Published July 24, 2015 By Dr. Adam Lowenstein

Yesterday I did three breast implant operations at my plastic surgery center here in Santa Barbara. One of them was what we call a primary breast augmentation, which means I operated on a woman who did not previously have breast implants and I did her breast augmentation for the first time. The other two patients were revision breast augmentations, meaning that other surgeons had previously performed breast augmentation on these two women and my plastic surgery operation was meant to revise their previous surgeries. These surgeries were for very different reasons and demonstrate the purposes of primary and secondary or revision breast implant surgery.

The first breast surgery of my day yesterday was for a woman who had her silicone breast implants placed 40 years ago by another plastic surgeon here in Santa Barbara. Yes, that’s right…. the breast implants were 40 years old. Her breasts were hard and contracted because her breast implants had ruptured long ago, but she did not seek revision for quite some time. Her operation required an extensive revision which included removal of scar tissue that had calcium deposits from waiting so long… the scar was literally partially made of rock! I removed all of this scar tissue as well as the old breast implant material, and additionally changed the breast implant pocket to one that allowed a more natural looking outcome, before placing new Mentor smooth round silicone breast implants in the revised pocket. The outcome was amazing! Her breasts that had been tight, hard, malformed mounds ended up soft, natural appearing and lovely (so she told me this morning). Patients like this are often as astonished as she was this morning, mostly that she lived so long with her old breasts and the spectacular difference that she saw immediately following revision.

The next patient was my primary breast augmentation surgery- a much more simple operation requiring me to create the breast pocket and place implants for the very first time. Although she started out with some significant differences in the appearance and size of her breasts, she also looked outstanding this morning at her postoperative appointment. I used 2 different sized silicone gel breast implants in her breasts to even out the appearance and we are both very happy with how things look this morning.

Plastic surgery case number three was another secondary breast augmentation, requiring a surgical revision of an operation done by a plastic surgeon from northern California. This young woman had capsular contracture on one side, where the natural capsule that forms around the breast implant tightens and makes the breast more firm that it should be. She additionally had “high profile” breast implants in place which were causing some distortion of her breasts. For her surgery, I had to remove the problematic scar tissue from the side that had capsular contracture. This requires careful dissection around the problematic tissue. Additionally, because the older breast implants were high profile, they did not fill out the width of her breast and did not give the best shape. I replaced them with a different silicone breast implant that rounded out her breast and resulted in a really nice tear drop shape- also looked excellent this morning at her postoperative visit in Santa Barbara.

And so we had another great day at Montecito Plastic Surgery, with a breadth of breast surgery patients that illustrated the many differences in techniques and decision processes used in the application of breast implants for breast enhancement and breast augmentation.

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