Breast augmentation can be a challenging operation to achieve the exact
results desired by the patient. During consultation with Dr. Zimmerman, an
extensive quantity of time is spent reviewing photographs and reaching a mutual
understanding of the desired appearance of the breasts. There are many variables
to consider when performing an augmentation including the maximum size implant
one can safely accommodate when a larger breast size is desired, and the
placement, and anticipated settling of the implant. There will always be
settling of the implant and resolution of the swelling (edema), which occurs
over the first three months following the surgery.
Unfortunately, on an occasion, the breast surgery must be revised because of
mal-position of the implant, or the desire for a different look or outcome.
Because of his vast experience with breast augmentation, Dr. Zimmerman sees
patients referred to him who are not pleased with the results they have
achieved elsewhere, or desire a change in their breasts, or revision or
replacement of an old implant. Each of these surgeries is unique, depending
on the problem at hand. An old silicone implant may require removal of the
implant and scar tissue surrounding it (capsulectomy), with replacement using
either a saline or silicone implant. An implant may require repositioning
either above or below the pectoralis muscle.
Occasionally, all that is
required is adjustment of the dimensions of the 'pocket' in which the
implant is sitting, or change of the size of the implant. It is also possible
to see an implant, which has migrated too low on the chest wall,
resulting in 'bottoming out' of the breast and the nipple pointing upward.
This may require a challenging revision called a capsulorrhaphy to close down
the inferior aspect of the pocket. There are also times when revision is not
advised, such as when further enlargement would result in breast sagging or
implant wrinkling from overly stretched skin, or when further improvement could not be guaranteed.