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Breast Implant Revision

Breast Implant Revision in San Antonio, TX

Lawton Plastic Surgery San Antonio TX | Breast Implant Revision

For all breast implant patients, there comes a time when a touch-up or perhaps even a major revision is needed to rejuvenate the look and feel of the breasts. The question is always when, not if.  Just as we expect the breast tissue itself to change with age, augmented breasts will also “age”.  This process can lead to a variety of distressing functional and cosmetic issues which may or may not require surgery to correct.  Although many women have anxiety about revision breast augmentation surgery, Dr. Albright is here to help!  He will give an honest assessment of the underlying problems and possible solutions to achieve an improved and more rejuvenated breast.

The first step to approaching breast implant revision is to identify the problem.  The common functional problems with implants are capsular contracture and implant rupture. These issues require surgery to fix and may need to be fixed sooner rather than later. Dr. Albright, one of the best Breast Implant Surgeons in San Antonio, TX, will discuss more detailed recommendations during your postoperative visits.

Even without a functional problem with the implants, plastic surgery patients may be dissatisfied with the appearance of their augmented breasts.  The cosmetic issues involved are more complex than many realize, as the problem may relate to the implant, the overlying breast/soft tissue, or, most frequently, a combination of both.  Dr. Albright is an expert in identifying these issues and utilizes the most up-to-date surgical procedures to address these concerns.

Dr. William Albright, MD, is a trusted plastic surgeon in San Antonio, TX. He is board-certified by the American Board of Plastic Surgery. He specializes in cosmetic and body surgery, including breast augmentation, breast lift, tummy tuck, and mommy makeovers. Schedule your appointment today at (210)-670-5302.

Great, so how do we fix the implants?

Dr. Albright utilizes the most up-to-date techniques to improve outcomes in revision breast implant surgery. Although no augmentation revision surgery is “permanent”, Dr. Albright will try to obtain lasting results by addressing the underlying problem with the most appropriate solutions. Get contact with Alamo Plastic Surgery is one of the best plastic surgery clinics for Breast implant revision Often multiple techniques are used during the surgery, and they include:

  1. Changing the implant (dimensions / volume / fill-type / implant shell surface)
  2. Changing the implant pocket
  3. Capsule adjustments including capsulorrhaphy (suture adjustment), capsulotomy (incision adjustment) and capsulectomy (capsule removal)
  4. Soft tissue reinforcement with mesh for implant support
  5. Removal of damaged excess skin
  6. Corrections to nipple placement

Breast revision surgery is most frequently done to replace ruptured original implants, enhance implant size, or address concerns like asymmetry.

Common Reasons for Breast Implant Revision

Common Reasons for Breast Implant Revision include both medical and cosmetic factors. Here are some of the most frequent reasons patients may seek revision surgery:

Capsular Contracture

One of the most common medical reasons for breast implant revision is capsular contracture, which occurs when the scar tissue (capsule) around the implant tightens, causing the breast to feel firm, look distorted, or become painful. Revision surgery may involve removing or releasing the scar tissue and replacing the implant.

Implant Malposition

Implants can shift over time, leading to implant malposition (e.g., implants drifting too far apart, too close, or dropping too low). This can result in an unnatural appearance and may require revision surgery to reposition the implants and restore symmetry.

Implant Rupture or Deflation

Both saline and silicone implants can rupture over time. A saline implant rupture is immediately noticeable due to deflation, while silicone ruptures (sometimes called "silent ruptures") may not be obvious without imaging. Revision surgery is necessary to remove and replace the damaged implants.

Desire for Size Change

Some patients choose breast implant revision because they want to change the size of their implants, either opting for a larger or smaller size to better suit their aesthetic preferences or body changes over time.

Aging and Natural Changes

Over time, the natural aging process, weight fluctuations, pregnancy, or breastfeeding can affect the appearance of the breasts, causing sagging or volume loss. Many patients seek revision surgery to refresh the look of their breasts by replacing the implants and possibly incorporating a breast lift.

Double Bubble Deformity

This occurs when the implant drops below the natural breast fold, creating a double bubble appearance. Revision surgery may be required to correct this issue by repositioning the implant or adjusting the breast fold.

Symmetry Issues

Some patients may experience asymmetry over time, either due to changes in the body or initial placement issues. Breast implant revision can be performed to restore a more balanced, symmetrical look.

Implant Rippling

Rippling occurs when the edges or surface of the implant become visible or palpable through the skin. This is more common in saline implants or in patients with thin breast tissue. Revision surgery may involve switching to silicone implants or placing the implants in a different position to reduce rippling.

Patient Dissatisfaction

Some patients are unhappy with the original results due to aesthetic preferences or surgical complications. Revision surgery can address these concerns by adjusting the implant type, size, or placement to achieve the desired outcome.

Surgical Techniques for Breast Implant Revision

Breast implant revision surgery involves different techniques to address implant appearance, positioning, or complications. Here are some standard surgical techniques used during breast implant revision:

Implant Replacement

Implant replacement is one of the most common techniques in breast implant revision surgery. It involves removing the existing implants and replacing them with new ones.

Capsulectomy

A capsulectomy is performed when a patient experiences capsular contracture, which occurs when the scar tissue (capsule) that forms around the implant becomes excessively tight or hard. This condition can cause discomfort, pain, and distortion of the breast shape.

Capsulorrhaphy

Capsulorrhaphy is a surgical technique used to correct implant malposition. Malposition occurs when implants shift from their original position, leading to issues like bottoming out, lateral displacement, or symmastia (when implants move too close together).

Breast Lift (Mastopexy)

A breast lift (mastopexy) is frequently combined with breast implant revision surgery, especially if the patient has experienced sagging or excess skin due to aging, weight fluctuations, pregnancy, or breastfeeding.

Fat Grafting

Fat grafting, known as fat transfer, is an increasingly popular technique in breast implant revision surgery. It involves harvesting fat from areas of the body with excess fat (such as the abdomen, thighs, or flanks) using liposuction and injecting it into the breasts.

Acellular Dermal Matrix (ADM)

Acellular Dermal Matrix (ADM) is a biological material that supports and reinforces the breast tissue during implant revision surgery. ADM is often used in cases where the patient’s natural tissue is insufficient to support the implants adequately or in patients with recurrent capsular contracture.

Typical Recovery Timeline

First Few Days:
‍You will experience swelling, bruising, and some discomfort, especially around the chest and incision areas. Pain medication will help manage discomfort during this phase. It's essential to rest and avoid strenuous activities.

1 to 2 Weeks:
Most patients can return to light activities and non-physical work within 7 to 10 days. However, physical exertion and heavy lifting should still be avoided. Swelling will start to reduce, but you may still feel tightness in the chest.

4 to 6 Weeks:
Patients can typically resume normal activities, including exercise, at 4 to 6 weeks, but it's important to receive clearance from your surgeon before engaging in any strenuous physical activity. By this time, the swelling should have subsided significantly.

3 to 6 Months:
‍Full recovery and the final results of your surgery, including implant positioning and reduced swelling, will become visible around the 3 to 6-month mark. Scars will also begin to fade during this period.

Before and After Gallery
Before and After Photo GalleryView photos
Financial Information
*includes general anesthesia, facility, surgeon's and implant fees.
Please call for your complimentary estimate
210-670-5302
6, 12, 24, and 36 MOnth Financing Available Through Care Credit, Patient FI, and Alphaeon

Breast implant revision FAQ’s

What is breast revision surgery?

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Breast revision surgery is a procedure performed to correct or improve the results of a previous breast augmentation. This surgery may be necessary to address complications, such as capsular contracture, implant rupture, implant malposition, or asymmetry, or to achieve new aesthetic goals, such as changing the implants' size, type, or shape. Breast revision can also be performed to address natural changes in the body over time, like sagging or changes in breast tissue due to aging, weight fluctuations, pregnancy, or breastfeeding. The procedure can involve implant replacement, implant repositioning, or additional procedures like a breast lift to create the desired outcome.

What is breast implant removal?

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Breast implant removal is a surgical procedure in which one or both breast implants are removed from the body. This can be done for a variety of reasons, such as addressing complications (like capsular contracture, implant rupture, or infection), health concerns (such as Breast Implant Illness), or personal preference. Some patients opt for implant removal because they no longer wish to have implants or desire a more natural breast appearance. Breast implant removal can be performed on its own or combined with additional procedures, such as a breast lift to improve the shape and contour of the breasts after the implants are taken out. The surgery typically involves using the same incisions from the original augmentation to minimize scarring.

What are the common functional problems with breast implants?

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Capsular contracture:  Although rates have steadily declined over the years, capsular contracture remains one of the most common functional problems with implants.  Capsular contracture is a progressive abnormal thickening of the scar tissue around the implant (the capsule).  Capsular contracture causes the implant to feel more firm, develop a more rounded breast shape, and may cause pain.  As with any breast pain, breast cancer should be excluded first.  The pain from a contracture can begin as intermittent feeling of tightness in the breast especially with certain arm movements, and can progress to chronic discomfort.   Although contracture occurs more frequently with implants above the muscle, any breast implant can develop it.  It can develop in one breast or both, with saline or silicone gel implants, and either smooth or textured surface implants.  The most frustrating issue with contracture is that a contracture can reoccur even after surgery to correct it. Dr. Albright will formulate an individualized surgical plan for you to help lower this risk and get your softer, more natural breast back.

‍Implant Rupture:  Although there are many different types of breast implants, all implants are man-made and will not last forever.  A common rule of thumb is that the annual risk of implant rupture is about 1% per year per implant.  Patients may have had blunt force trauma to the implant, or no trauma at all.  For saline implant rupture, patients may experience a gradual reduction in volume or present with a more sudden decrease in breast size.  For silicone implants, particularly the newer generation of cohesive gel implants, patients (and surgeons!) may not be able to identify a ruptured implant as it may not look or feel different.  For this reason an MRI may be necessary to help identify a ruptured silicone implant (although this too is not 100% accurate!).  With a ruptured implant, you have surgical options depending on your preferences and desires.  Whether it is to remove the implants without replacement or a more advanced Breast Implant surgery, Dr. Albright will help you make an informed decision.

What are the common cosmetic issues with breast implants?

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Waterfall Deformity is seen in the seated or standing position where the implant stays high up on the chest, and the breast tissue starts “sliding off the mound” as it is pulled downward by gravity.  This is also called the ‘snoopy deformity’, as the hanging breast tissue resembles snoopy’s face in profile.  Typically this involves an implant that is completely under the muscle, whereby the muscle has continued to support the implant high up on the chest while the native breast has begun to droop. It tends to occur in women who are prone to droopy breasts (multiple pregnancies with breastfeeding, and large native breasts).  Often, some form of breast lift surgery will be needed to fix this issue.

‍Implant Displacement can occur due to gravity pulling on the implant (all implants), or by active displacement due to muscle contraction (below muscle implants).  There are a variety of breast deformities that are due to implant displacement.  The stretch deformity is most characteristic of implants placed above the muscle or partially under the muscle, and have  inadequate soft tissue support.  With stretch deformity, the implant migrates downward and begins to stretch the skin of the lower pole of the breast, and the nipple may remain high. This is different than a Double Bubble deformity, where the implant has actually moved downward and below the native lower breast fold (IMF).   This creates a step-off from native breast tissue to a lowered bottom edge of the implant, and typically occurs with partial submuscular implants in which the muscle has forced the implant past this natural barrier.  Finally, another commonly encountered issue is implants that have moved toward the armpits.  Not only does this bother patients as their arms can bump into the displaced implant during exercise, but also the patient will develop a breast implant "gap" between the breast mounds.  

‍Visible rippling or implant folds can be particularly distressing to patients and are typically a result of implant characteristics, implant pocket, and patient soft tissue coverage. Whether saline-filled or silicone breast implants, every implant currently in the US has rippling of the shell but they differ in how pronounced the rippling is.  The other critical factor is how well this inherent rippling is disguised or camouflaged by the patient’s own soft tissue (how thick is the skin, fat, breast and/or muscle). Thinner patients are at a higher risk for being able to see the ripples and feel the implant edges or folds. Fat transfer to the breast is one possible solution to correct (camouflage) implant rippling.

Is revision implant surgery more complicated than initial breast augmentation?

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Patients’ fear of revision breast implant surgery is not completely unfounded, as there is an inherently higher complication rate with revision breast surgery when compared to the first augmentation procedure. There are many reasons for this.  But broadly, the tissues themselves have changed due to: scar tissue from previous surgery, the weight of the implant on the soft tissue, and from the natural aging of the breast. As the skin around the implant begins to sag, longer incisions are often needed which increases risk of wound healing problems, operative time and creates less well-hidden scars.  Patients may also be less medically healthy than they were when they had the implants placed. To minimize your risks for complications, it is important to find a surgeons who will take these factors into account when formulating an individualized surgical plan, such as Dr. Albright, a board-certified plastic surgeons in San Antonio.

Can my health insurance cover my cosmetic breast implant revision surgery and what about my breast implant warranty?

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Patients often wonder why their personal health insurance will not cover the cost of their revision surgery especially if they are experiencing a functional problem like capsular contracture. Whereas in the past insurers may have been less restrictive and covered claims made for complications from cosmetic surgery, nowadays insurers almost always deny these claims.  Even if the surgery is performed and a claim is submitted, once it is rejected by your insurer, you will be on the hook for the full insurance rate charges from the surgeons, anesthesiologist and surgical facility; typically a much higher bill than full cosmetic rates. For this reason, Dr. Albright will not submit insurance claims for cosmetic surgery.

All current implant manufacturers in the US provide a basic limited warranty for implant rupture by providing replacement implants at no cost. However the cost of the implants themselves is a relatively small part of overall surgery cost.  Manufacturers in the past, offered an additional warranty that patients had to pay extra money for at the time of the implant placement. Typically, within ten years, if the implant were to fail, the manufacturer would write a check to offset some of the out-of-pocket expenses from revision surgery.  However, even this is not typically enough to cover all expenses.  Today, implant warranties offer more inclusive coverage, but still fall short of covering expenses. Dr. Albright, one of the best breast implant surgeons in Texas, and his staff will help assist you with taking advantage of any available implant warranty you may have.

Why is revision breast surgery more expensive than my first augmentation surgery?

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One of the most frequently cited issues for patients seeking revision of their cosmetic breast surgery is cost. There is no denying that it is expensive.  Implant warranties are variable and rarely contribute enough to cover surgery expenses. Health insurance plans will not cover complications from cosmetic surgery.  Therefore patients usually will have to pay for the care out-of-pocket. The costs for breast implant surgery are higher than initial augmentation surgery because the surgery is more complex and time-consuming.  There may be more supply costs for new implants, surgical mesh and postoperative garments. Surgeons, anesthesia, and facility fees are usually based on the complexity of the procedure and operation time.  There are also additional miscellaneous fees such as cosmetic insurance and financing fees which may be different than previous arrangements. All together, revision surgery can be expensive.  Dr. Albright is a breast implant specialist, and he is sensitive to this issue and offers financing plans, as well as competitive pricing to get you the best results possible.

Will my breasts look saggy if I remove my breast implants?

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After breast implant removal, your breasts may appear saggy or deflated, especially if your implants were large, you’ve had them for a long time, or your skin has stretched due to the implants. Factors such as skin elasticity, the size of the implants, and natural aging can all affect how your breasts look after implant removal. In some cases, the breasts may look smaller or have loose skin after the implants are removed. To address this, many patients choose to combine implant removal with a breast lift (mastopexy), which can tighten the breast tissue, remove excess skin, and elevate the breasts to a more youthful position. This combination procedure can help restore a more natural and firm breast shape after implants are removed. Your surgeon will assess your situation and recommend the best approach to achieve your desired results.

How long will it take my breasts to settle after implant removal?

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After breast implant removal, it typically takes several weeks to a few months for your breasts to fully settle and achieve their final appearance. Initially, you may experience swelling, and your breasts may look different than expected right after surgery. Over the first 4 to 6 weeks, swelling will gradually subside, and the breasts will begin to settle into a more natural position.

However, the settling process can take up to 3 to 6 months, especially if a significant amount of skin or tissue was stretched due to larger implants. During this time, your body adjusts to the absence of the implants, and the breast tissue naturally contracts and reshapes. If you had a breast lift along with the removal, the healing and settling process may take longer as the tissues heal and adjust.

Your surgeon will provide guidance on what to expect during recovery and may recommend wearing compression garments or a supportive bra to help with healing and skin retraction during the initial recovery phase.

When can I resume regular activity after breast implant removal?

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After breast implant removal, you can generally begin to resume light activities within 1 to 2 weeks, but full recovery will take longer. Depending on their feelings, most patients can return to non-strenuous work or daily activities after the first week. However, avoiding heavy lifting, strenuous exercise, and activities that engage the chest muscles for at least 4 to 6 weeks is important. These restrictions help ensure proper healing and prevent complications.

By six weeks, most patients can fully resume regular physical activities, including exercise. Still, getting clearance from your surgeon before returning to intense workouts or heavy lifting is crucial. Your surgeon will provide personalized recommendations based on your recovery progress to help you safely return to your routine.

How soon after breast augmentation can I get breast implant revision?

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It’s generally recommended that you wait at least 6 months to 1 year after your initial breast augmentation before considering a breast implant revision. This waiting period allows enough time for the implants to settle fully, the swelling to subside, and the final results to become visible. Many post-surgical changes, such as minor asymmetry or uneven positioning, may improve independently during this time.

However, if you are experiencing complications such as implant rupture, capsular contracture, or significant discomfort, revision surgery may need to be performed sooner. It's essential to consult with your surgeon, who will evaluate your situation and determine the best timing for revision surgery based on your healing and the nature of your concerns.

How long should I stop physical activities until I get a full healing period?

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After breast implant revision surgery, it's essential to follow your surgeon's recommendations on when to resume physical activities to ensure proper healing. Generally, you should stop all strenuous physical activities, including exercise, heavy lifting, and movements that engage the chest muscles, for at least 4 to 6 weeks after surgery. You’ll need to focus on rest and allow your body to heal during this time.

For the first 1 to 2 weeks, limiting activity to light walking is advisable to promote circulation, but avoid any movement that could strain the chest area. After six weeks, most patients can gradually resume their regular exercise routine, including more intense activities, but it’s important to get clearance from your surgeon before doing so. Complete healing, including the settling of implants and reduction of swelling, can take up to 3 to 6 months, but your surgeon will provide personalized guidance based on your recovery progress.

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Healthgrade Review | Alamo Plastic Surgery | Dr. William Albright5 stars for Dr. William Albright | Alamo Plastic Surgery
4.9 / 5.0 for 48 Reviews
Breast Implant Revision
“ Dr. Albright and his staff were all very friendly and helpful. He replaced my old breast implants that I had had since my mastectomy about 15 years ago, I would recommend him.”
Healthgrade Review | Alamo Plastic Surgery | Dr. William Albright5 stars for Dr. William Albright | Alamo Plastic Surgery
4.9 / 5.0 for 48 Reviews
Breast Revision
“ Dr. Albright has really helped me through such a rough patch of my life. I struggled with a breast deformity and through this uncomfortable process, Dr. Abright handled my case with such grace and made me feel comfortable under the circumstances. Great care, and great nurses on staff. If you do happen to get surgery for whatever reason, you are in GREAT hands. I really can't thank him & his staff enough for what they've done for me. I finally feel comfortable in my own skin.
Thank you. ”
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Tummy Tuck
" I traveled to have Dr. Albright as my plastic surgeon and it was well worth the time and miles. I was referred to Dr. Albright by my oncologist for a second opinion to have my implants corrected as there had been some movement with the one. My first appointment with the doctor was very detailed and informative. He was very kind and patient answering all my questions and telling me the pros and cons to both surgeries I was considering. After that appointment I knew which surgery was best for me and felt very confident that I had found the best doctor for me as well. I truly believe his goal was to make me feel and look great again, which he did. Should I have a need again in the future for a plastic surgeon, he will be the only doctor I see. "
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Breast Augmentation
“ Dr. Albright spent a great deal of time to explain pros and cons and the best options that would benefit me the most regarding my breast augmentation. The best place to go for honest and open discussions, reality vs misconceptions and the confidence of feeling better about oneself. Highly recommend!”
Diane
Alamo Plastic Surgery San Antonio TX | Team - Dr. Albright, Franchesca Espinosa, Juli Albright
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Breast Implant Revision

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San Antonio, TEXAS

Breast size, shape and proportion play a unique role in every woman’s self-perception, sense of physical balance, femininity, and confidence. The art of Breast Implant Revision in Texas is so much more than simply “enlarging” the breasts — it is realized through the profound consideration of each individual’s desires, inherent anatomical forms, and meticulous attention to the techniques and safety of their union.

Breast Implant Revision San Antonio – Gallery

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These Breast Implant Revision before and after pictures represent actual patients from Dr. Albright. They will help to assist you in understanding your various options and enable you to set realistic goals for your own surgical outcome. Click on a patient for their specific case details.

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Breast Implant Revision

No two breast augmentations are the same; each is as diverse as a woman's unique goals and physique, and as different as the surgeon who performs them.

As a leading board certified plastic surgeon in central Texas, Dr. Albright consistently delivers life-changing surgical results and an exceptional plastic surgery experience for his patients. After training with plastic surgeons from around the world, Dr. Albright wanted to bring his expertise back to his hometown of San Antonio.

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Check our blog article about Breast Implant Revision:
5 Tips for Breast Augmentation

Women seek breast enhancement (augmentation mammoplasty) for a variety of reasons. For many women, it is not just to increase the size of their breasts, but may be to feel more comfortable in a swimsuit or confident out of clothes.  It may be to return to their pre-pregnancy shape and volume. Some aim to correct an asymmetry or abnormal breast development that has plagued them since adolescence. Whether a woman wants people to know they’ve had a “boob job” or prefers a more reserved look, Dr. Albright will assist you in achieving your specific goals with breast augmentation in San Antonio TX.

Given the variety of goals and body shapes, breast augmentation may seem a bit overwhelming.

Relax! Dr. Albright, one of the best breast augmentation surgeons in San Antonio, TX, has the skills and experience to walk you through the options that are best for you.  He will explain breast implants and augmentation techniques in a way that makes sense. Breast lift, Breast Augmentation with Breast Lift, or Breast Fat Graft might be another option for you. Dr. Albright takes the time to explain the relative risks and benefits of different breast augmentation techniques so you can make the best decision for you.

Check out Dr. Albright's YouTube video for a brief introduction to Breast Augmentation:

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FINANCIAL INFORMATION
*includes general anesthesia, facility, surgeon's and implant fees.
Please call for your complimentary estimate:
210 670 5302
6, 12, 24, and 36 month financing available through Care Credit Patient FI, and ALPHAEON
Financing is available through our finance partners
Preparing for BREAST AUGMENTATION

When planning your breast augmentation,
there are four primary components that are essential to consider:

Type Of Breast Implants: Silicone Gel Vs. Saline
Access Incisions For Breast Enlargement
Position Of Breast Implants
Breast Implant Style, Profile, & Sizing

The two primary breast implant options available for cosmetic breast augmentation are silicone implants and saline implants. Both breast implants are safe, FDA approved devices that are excellent choices for breast enlargement. The current generation of silicone breast implant is pre-filled with a cohesive silicone gel, and saline implants are filled with salt water solution at the time of surgery. Each has a similar silicone elastomer outer shell. At comparable volumes, the look of each implant is virtually identical. To the touch, the silicone gel implants have a more natural, breast-like feel.

Breast augmentation can be performed using incisions in the lower crease beneath the breast (inframammary crease incision), along the lowest border of the pigmented areola (periareolar incision), or within the underarm (transaxillary incision). In consideration of a variety of factors including areolar size, breast shape, breast glandular density, inframammary fold definition, size goals, implant selection, and personal preferences, Dr. Kolker will advise you on the best breast augmentation incision options.

To minimize incision length and to gently introduce silicone gel implants with a minimal or “no-touch” technique, a Keller Funnel is uniformly used. The Keller Funnel is an implant insertion device with a slick, low-friction surface that enables the placement of silicone breast implants through smaller incisions. Using these devices since 2010, Dr. Kolker uses the Keller Funnel for every breast augmentation.

Breast implants can be placed below the muscle (submuscular augmentation), or above the muscle (subglandular augmentation). Submuscular augmentation confers the following benefits:Provides increased coverage of the breast implantsSoftens the upper pole of the breast leading to a more seamless, natural transition from collar bone to nippleMaintains long term stability of the breast pocketMarkedly decreases rates of capsular contractureLessens influence on mammographyDr. Kolker uniformly utilizes a submuscular pocket plane. “Dual plane” augmentation is a form of submuscular augmentation that allows for maximal coverage of the upper pole of the implant by muscle, and direct effacement of the lower breast gland; this maneuver is employed when there is minor lower pole soft tissue excess or mild droop (ptosis) of the breast.

Breast implants are available in a wide array of shapes, profiles, and sizes. Round implants or anatomical implants can be used. Both implants assume a tear-drop shape when upright. Implant profile refers to the projection of an implant for a given base dimension. Choices are made from among three profiles, corresponding to low or moderate projection (less volume and anterior convexity), midrange or moderate plus projection (intermediate volume and convexity), and high profile (maximum volume and convexity). Considering the nuances of your anatomy and the subtleties of your specific desires, Dr. Kolker will advise you on the best breast implant style, profile, and projection options to achieve your goals.

Choosing the correct breast implant size is a process that begins with your initial consultation. Dr. Kolker is fastidious about getting to know the nuances of every individual’s wishes and goals. These desires are married with the careful anatomical measurements and tissue assessment to establish an initial size “range”. At a preoperative visit approximately two weeks before surgery, the goal is further confirmed with a series of neoprene bead-filled sacs used as “sizers” that are placed into a special brassiere; you will try a range of sizes to get a better sense of dimension and proportion. Finally, Dr. Kolker uses silicone gel or saline implant sizers during surgery to confirm the size selection. As a rule in realizing the most beautiful endpoint, Dr. Kolker strives to achieve natural and proportional size and shape, directed by your thoroughly considered desires and goals. With his years of experience and attention to detail, Dr. Kolker has earned a reputation amongst his patients for providing high quality breast implants and cosmetic surgery.

FAQ

Frequently asked questions about breast augmentation

What is the recovery time and activity restrictions after breast implants?

Dr. Albright wants all of his patients to get the best result possible.  What we do after breast augmentation surgery is just as important as the surgery itself.  Although there are slight variations in breast augmentation techniques, patients will have 2 weeks with minimal reaching/pulling with the arms, and less than 20 pounds lifting of weight.  This is followed by 2 more weeks of less than 45 pounds lifting, but during this time you may reach and pull with the arms.  In total, there will be 4 weeks of no intense exercise and you will be in a bra 24/7 except for showering.  After these 4 weeks, most patients may begin regular exercise as tolerated. See below for quick 4 minute video from Dr. Albright on recovery:

What type of breast implant is the best choice, silicone or saline?

During your consultation, Dr. Albright, one of the best breast implant surgeons in Texas, he will discuss the differences between salt-water (saline) filled versus silicone gel filled breast implants. For most patients the choice will boil down to the overall comfort level with risks/benefits of the implant fill material.  Here is a brief comparison of saline versus silicone breast implants. For further information check out our blog article on the different types of implants.

1. Breast Implants and Rupture
For saline implants, if the implant were to rupture, your body would slowly absorb the salt-water and you would notice a “deflation” or loss of volume in the affected breast. Conversely, with newer cohesive silicone implants, implant ruptures are often “silent”, meaning you may not be able to see or feel a difference in the implant after a rupture.  The FDA recommends scheduled MRI surveillance of silicone implants to help detect these silent ruptures.  If your silicone implant ruptures, the FDA recommends having it removed with or without replacement.  The recommended MRI’s are not covered by insurance and will have to be paid out of pocket.

2. Breast Implant Cost
Saline implants are typically less expensive to purchase than silicone implants (typically several hundred dollars) but may have less extensive warranty coverage.  An exception to the cheaper initial cost for saline-filled implants is the new “Ideal Implant”, which is a “structured”saline-filled implant that is purported to feel more like a silicone implant and has a similar overall cost to silicone implants.

3. Breast Implant Feel
Silicone implants, including gummy bear breast implants, are widely accepted as feeling more “natural” or“breast-like” particularly when squeezed or prodded. However, this is likely an over simplification. The overall implant feel is also affected by implant pocket selection, implant fill characteristics (over-filled vs under-filled saline and more or less cohesive silicone gel), and overall soft tissue coverage.  Dr. Albright typically reserves saline-filled implant use to below the muscle (total submuscular) to minimize any unnatural feel.  Furthermore, he discourages using saline implants in a dual-plane pocket as these implants may migrate more quickly due to a water hammer effect from the saline fluid on the surrounding soft tissue.

4. Breast Implant Weight
The implant fill density (typically grams per cc of volume) is very similar between 0.9% Normal Saline, and cohesive silicone gel.  Both approximate 1g per cc.  Since saline implants come deflated and are filled with salt water during the procedure, they have a range of fill volumes that can be placed and are more adjustable, whereas silicone implants come pre filled and have a fixed volume. But even with these variables, differences between implant weight (at least within the range of most implant sizes) are negligible.

5. Implant Rippling
‍Alamo Plastic Surgery is the one of the best places to get breast implants in Texas. Every breast implant has the risk for rippling/scalloping/waviness/folding in its shell.  This is why ensuring adequate soft tissue coverage to “hide” the implant is so important. There are certainly differences in overall risk of seeing or feeling these ripples or folds. Underfilled-saline implants are at greater risk than over-filled saline implants.  Less cohesive silicone gel filled implants are at greater risk than more cohesive silicone gel implants.

Should my breast implants be placed over or under the muscle?

Implant pocket is the most important determinant of outcome and is described by the relationship of the implant to the pectoralis muscle on the chest.  The “pec” muscle is a flat fan-shaped chest muscle connected to the front of the chest on three sides (collar bone, outside border of the breast bone, and along the ribs near the lower part of the breast).  The muscle is not connected to the chest wall on the side toward your armpit (you can pinch the muscle between your fingers on the side) as it spans over the armpit to connect the chest to your upper arm.  Placing the implant above this muscle is called subglandular or prepectoral.

Placing the implant below the muscle is called submuscular or subpectoral, and can be further differentiated by being completely under the muscle (total submuscular), or partly under the muscle (dual-plane). When an implant is placed below the muscle, the procedure is more painful and you may need more pain medication. However, for most women, the pain is temporary and there is no difference in pain long term. By changing the pocket, you can change the overall breast look as well as the relative short and long term risks and benefits of the procedure.

During your consultation from the breast implant specialist, Dr. Albright will help you decide which implant pocket is best for you.

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What is the right size breast implant for my body?

Although most women worry about specific implant volume, implant pocket and implant dimensions are more important considerations - especially if you have a particular “look” you are trying to achieve.  To this end, a simple exercise for patients considering breast augmentation is to begin collecting photos of models you like, in clothes/swimsuits/underwear/naked. You can also view Dr Albright’s B&A gallery online or in the office to get additional examples. Together you and Dr. Albright, who owns Alamo Plastic Surgery (one of the best places to get breast augmentation) will figure out how to achieve your best look.

Please see 3 minute video below from Dr. Albright on sizing implants:

Do I need a breast lift with my breast augmentation procedure?

This is the first question to answer when considering a breast augmentation. Dr. Albright will assess your breast tissue, the skin of the breast and the position of the nipple to help you decide which of breast augmentation, breast lift, or breast lift with breast augmentation would be best.

The ideal breast augmentation candidate is a patient that desires more breast volume. If you desire to wear a larger cup size, then more volume will be needed. If you are happy with the volume of breast tissue in a bra, but not with the droopiness of the breast out of clothing, then a breast lift is best. Do you want more volume and need to fix a little breast droop? Typically, if the nipple position is below the fold of the breast while standing in front of a mirror and you want larger breasts, a lift with an implant (augmentation mastopexy) procedure will likely be needed.

Visit Alamo Plastic Surgery for an affordable breast augmentation quote with financing starting at $257/month. For a full explanation visit Dr. Albright's YouTube explanation on breast implants with lift versus breast augmentation.

Please see short 4 minute video below on how to tell if you need a lift with breast augmentation:

Why do breast implants move/displace over time?

Gravity, muscle contraction, and soft tissue resistance to these forces.

Gravity
All implants will have a natural tendency to displace over time due to gravity.  Implants are weights.  In fact, implants are typically more dense (weigh more given same volume) than breast tissue!  Implant pocket will affect the degree of implant displacement due to gravity.  When the implant is placed completely underneath the pectoralis muscle (the lower part of the muscle is still connected to the ribs near the bottom fold of the breast), the implant will be supported by these muscle fiber attachments and resist downward movement of the implant due to gravity.  Subglandular and Dual Plane Submuscular pockets do not have this lower muscle support and therefore will be more likely to allow implants to move down the chest. Get your breast implantation surgery from the one of the top rated breast implant surgeons in Texas - Dr. Albright.

Muscle Contraction
When an implant is placed underneath the pectoralis muscle and the muscle contracts, the muscle fibers will shorten and create a pressure on the implant.  The implant will want to go where there is less pressure, and this is typically where there is no muscle coverage.  Imagine squeezing a balloon in your fist, the balloon will be pushed out through the open side of your fist.  Both total submuscular implants and partial submuscular (dual plane) implants are subjected to this force from contracting muscle.  These two implant pockets will tend to push the implants toward the armpits over time.  Additionally, for dual plane implants, where there is no longer muscle support from the bottom side of the breast, and therefore, the implant can also be pushed out from under the breast toward the belly.  This creates a “double-bubble” deformity.  When an implant is placed above the muscle, it is not squeezed by the muscle and actively displaced by muscle contraction. Dr. Albright has great skills and expertise in breast implantation and he is considered as one of the best breast implant surgeons in Texas.

Soft Tissue Resistance
The only thing resisting gravity and muscle contraction is soft tissue (skin, fascia and scar tissue). The skin and fascia of the breast are designed to stretch to allow for possible milk production, and are therefore not ideal counter-forces. Women with damaged skin and stretch marks on the breasts are particularly at risk. The only remaining soft tissue support is the scar tissue that forms around the implant. When an implant is placed in your body, your body will start to wall it off with scar tissue. This scar tissue is called the implant capsule.  Patients differ in how robust this scar tissue layer is.
Plastic surgeons’ do not have a way to predict how thick or robust this scar tissue will be for patients.  If you happen to produce a thin/flimsy capsule, your implant will be more likely to migrate out of position. Plastic surgeons’ have tried to create a thicker capsules by using textured surfaces to the implants, and a variety of meshes to reinforce the capsule. Textured surfaces on the implant allow a more intimate connection between the scar tissue and the implant thereby resisting movement of the implant. However, these textured surfaces have been implicated in a very rare type of cancer. The lone remaining viable option is  to use a mesh to support the implant and resist displacement due to muscle contraction.  Meshes are either biologic or synthetic and all have unique benefits and drawbacks.

Dr. William Albright is one of the premier plastic surgeons in Texas and offers first-class plastic surgery services in a comfortable and private environment.

Please see video below from Dr. William Albright on breast implant migration factors:

Which breast augmentation incision is best for me?

Dr Albright recommends placing the breast augmentation incision along the lower breast fold (inframammary fold). This affords the best control of implant pocket dissection, a critical step during breast augmentation. Additionally this incision is associated with the lowest risk of developing capsular contracture, which is a progressive pathologic thickening of the scar tissue around the implant (the capsule).

The most widely accepted cause of capsular contracture is chronic inflammation in the scar tissue around the implant due to bacteria colonizing the surface of the implant. The bacteria may be encountered during implant placement either through milk ducts around the areola or in hair bearing pores / sweat glands in the armpit (axilla). Accessing the breast pocket through the belly button (umbilicus) or TUBA (transumbilical breast augmentation), has been criticized for difficulty with pocket development, and limits implant selection to saline implants.

How can I maintain my results from breast augmentation?

Understanding that the biology of aging can’t be reversed with a scalpel, there are some common sense precautions you can take to prolong the longevity of your result.  Breast tissue and breast implants have weight.  In fact, breast implants are typically heavier than native breast tissue for the same volume.

Fat transfer breast augmentation has gravity and activities will move this weight over time, and eventually overpower the soft tissue support creating droopiness and a poorly positioned implant. For this reason, Dr. Albright recommends wearing breast support as much as possible, including at night, for life. Related to this concept of soft tissue strain, one should avoid significant weight fluctuations either up or down.

Finally, we can avoid unnecessary damage to the soft tissue by limiting nicotine exposure and tanning.

When will I see results from my Breast Augmentation?

For most patients there will be initial swelling from breast augmentation surgery followed by gradual resolution of the swelling with a resulting loss of volume. Around 2 months, most of the swelling has resolved and you will be at your approximate breast size. At this point you can go out and purchase your new wardrobe (bras, bikinis, etc)!

However, even at this point, you may not have your final breast SHAPE out-of-clothes (how the breast will look when standing naked).  This is because the overlying soft tissues are still adjusting to the implant which takes about 2-3 months for above-the-muscle implants to about 4-6 months for below-the-muscle implants.

Depending on your goals, this may help you figure out when to schedule your breast augmentation surgery Stone Oak, TX.

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19016 Stone Oak Parkway Suite 240, San Antonio, TX 78258
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Map Pin Address Alamo Institute of Plastic Surgery.
Office Address
19016 Stone Oak Parkway Suite 240, San Antonio, TX 78258
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