Breast Implant Exchange with Fat Enhancement

Breast Implant Exchange with Fat Enhancement

Amanda’s first breast implants were placed by another surgeon approximately 15 years earlier. 425cc anatomical saline breast implants were placed under the muscle. She was unhappy with the breast implant rippling, breast gap and muscle flexion distortion. Even under the muscle, the implants were still very visible as coverage was so thin. Being very lean also made her naturally wide breast gap seem even more prominent. Displacement and flattening of the implants occurred with every muscle contraction. Implants placed above the muscle would have resulted in more visibility due to less coverage. Implant placement under the muscle also created a wider breast gap visible in clothes. Rippling was more pronounced with saline implants especially when leaning forward.

Amanda first presented to our practice 10 years earlier for her tummy tuck. Her satisfaction and trust allowed her to feel confident in having breast surgery as well. Correction involved removing the implants and restoring the muscle to its original position. Placing cohesive, gummy bear, anatomical, silicone gel implants in a new pocket above the muscle. Then filling the overlying skin envelope with fat grafts to add cover, volume and cleavage

Amanda is seen at her initial visit four years earlier with her original saline breast implants The center photos show her four years after initial implant exchange to 350cc smooth, round, silicone gel implants (still under the muscle) with 50 cc of fat placed above. There was significant improvement but she still wanted to reduce the gap and muscle animation even more. As she was lean and also very athletic, she wanted complete muscle correction. Mentor MH 440 CC, anatomical, textured cohesive gel implants were placed over the repaired muscle. 75 CC of fat was also placed into the overlying breast envelope for coverage, volume and contour. She is now seeing with her final results 2 months after implant relocation and fat transfer. The fat grafts have completely integrated and have the potential to last a lifetime. There are no visible or palpable irregularities and full natural breasts have been achieved. Amanda went from a C to her desired D cup and… she finally has cleavage. The animation deformity is completely corrected and a soft natural appearance is finally hers.

Hello! This is Dr. Kayser

photo_drI wanted to spend just a minute with you and discuss a subject of credentialing as I have been hearing more and more about blunders and problems in the world of plastic and cosmetic surgery. It certainly goes without questions that as the world of medicine is changing and insurance reimbursements are continuing to decline, so are more non-qualified doctors and even NON-physicians getting into this market to cash in. OMG, this has become an epidemic and so many innocent patients are paying the price.

Becoming a plastic surgeon is a life long endeavor that requires, not only years of education and training but, ongoing learning and experience as well. Only after four years of medical school, 5 years of a general surgery residency, 2 years of plastic surgery training and another year of an additional fellowship in a plastic surgical specialty, did I become eligible to qualify for board certification! Then it required passing both a written and subsequent oral examination to finally meet the high standards to become a board certified plastic surgeon. But it wasn’t over as my entire career has required ongoing training, education and examinations to maintain my status.

Unfortunately, many states, including Michigan, do not regulate who does what and where. Your obstetrician or family doctor, for example, can perform procedures in their offices that would scare you if you realized how little training and experience they had! And companies, such as breast implant or laser manufacturers don’t help as they will sell to anyone who will buy from them. Although most hospitals require only board certified plastic surgeons to have privileges, this does not stop all the others from having their own facilities and operating there. We are then left to pick up the pieces but only after it is often too late:(.

When searching for a surgeon, make sure they are certified by The American Board of Plastic Surgery and that they have full privileges (in this specialty) at a fully credentialed hospital. I would encourage any of you seeking to have any plastic or cosmetic procedures in the future to consider this, and although cost may be a factor to take shortcuts, the price to be paid if disaster strikes will be so much more in the long run.

I wish you all a wonderful day!

Dr. Kayser

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