be removed and replaced no matter what method is used. Simply trying to anchor the implant to a better location using sutures is usually not a permanent solution. Dr. Lampert will employ a technique that creates a permanent pocket in the right location so that the implant stays in place. At the same time, Dr. Lampert often creates an internal structure, or sling, to support the implant in the desired position.

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Incorrect Implant Size

In this case, Dr. Lampert can employ different correction methods depending on the type of implant used, shape of the breast, and prior scars. Dr. Lampert can usually remove and replace the implants using the original incision sites to minimize scarring. If scarring is a problem, a scar revision can be done during implant replacement. Many women change their minds regarding implant size as they get older and opt to downsize. Some women are disappointed to find out that there really hasn’t been enough of a change in their appearance, and they want to go a little larger. Whatever the breast issues or problems may be, Dr. Lampert is dedicated to helping his patients achieve their personal image goals and desires.

Symmastia

This is a condition in which the left and right implants move toward each other too close together, eliminating definition between the two sides. The two implants can even touch each other or nearly touch. The breast implant pocket was likely dissected too far in the cleavage area. The skin over the sternum (or chest breast bone) stretches, creating a web-like structure. The effect is to blend the two sides creating a ‘bread loaf’ deformity. Repair of symmastia requires surgical skill and the best breast revision Miami has available.

Muscle Flex Deformity

Implants that are placed submuscularly, or under the pectoralis muscles, must have sufficient room to remain unaffected when this muscle is flexed.

If preparation of the site has been inadequate and not enough muscle has been released, patients will notice the implants moving abnormally when working out or lifting heavy objects.

Why Choose Dr. Lampert?

Because breast surgery is so popular today, many plastic surgeons have jumped at the opportunity to see a high volume of clients, rushing through consultations and procedures without much thought for safety or aesthetic excellence. Dr. Lampert is different. He only sees a select number of clients, treating each with the same delicacy and meticulous precision as he would bestow upon any family member or loved one. He replaces aggressive sales tactics with a genuine desire to educate, inform, and empower his patients so that they can enjoy a successful outcome and lifelong contentment with their appearance.

Safety is a top priority for Dr. Lampert. To this end, he created his own state-of-the-art Ambulatory Surgery Center, Miami Surgery, LLC, an immaculate facility that houses among the most cutting-edge technology and equipment currently on the market. Unlike almost every other plastic surgery operating room in South Florida, Miami Surgery, LLC is Federally Certified by the Florida Agency for Health Care Administration (AHCA), the same agency that licenses all of the best hospitals in Florida.

Miami Surgery, LLC is one of only three other AHCA-certified ASCs in Miami-Dade County dedicated to plastic surgery and operated by only Board Certified Plastic Surgeons (American Board of Plastic Surgery) and Board Certified Anesthesiologists. Patients under Dr. Lampert’s expert care can trust that his facility meets and exceeds the same operating standards as the Ambulatory Surgery Centers found in elite, world-class hospitals nationwide.