Secondary Breast Surgery

The most common surgical stigma after breast augmentation is the denominated “separa-ted breasts deformity”. Other frequent deformities are inframammary fold asymmetries or in the size of the pocket where the implants are placed in the breast, capsular contracture or ex-cessive breast firmness and widened scars with dilated areolas or other problems such as rip-pling (wrinkles in the breast surface caused by the implant) or a waterfall or snoopy deformity (due to a high riding implant with with the patient´s breast tissue sliding bellow it).

After a mastopexy or breast elevation, or after a breast reduction there can be widened or hypertrophic scars, asymmetric or non-circular irregularly shaped areolas, as well as a loss of projection of the upper pole of the breast with a drooping lower pole and an excessively high nipple (a deformity known as “bottoming out”).

Dr. Bravo performs complex procedures to repair breast augmentation surgeries that have yielded unsatisfactory results. He employs techniques to manage the breast capsule (capsulec-tomies, capsulotomies and capsular flaps) and to improve the support of the breast through the use of acellular dermal matrixes in selected cases. He also often combines fat grafting to the cleavage area and a complete revision of the breast pockets, reconverting them to neosubpec-toral pockets, as well as a revision of previous scars.

In procedures performed to reconstruct mastopexies or breast reductions with inadequate results, he reattaches the breast tissue to a high pectoral location and employs a circumvertical technique with lateral extension, which improves the projection of the breast and cleavage area, also reducing the size of the areolas and making them more circular. He also applies fat from the patient or small implants placed in the partial submuscular dual plane pocket to improve the results.