Breast Implant Revision Surgery - Honolulu Hawaii
Hawaii plastic surgeon Dr. Michael Pasquale has extensive training and experience with breast revision surgery and breast implants.
Implant Size Revision | Capsular Contracture | Symmastia
Bottoming Out | Ruptured Implant | Double Bubble
Dr. Pasquale has spent years analyzing and correcting patients with failed breast reconstructions, bad breast augmentations, capsular contractures and uneven breast lifts.
There are various reasons why a woman may seek to have further surgery. As alluded to above, breast implant deflation is a common reason why women may need more surgery. The devices, whether saline or silicone, may leak and the woman may notice that one or both of her breasts has changed 
shape or size. With saline implants it usually is readily apparent when they leak. As the saline is absorbed by the body the breast becomes softer and smaller. With a leaking silicone gel implant this may not be noticed as quickly. In most instances, the silicone gel leaks out of the implant in the capsule or pocket and is usually self-contained.
Do you need a Breast Revision?
Most women can tell a subtle change in their body or shape while others notice nothing at all. There are tests, such as a mammogram, MRI or ultrasound that can help to determine if there is a problem with your breast implants, but ultimately the best determination is made by an experienced plastic surgeon. A plastic surgeon who has seen most if not all the problems and complications that occur with breast implants will be able to not only tell you what problems you are having but the solutions that will be needed to correct them.
Finding a surgeon for Breast Revision
Many surgeons (plastic or cosmetic) are reluctant to admit that they do not know what problem you are having, offering a flawed diagnosis based on their limited experience or training. This would obviously result in an erroneous plan to correct the misdiagnosis, leaving you with the same problem or worse. You would also have paid to have a meaningless surgery in addition to the pain and discomfort (mental and physical) that goes along with any surgery.
Many of the best plastic surgeons to consult with for these problems are board certified in reconstructive surgery. Others have specialized in breast reconstruction for cancer patients and breast augmentation specifically. Whomever surgeon you should choose should have the ability to perform breast augmentation through numerous approaches (periareolar, axillary, inframammary, perithelial), they should have a lot of before and after pictures of breast implant patients (10 or more years of experience with breast implant surgery), and they should be a board certified plastic surgeon. It also helps to get several opinions in regards to the cause of your particular problem and which course of action can or should be taken to correct it.
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> Implant Volume / Size Revision
Patients with saline implants who aren't happy with the volume or size of their breasts can elect to have revision surgery to add or remove saline from their implants. Silicone patients would have to purchase a new silicone implant in the desired size.
> Capsular Contracture
This is the most common complication for breast implant patients. A capsule is the fibrous tissue that grows around the breast implant (as with any foreign object placed in the body).
> Symmastia
The breasts appear too close at the center and the implants can appear to be touching each other. Symmastia (aka - uniboob, breadloafing) occurs only when an implant is placed under the muscle (submuscular) and the pectoralis muscle is severed from the sternum.
> Bottoming Out
Breast implants that have bottomed out can have nipples that appear too high or an inframammary fold that appears unnaturally low.
> Ruptured Implants
Decreased breast size, uneven breasts, pain or swelling can indicate a ruptured breast implant (saline or silicone breast implants). Most ruptures are covered by the implant manufacturer, although surgical costs for replacing the damaged implant are still incurred.
> Double Bubble
When tissue hangs beneath an implant which has been placed submuscular, this is referred to as a double bubble or high-riding implant. This usually occurs with an individual who has sagging breasts before their breast augmentation surgery.
