Hearing a tale of breast surgery gone wrong can easily plant a seed of doubt in the mind of anyone considering breast augmentation. To understand why problems happen and how to prevent them, we sat down with Austin-based plastic surgeon and breast specialist, Dr. Robert Whitfield.
“I’ve gotten referred several cases, either through the internet or from other plastic surgeons, where patients aren’t happy with their implants,” says Whitfield. In each of these referral cases, he explains, the problem was not a result of an implant failure. Instead, improper surgical technique and implant selection led to a second surgery to remove the implant.
Problem #1: Technique
Plastic surgeons have several options for where to place an incision to insert an implant. Most common incision choices include the fold beneath the breast, called inframammary, or the area around the nipple, called peri-areolar. Other less common options are transumbilical, which means through the belly button, and trans-axillary, which means through the armpit. While the armpit and belly button incisions have the benefit of avoiding any visible chest scars, proper positioning of the implant is more difficult to control with these surgical techniques.
One patient came to Dr. Whitfield from Japan with implants that had been placed through the armpit. “They were too low, the nipple complex was pointing up instead of off the face of the implant, and she was very uncomfortable in clothing. She would not wear a swimsuit and didn’t want to wear workout clothes,” he explains. “She asked that we remove them, and I took them back out through the same incision in her armpit.”
Problem #2: Implant Selection
Another patient came to Whitfield asking him to remove her implants because they were interfering with her athletic lifestyle. In this case, the patient was an avid swimmer prior to her surgery. Her initial surgeon had selected implants that were too wide for her chest and had placed them beneath her muscle.
In both of these examples, proper implant selection and proper surgical technique could have prevented the problems that led to removal of implants. It wasn’t the implants that “went wrong” so much as the surgery planning process.
“If you do things in a way that creates problems for the patient, then you’re going to stigmatize the device,” says Whitfield, “because they think its the devices fault, and really, it’s the choice of the device and the placement of the device overall that made that a problem.”
Prevention through Proper Planning
In his practice, Whitfield uses several tools to ensure the right implant and surgical technique result in implants that fit each patient’s lifestyle and body. “We do measurements and we incorporated 3D imaging into every patient’s care plan. Based on measurements, we develop options for them. If they’re picking a different option, or don’t like the options we’ve chosen and they want something larger, I will just tell them, ‘It doesn’t fit your body, and I won’t do that for you.’”
Breast augmentation is a relatively straight-forward procedure, especially in the hands of a board certified plastic surgeon who routinely performs breast surgery. With that said, the consultation and planning aspect takes a considerable amount of time and will pave the way for the entire procedure. Getting it right with your surgeon before entering the OR is how great breast augmentation results happen!