When the patient is unsatisfied with the outcome of the augmentation mammoplasty; or when technical or medical complications occur; or because of the breast implants’ limited product life, it is likely she might require replacing the breast implants. Common revision surgery indications include major and minor medical complications, capsular contracture, shell rupture, and device deflation.[44] Revision incidence rates were greater for breast reconstruction patients, because of the post-mastectomy changes to the soft-tissues and to the skin envelope of the breast, and to the anatomical borders of the breast, especially in women who received adjuvant external radiation therapy.[44] Moreover, besides breast reconstruction, breast cancer patients usually undergo revision surgery of the nipple-areola complex (NAC), and symmetry procedures upon the opposite breast, to create a bust of natural appearance, size, form, and feel. Carefully matching the type and size of the breast implants to the patient's pectoral soft-tissue characteristics reduces the incidence of revision surgery. Appropriate tissue matching, implant selection, and proper implantation technique, the re-operation rate was 3 percent at the 7-year-mark, compared with the re-operation rate of 20 per cent at the 3-year-mark, as reported by the U.S. Food and Drug Administration.[64][65]
Don't be afraid to ask questions. Make a list of questions you want to ask your physician and bring it with you to your Botox consultation. That way you won't forget what you want to ask. Ask how much the treatment will cost, how many units of Botox you will need, how long the he/she has been giving Botox injections, etc. Ask about side effects, risks, and how you should take care of your skin after Botox and how often someone with your skin condition should get Botox.
For my patients, I also provide a post-operative packet. This includes arnica and other ointments, gauze and tape, an ice pack, and nasal decongestant spray. If your surgeon does not provide these items to you before or after your surgery, they are all helpful during the healing process. I encourage my patients to get anti-nausea medication for the first few days following surgery as well.
Since experienced surgeons are aware of these issues with saline breast implants and their need for eventual replacement, they opt to place them under the chest muscle. The chest muscle works as an extra layer of tissue over the implant, which makes for a smoother transition from the chest wall to the implant. The finished product is a more seamless transition versus a more visible and abrupt change when the implant is not placed below the pectoral muscle. As for gel breast implants, they can also be safely placed below the pretorial muscle if that is a viable option for the patient since replacement and wrinkling is less common with this type of implant.
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