: Before & After Photos

Having performed well over 5,000 breast surgeries throughout my career, I can tell you, every situation is unique. Some women may need to have their implants replaced within just a few years while others are perfectly happy with their augmentation decades later. Of course, having a skilled surgeon such as myself can prolong the life of your implants, and annual follow-up exams will go a long way to giving you peace of mind.  As part of my practice, all of my patients who’ve had breast surgery are encouraged to come for annual check-up exams and I never charge for these follow up visits.  With proper monitoring and care, your initial breast augmentation can last years. I recommend monthly self-exams along with physical exams on a regular basis.

There are five reasons that women commonly consider breast implant replacement (or BIR).

Change in implant size is sometimes desired with weight change or simply a change in your personal aesthetics.  In general, but not always, women tend to favor smaller implants as they age.  Weight gain, common with aging, may make your natural breast tissue larger, and since the size of your breasts is the sum of the natural breast tissue plus the implants, weight gain may be a reason for going smaller.  On the other hand, with aging or following pregnancy, natural breast tissue may shrink, and larger implants may be necessary to maintain your desired size.

Breast droop, with age, after pregnancy, or with weight change, may be a reason for a breast lift, and if it’s been a few years since your implants were placed, this is a common time for breast implant change.

Other surgery (non-breast) such as facelift, liposuction, or tummy tuck, means a trip to the operating room.  Changing your breast implants in conjunction with unrelated surgery saves money and recovery time.  Since most breast implant changes are quick and relatively easy, doing it with other surgery makes sense.

Breast implant issues – deflation or rupture – eventually happen with all implants.  Saline implants deflate (either slowly or rapidly) and this is easy to diagnose.  Your breasts change size as the implant goes flat.  There is no health risk but if you’re planning to replace the implant, it’s best to do it within 4-6 weeks after a deflation.  After 4-6 weeks, the breast pocket where the implant is located tends to shrink to fit the smaller implant, and replacement may require additional surgery to re-open the pocket.  Rupture of the silicone gel implants, particularly the current cohesive gel implants, can be difficult to diagnose by physical exam.  Since the gel sticks together, even when the implant shell tears, the breast may not change shape or volume.  Short of surgery to look at the implant, the best method of examining the implant is an MRI.  An MRI detects about 85% of silicone gel breast implant ruptures.  Like saline implants, rupture of a silicone gel implant is not an emergency, but once diagnosed, the implant should be removed and replaced within 4-6 weeks.

Non-implant complications, such as capsular contracture, wrinkling, implant position change, or desire to remove older textured implants may require surgical correction, and this is a common time to consider breast implant replacement.

The cost and recovery time for breast implant replacement varies based on what procedure is done.  Simple replacement generally requires only one or two days off work, with return to unrestricted activity by 3 weeks.  Pain is minimal to non-existent and usually, the same incision that was made for the original augmentation can be used again.

The only real way to determine if your implants need to be removed or replaced is through an in-person consultation. Remember, if I did your first breast surgery, you’re part of the Dr. Barnett Family, so no charge for the check up.  If your surgery was performed by another doctor, you’re welcome to come in for a consultation and my regular initial consultation charges apply.  New patients should do their best to get copies of their previous operative reports and information about the brand, style and size implants that were placed.  If you don’t have this information, my office can help you obtain it from your previous surgeon.

What’s Right for Me?

Your second breast augmentation will be very similar to that of your initial surgery. I take pride in my personalized care and have helped many women achieve their desired results. At the time of your consultation, we’ll discuss your options in-depth.

Take the Next Step

Ready to look and feel your best? Schedule a consultation to discuss your options today. Consultations are available in both our San Francisco and Walnut Creek offices. You may schedule for either location by calling (415) 362-1221.  Renee or Laurie will help you and answer any pre-consultation questions you may have!

Fat grafting, or fat transfer, is a more involved procedure that requires a skilled surgeon. The minimally-invasive procedure removes your fat (it has to be yours – no “friend” donations!) from the abdomen, thighs, or anywhere excess fatty tissue can be found. The fat is then purified and placed in a more aesthetically pleasing location. The process can take much longer than a quick injectable filler. I only do fat grafting in the operating room (anesthesia may or may not be required).  I frequently do fat grafting with other procedures, such as a facelift, and so many times the patient is already in the OR.  And, if you’re having liposuction to remove fat, it’s a good time to put the removed fat to use!

What about results? Patients will see noticeable results immediately after their appointment with both treatments. Generally, there is more swelling with fat grafting because, in general, substantially more fat is placed than fillers, and more areas are treated.  For larger volumes, fat is much more natural – it is living and moves and feels like living tissue.  Large volumes of filler can give the face a stiff look, and move as a block when the patient smiles.  This is sometimes referred to as “Pillow Face”.  Fillers are much better for small areas, fine wrinkles, and touch-ups – as well as being much less expensive.  However, fat grafting is considered a ‘lifetime’ procedure because fat cells that make it through the injection process remain intact for good. Dermal fillers on the other hand, can last anywhere from several months up to 1-2 years, and then have to be replaced.  The cost for fillers is ongoing.

Fat grafting can be safer for some patients. Because we’re using autologous fat (fat from your own body), we’re reducing the chance of a possible allergic reaction to a foreign substance.

So – both fat and fillers are excellent techniques to deal with volume or wrinkle issues.  They each have positive and negative aspects.  One is not “better” than the other – they both have their place. A doctor that offers both can give you an honest discussion of the options.  Doctors or nurses that only offer fillers may be anti-fat simply because they can’t offer fat grafting and they’ll “sell” what they have.

I offer and believe in both – I’ll work with you to determine which is better for a given issue, and many of my patients receive both from me.

What’s Right for You?

At your initial consultation, I’ll explain all of your anti-aging options in-depth. Fat grafting can be done on its own or paired with other procedures for even more dramatic results. Together, we’ll create a treatment plan that’s appropriate for your individual needs.

Take the Step Next

Ready to look and feel your best? Schedule a consultation to discuss your options today. Consultations are available in both our San Francisco and Walnut Creek offices. You may schedule for either location by calling (415) 362-1221.  Renee or Laurie will help you and answer any pre-consultation questions you may have!