Dissatisfaction with the outcomes of a breast augmentation mammoplasty is uncommon, but it does occur. Dr Tavakoli has experience in correcting post breast augmentation (mammoplasty) complications.
Breast Procedures
Breast Implant
Revision Surgery Sydney
Researching the plastic surgeons in Sydney can be a timely process before women choose to undergo breast surgery. Dr Tavakoli and his team provide support throughout the surgical journey. Whatever your reasons are for considering breast surgery in Sydney, Dr. Tavakoli works with you to understand your desires and expectations.
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DR TAVAKOLI’S PHILOSOPHY ON CORRECTIVE BREAST SURGERY & THE INTERNAL BRA TECHNIQUE
Dr Tavakoli has a large referral base of women with poor breast augmentation (mammoplasty) outcomes from other centres in Australia. These complications or undesired outcomes are very rare; however, no plastic surgeon in the world including Dr Tavakoli has a zero complication rate. Lack of experience in breast implant surgery almost invariably can lead to poor outcome requiring costly revisional surgery to fix. Enquire about your doctor’s level of experience before undergoing breast augmentation mammoplasty.
Breast Implant Revision
Before & After Gallery
Disclaimer: The outcomes shown are only relevant for this patient and do not necessarily reflect the results other patients may experience, as results may vary due to many factors including the individual’s genetics, diet and exercise.
View Our Before & After Gallery
Disclaimer: The outcomes shown are only relevant for this patient and do not necessarily reflect the results other patients may experience, as results may vary due to many factors including the individual’s genetics, diet and exercise.
Internal Bra Technique by Dr Tavakoli, FRACS
The principles of corrective surgery are complex & set out below (One step operation or two step operation):
- 1. Recognising the initial problem using old photos, operation reports, implants used etc.
- 2. Rectifying the implant pocket or creating a new implant pocket
- 3. Replacing the incorrect implant size & dimension with the correct ones
- 4. Addressing the overlying breast skin with possible breast lift (mastopexy) skin tightening procedure & nipple re-positioning
- 5. Using Acellular Dermal Matrix (ADM) or second skin (made from human cadaver) where needed to replace tissue excessively removed
- 6. Extensive use of permanent barbed sutures to re-create the implant pocket
- 7. Use of fat graft technique to camouflage & correct breast asymmetry
Please note that revisional surgery can take up to 4 hours & therefore the fees/costs for corrective surgery are higher than primary augmentation (mammoplasty).
Re-do Implants Breast Procedures
Redo breast procedures, also known as corrective breast surgery, are designed to address issues stemming from previous breast augmentation, lift, or reduction surgeries. These procedures aim to resolve complications such as implant displacement, asymmetry, or dissatisfaction with the original results. With a focus on enhancing both aesthetics and patient comfort, Dr. Tavakoli offers tailored corrective solutions to restore confidence and achieve the desired outcome.
Dr. Tavakoli has extensive experience in performing a variety of redo breast procedures, and you can explore the results by viewing the case studies below.
Capsulectomy or excision of capsule for hardness
The incidence of this condition has dropped from 35% down to 5% in most international studies. Dr Tavakoli uses a super sterile technique to insert lightly textured Mentor implants in mostly Dual Pocket. This helps reduce the incidence of capsular contracture.
It is not fully understood the reason for this occurrence of this condition. Capsular hardening or contracture is more common in certain ethnic groups such as Asians and Africans. It can however affect any racial group. Theories range from Biofilm related to bacteria Staph Epiderdimis to serum production as a result of body’s reaction to the implant covering.
The hardening is caused by excessive scar tissue forming around the implants. It can occur as early as 6 weeks after surgery and as late as 10 years. The best way of preventing this is to massage the augmented breasts in the postoperative period so that the capsule forms softly around the implant. The breast hardening process or capsular contracture can have both and pain implications.
The capsulectomy operation removes the hard capsule and the new implants are inserted in a fresh pocket preferably behind the pectoralis muscle.
Case Studies
Disclaimer: The outcomes shown are only relevant for this patient and do not necessarily reflect the results other patients may experience, as results may vary due to many factors including the individual’s genetics, diet and exercise.
Change of implant pocket and breast lift (mastopexy)
Case Studies
Case Study No. 1
This Study was for a 43yo female, removal of implants, followed by bilateral breast reduction mammoplasty & lift using CPG Mentor 445cc-332, anatomical (teardrop) implants.
Case Study No. 2
Bilateral re-augmentation to correct capsular contracture and change of pocket from subglandular to submuscular. Bilateral mastopexy was performed to remove excess skin and reposition and resize the areola.
Disclaimer: The outcomes shown are only relevant for this patient and do not necessarily reflect the results other patients may experience, as results may vary due to many factors including the individual’s genetics, diet and exercise.
Implant rippling correction using fat graft
Case Studies
Case Study No. 1
Fat grafting (35mL) to cleavage to correct rippling of implants. Implants removed and replaced with Mentor CPG 332-350cc anatomical (teardrop), tall height, moderate plus projection, anatomical (teardrop) implants placed in a dual plane pocket
Disclaimer: The outcomes shown are only relevant for this patient and do not necessarily reflect the results other patients may experience, as results may vary due to many factors including the individual’s genetics, diet and exercise.
Excessive cleavage gap
Excessive cleavage gap between breasts creating undesirable breasts. This condition usually arises from poor choice of implant and inadequate submuscular dissection.
By further dissection and appropriate use of a broader based implant this condition can be improved. Please note that some women are prone to having this issue as a result of the poor curvature of their chest wall.
Case Studies
Case Study No. 1
25 yo old female, 350cc High profile smooth round gel implants with excessive cleavage gap, Dr Tavakoli up-sized to 485cc High Profile anatomical (teardrop) silicone gel implants with fat grafting to the sternum.
Case Study No. 2
25 yo old female, 350cc High profile smooth round gel implants with excessive cleavage gap, Dr Tavakoli up-sized to 485cc High Profile anatomical (teardrop) silicone gel implants with fat grafting to the sternum.
Disclaimer: The outcomes shown are only relevant for this patient and do not necessarily reflect the results other patients may experience, as results may vary due to many factors including the individual’s genetics, diet and exercise.
Symmastia or synmastia
Symmastia is a condition is described where there is no cleavage or very tight cleavage. Patients can rarely be born with this condition (congenital) or commonly acquire it after breast augmentation (mammoplasty).
Acquired Symmastia
Grade 1 tenting: Internal Bra
Grade 2 kissing: Internal Bra +/- ADM
Grade 3 kissing & tenting: 2 stage reconstruction
Risk factors:
-Narrow chested patients & cleavage webbing
-Overdissection of pocket medially
-Use of wide based implant typically
-Usually moderate projecting round implant
-Overuse of postoperative bra
If apparent immediately after breast augmentation (mammoplasty), it has occurred as a result of over-dissection centrally and/or use of very large based implant so that the implants are left too close in the middle. It can also develop months later but overzealous use of “push-up” bras creating thinning of tissue centrally.
Surgical treatment is possible but needs complex re-adjustment of the pockets using permanent suture technique and smaller size implants with narrower base.
In moderate to severe cases if the implants are submuscular the choices are either to suture down the tissues centrally with permanent sutures and dissect the pocket laterally so the implants have room to shift outwards. If the implants are subglandular the implants need to be placed in a new submuscular pocket.
In severe cases Dr Tavakoli prefers the 2 stage technique. The implants have to be removed for 6-12 months and replaced after pocket healing has taken place.
Post operatively ALL patients need to wear a special bra for 3 months with no activity.
Congenital Symmastia:
Correction of Congenital Symmastia.
Acquired Symmastia: Case Studies
Correction of Symmastia using suture technique.
Disclaimer: The outcomes shown are only relevant for this patient and do not necessarily reflect the results other patients may experience, as results may vary due to many factors including the individual’s genetics, diet and exercise.
"Double-Bubble” deformity
This is a condition where the implant and the native breast are in completely different anatomical (teardrop) levels. Routine subpectoral mammary augmentation in women with a small breast lower pole deficiency may lead to unwanted late results with the appearance of a double-bubble deformity. The surgical correction is complex and requires the need for a series of a. excision of breast tissue, b. pocket adjustment or capsulorrhaphy and c. exchange of implants or any combination of the above.
Case Study No. 1
31yo female, 3 previous surgeries by another surgeon resulting in Double Bubble and rippling. Dr Tavakoli sutured down the breast pocket and complex Double Bubble repair, and removal and replacement of breast implants with Lolly-pop lift using 480cc Ultra High Profile silicone gel textured round implants placed in Dual Plane pocket, type 2. Patient photographed 4 weeks post op.
Disclaimer: The outcomes shown are only relevant for this patient and do not necessarily reflect the results other patients may experience, as results may vary due to many factors including the individual’s genetics, diet and exercise.
Change of implant pocket
There are many reasons why one would opt for change of implant pocket.
- A. Rippling and implant edge visibility are hard to get rid of. One way is for the patient to put a small amount of weight and increase the padding around her breasts. Exchange of implant to smooth high filled implant &/or going behind the muscle also can be very helpful manoeuvres. Fat grafting is also a possible solution.
- B. Placing the implant behind the pectoralis muscle can create an issue namely “winking”. In most patients this is not a major issue but in some women with strong muscles may find this undesirable. Dr Tavakoli normally recommends no surgery for this condition, but some may want to opt to have the implant placed in front of the muscle.
Disclaimer: The outcomes shown are only relevant for this patient and do not necessarily reflect the results other patients may experience, as results may vary due to many factors including the individual’s genetics, diet and exercise.
Case Study No. 1
Exchange of implants
For size issues (usually seeking a bigger cup size) or content (usually saline to gel). 33yo, 2 pregnancies Implant removed – Mentor 295cc round silicone gel in a sub glandular pocket.
Correction of breast implant bottoming out
This condition is a form of implant migration. Although can be seen with all types of augmentation (mammoplasty) it is more common with smooth implants. The treatment is very complicated and involves pocket repair and exchange with polyurethane coated implants.
Disclaimer: The outcomes shown are only relevant for this patient and do not necessarily reflect the results other patients may experience, as results may vary due to many factors including the individual’s genetics, diet and exercise.
Replacement of ruptured implant
Plastic Surgeon Dr Tavakoli’s carries out complex corrective breast augmentation mammoplasty surgery on patients Mindy B and Lauren G who need a revision post surgeries performed in Thailand and Malaysia.
MEDICAL TOURISM ALERT: Travelling overseas for cosmetic surgery just to save money can lead to poor outcomes, often with avoidable complications, little or no recourse to return for additional revisional treatment, and sometimes resulting in significant complications.
Breast correction after implant rupture and capsulization. Original surgery done overseas in 2006, 26 yr. old female presented to Dr Tavakoli unhappy with the shape of her breasts following a severe accident. Dr Tavakoli performed a capsulectomy/removal of ruptured gel implant on the left breast. New sub muscular pocket created, 400cc HP round mentor textured implants inserted.
Disclaimer: The outcomes shown are only relevant for this patient and do not necessarily reflect the results other patients may experience, as results may vary due to many factors including the individual’s genetics, diet and exercise.
Reconstruction after removal of infected implant
Breast implant infections are extremely rare but they can unfortunately occur. Dr Tavakoli has successfully performed reconstruction following this condition in the past.
Disclaimer: The outcomes shown are only relevant for this patient and do not necessarily reflect the results other patients may experience, as results may vary due to many factors including the individual’s genetics, diet and exercise.
Scar revision after breast lift (mastopexy)
Scar revision may be needed for poor scarring such as Hypertrophic scar or Keloid. Prior to scar revision Dr Tavakoli recommends the FRAXEL laser technology to improve the quality of the scar and /or a course of intralesional steroid injections. Failing the latter then formal surgery on the scar by re-cutting and suturing can improve the quality of the scar.
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