Breast Revision Surgery
Breast Revision Surgical Techniques Have Advanced In Significant Ways
Breast revision surgery involves a number of situations: breast augmentation, breast lift, breast reduction and breast reconstruction. For more than 20 years, I have cared for patients who have had previous breast surgery and are in need of revision.
Over time, I have come to recognize common patterns in revisional breast surgery and I have assembled a portfolio of techniques to address these patterns. The good news is that in the last few years there have been several significant advances, which have improved our success rate in this field.
NEW TOOLS ARE AVAILABLE FOR BREAST SURGERY REVISION
Like the rest of surgery, revisional breast surgery requires an accurate diagnosis of the problems that a patient is experiencing and a series of steps that will provide an improvement.
There are several new developments, which have opened up new possibilities for helping patients who require revision. These developments include acellular dermal matrix, form stable implants, autologous fat transfer, and structural techniques of breast surgery.
ACELLULAR DERMAL MATRIX
Acellular dermal matrix is a biological scaffolding that has several useful roles in revisional breast surgery. For breasts that have become stretched out in their lower portion, it can help to support the breast structure in a new position. For implants that have moved out of position, it can help to stabilize the pocket for the implant.
Acellular dermal matrix can also be used to help camouflage irregularities that sometimes occur from breast implants in thin patients, especially in breast reconstruction.
Acellular dermal matrix can also be very helpful for patients who have developed capsular contracture around implants. Sometimes the body develops a tight pocket of scar tissue around a breast implant which can distort the breast shape and cause the breast to be unusually firm.
Like many surgeons who do revisional breast surgery, I have been impressed by the ability of acellular dermal matrix to prevent the return of capsular contracture. The strategy is to cover a portion of the implant with the acellular dermal matrix. This seems to prevent the body from making scar tissue at this location, and this loosens the grip of any capsule that may form.
FORM STABLE IMPLANTS
Unlike standard breast implants, which have a uniform round shape, form stable breast implants have a natural breast-like shape, with a greater degree of fullness in the lower portion of the implant, This helps to diminish the likelihood of a “top-heavy” breast, one with too much fullness in its upper portion. This is a distinctly unnatural look that, in my opinion, should be avoided in all types of breast surgery.
Form stable implants are particularly helpful for revisions of breasts that have undergone post-mastectomy reconstruction, but I also find them useful for other breast surgeries.
AUTOLOGOUS FAT TRANSFER
My familiarity with techniques of fat transfer is extensive, since I have used fat transfer to restore volume in my facial rejuvenation patients for over 15 years.
Over the past five years I have employed fat transfer to the benefit of my breast reconstruction and my breast revision patients. Fat is a remarkable tool because it can be used restore or add volume to very specific areas of the breast.
It can help to camouflage breast implants, particularly in thin people. Fat can also be used to improve the quality of skin that has been irradiated.
STRUCTURAL BREAST SURGERY TECHNIQUES
The development of structural techniques of breast surgery has been a major project of mine for the last 5 years. The rearrangement of breast structure to restore natural volume to the upper portion of the breast and the deep structural anchoring of the breast can be very useful in a variety of circumstances when I revise previous breast surgery.
SKIN STRETCHING TECHNIQUES THAT HELP PREPARE THE BREAST FOR RECONSTRUCTION
For years tissue expanders have been key devices for breast reconstruction. The expander is placed under the skin and pec muscle and is gradually stretched with weekly injections of salt water through a valve. This prepares a space for the reconstructive implants.
As fat assumes a greater role in breast reconstruction, the preparation of a space to accommodate the fat becomes very important. There are external devices that allow us to stretch the skin of the chest area, so that it is optimized to receive transferred fat. This is very helpful in complex breast reconstruction surgeries.
Contact Dr. John Q. Cook Today
Dr. John Q. Cook is a renowned breast surgeon who has helped many women get the beautiful, natural-looking results they deserve. He is pleased to offer the very latest, safest and most effective techniques. To learn more, or to schedule a consultation contact his Chicago office at 312-751-2112 or 847-446-7562 for his office in Winnetka.
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