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Secondary Breast Augmentation Surgery
Thursday, 01 April 2021

When a woman undergoes cosmetic breast augmentation surgery, the last thing she thinks about is that she will have to have a secondary surgery, in a short period of time. However, patients dissatisfied with breast augmentation surgery frequently appear in a cosmetic surgeon’s office. The reason for this dissatisfaction can be as a consequence of a bad surgery, although sometimes it is due to a complication. In other cases, it is due to a lack of communication between patient and surgeon. Due to aging, many patients revisit a cosmetic surgeon to present a breast deformity that they did not initially have.

For this reason, the most important thing before undergoing a breast augmentation intervention is that you choose a good hospital. It should be a doctor who specializes in reconstructive and aesthetic plastic surgery with extensive training in cosmetic breast surgery. It is also important that you are sure that your plastic surgeon has understood which ones are your illusions. This will ensure that you don't have unreasonable expectations.

Some of the issues that lead to a secondary breast augmentation are mentioned below.
 

CAPSULAR CONTRACTURE

 
Capsular contracture or encapsulation of a prosthesis, after breast augmentation, manifests as the progressive hardening of a breast. It is sometimes accompanied by externally visible deformity. The prosthesis is rounded and moves up and out, sometimes leaving the lower pole without prosthesis. Capsular contracture has been linked to the following:
 
  • The use of smooth prostheses in the subglandular plane.
  • With aggressive surgery.
  • With a postoperative complication such as hematoma and seroma.
  • With aggressive mobilizations during the first postoperative month.
  • With a special sensitivity of some patients.
 
Once capsular contracture appears, the plastic surgeon can change the prosthesis and place it in the subpectoral plane. This can only happen if the prosthesis is in the subglandular or subfascial plane. Also, if the prosthesis is smooth, it will be changed to textured.A polyurethane prosthesis can also be implanted, if the patient has silicone implants. If everything fails, a cosmetic surgeon will have to remove the prosthesis altogether and reconstruct the breast using an autologous tissue.
 

ROTATION OF AN ANATOMIC PROSTHESIS

 
The rotation of an anatomical prosthesis can be due to excess pocket during surgery. It can also be due to an unresolved postoperative complication that prevents fixation of the prosthesis. Furthermore, excess mobility or exercise during the first postoperative month, can also cause this rotation.
 
Once the rotation of an anatomical prosthesis has occurred, the correction will achieve the fixation of the prosthesis, for this, cosmetic surgeons practice a complete capsulectomy and the closure of the pocket, if it is excessive. If the capsule is soft, changing the form of prosthesis and placing a circular prosthesis may sometimes be the best option.
 

PTHOSIC BREAST

 
If a breast sag occurs in the immediate postoperative period, it is as a consequence of the breast requiring support. Drooping of the breast is often due to the prosthesis's excess weight or a poor quality of the breast tissue.
 

INSUFFICIENT SIZE OR TOO LARGE

 
it is normal for patients to arrive unhappy with the size achieved. It's almost always due to a miscommunication with the surgeon.
 

LACK OF CORRECTION OF A PREVIOUS DEFORMITY

 
The most common unresolved deformity is the tuberous breast. There are many varieties of the tuberous breast that require very different approaches. Sometimes the plastic surgeon may see that the problem was not even previously diagnosed. In this case, it is impossible to correct it.
 

INADEQUATE PROSTHESIS POCKET

 
Many plastic surgeons encounter this problem on a regular basis It's an overabundance or defect in the lower pocket. In the first case, low breast prostheses are common with the nipple facing upwards. However, in the second case, high prostheses along with the nipple pointing downward is usually seen. Furthermore, pockets are sometimes too large that it causes the prosthesis to not be fixed or to separate excessively, when the patient is lying down.
 

CHANGE OF THE PATIENT'S DESIRES WHEN THEY GET OLD

 
Sometimes as patients get older, their taste for a certain breast size or look changes. The most common is that they request smaller breasts. They usually desire a mastopexy without the placement of a prosthesis. In some cases, they may request placement of a smaller or rounder prosthesis. Although it is less frequent, sometimes women come who want larger prostheses.
 
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