Side effects of breast augmentation surgery may result in revision surgeries, which means breast augmentation surgery needs to be a carefully considered operation. Thorough research on conditions before reaching out for help is essential, but ensuring that your medical professional is careful and compassionate is critical, too.
A common problem associated with breast augmentation is the capsular contraction. Capsular contraction occurs when internal scar tissue forms a tight capsule around the breast implant, constricting it until it becomes hard and misshapen. Scar tissue that forms around the implant is normal. Only when it contracts and becomes an impediment to the movement of the implant does it pose a problem.
Capsular contraction symptoms can occur at any time but usually happen within the first two years after breast augmentation surgery. Instances of capsular contraction are lower with saline than silicone gel implants. In the case of gel implants, a capsular contraction that occurs more than two years after breast augmentation could be due to a breast implant rupture.
Reasons for capsular contraction can be varied. Some patients are more likely to develop it than others. The exact reasons for capsular contraction and why one person is more likely to get it than another are unknown. Some of the causes of capsular contracture are thought to be old silicone implant leeching silicone molecules to the body, radiation therapy, subglandular versus submuscular placement, untreated hematoma, untreated infection, and severe breast trauma.
Capsular contraction has many different treatment options, but Dr. Mark Mofid wasn’t satisfied with the status quo in surgical options. He continued to work with the latest techniques to find something better for his patients. Using the latest products, he has worked to lower the rates of pathologic capsular contraction and forward the research and development of innovative products to help in revision surgeries.
Subglandular versus Submuscular Implants
The pectoralis major, or pectoral muscle, runs from the collarbone attaching at the breastbone and attaches down to the lower ribs. It is the muscle that runs across your entire side of the front of your chest, and there is another pectoral muscle on the other side of your chest.
A submuscular, sometimes called “dual plane” implant creates a pocket behind the pectoral muscle to place the implant. Typically, the upper portion of the implant is behind the pectoral muscle while the lower part is behind the breast gland because the pectoral muscle isn’t large enough in that area to cover the entire implant. The benefits of this type of implant are that there are less capsular contraction risks, may be easier to image with mammography, and may look more natural for thinner patients.
A subglandular breast implant is an implant that is inserted atop the pectoral muscle but behind the breast gland. The advantage of this implant is that there is no surgical interference with the pectoral muscles, shorter recovery time, and you have animation in your breast when you move. It tends to be better for patients with sagging breasts who do not want to have a breast lift.
Subglandular breast implants were the way to go in the 1980s, but the latest, more modern preference to breast augmentation is the “dual plane,” or submuscular technique so called because it exists partially behind the pectoral and the breast gland—both planes.
Changing Subglandular to Submuscular
When a submuscular implant is performed, the lower portion of the pectoral muscle is separated from rib to form the space for the pocket. As noted the medical site FeelBeautiful.com, if not done precisely, the pocket can allow for the implant to settle low into its final resting place. If the bottom pocket is open too widely, another internet doctor warns, the implant can be too low, if not opened enough the implant can be too high. These doctors wanted to do more subglandular implants because they go on to say you could have the wrong cleavage if he didn’t divide the inner edge of the pectoralis enough.
Working with Dr. Navin Singh, Dr. Mofid helped to design a more safe and easy way to create the pocket in the submuscular implant technique for patients who required revision surgery. Most of these patients already had the space needed for their implants because they already had implants in place. What they needed was to take their subglandular implants and change them into a submuscular implant. Dr. Mofid, already confident in his ability to perform this operation, sought to help other providers find an easier way to offer this to their patients. He published a paper on his pocket conversion technique in the Aesthetic Surgery Journal.
The simple technique he used was an AlloDerm graft that filled the gap between the pectoral muscle and the chest wall making the pocket complete. Prior to this, the implant was at the mercy of the surgeon’s ability to not cut too much of the pectoral muscle so that enough of it was still attached to the ribs to create a triangular pocket up to the collarbone to hold the implant in place with compression of the muscle. Now, with this technique, this pocket is complete along the bottom with no chance for the implant to settle low, as space is predetermined.
Considerations for Breast Augmentation Surgery
Complications regarding breast augmentation surgery are rare. However, there are things you can do to improve your chances of a successful outcome, like following your doctors after surgery care instructions. If you think you may be experiencing complications with your breast implants, please see your doctor. If you are looking for compassionate, conscientious plastic surgery in the San Diego area, please contact Dr. Mark Mofid.
Dr. Mofid is a board-certified plastic surgeon practicing in the San Diego area. He has a lifelong commitment to learning and applying his knowledge to achieve better outcomes for his patients.