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Breast Procedures

Breast Implant Revision

On occasion, surgery must be performed to revise the results of previously performed surgery on the breasts. Fortunately, this is not common. Dr. Burden and Dr. Ennis frequently evaluate patients who are sent from other physicians to evaluate their results following breast augmentation, breast reconstruction, and breast reduction. Each problem is specific to the primary procedure performed.

Dr. William Burden and Dr. Scott Ennis of Destin Plastic Surgery are committed to helping you with the important decisions you face when a revision is needed. Women visit them from neighboring states and international locations, as well as surrounding cities like Pensacola, Panama City, and Destin, Florida for breast implants revision surgery. To find out more, request a consultationrequest a consultation online or call our office at (850) 654-1194 to schedule your appointment.

Results Worth The Drive

See why people travel to Destin Plastic Surgery from Mobile, Dothan, Gulf Shores, and other Alabama communities.

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While at the University of Florida, Dr. William Burden performed many revisional surgeries during the silicone implant crisis. As an investigator for the national Adjunct Study for silicone implants, Dr. Burden cared for many patients who traveled from other areas of the country. He removed their failed implants, reshaped their breasts, and placed new cohesive gel implants to obtain an improved shape and appearance. Dr. Burden has been recognized by the implant manufacturing corporation Mentor for his work in the Adjunct Study.

Dr. Burden has combined his silicone implant experience with his exceptional fiber-optic surgical experience to be able to revise some cases through the underarm approach to avoid a scar on the breast. He has performed many surgeries for patients from other areas of the country using this fiber-optic technique. Now most women can have their implants replaced using the underam (transaxillary) approach.

Dr. Burden has taught courses on revisional surgery using the endoscopic technique. Surgeons from around the country have come to watch Dr. Burden perform these procedures at the Destin Plastic Surgery facility. This technique is very sophisticated. Only those surgeons who have significant fiber-optic experience should perform these procedures.

Patients have traveled from Washington, D.C., New York state, and California, just to name a few areas, to have Dr. Burden perform their revisional surgeries. Dr. Burden understands that revisional surgeries for the breasts are often complex and carry with them significant emotional strife. He will try his best to improve the result.

Toll Free: (866) ENHANCE 4485 Furling Lane, Destin, FL 32541
Dr. Burden

Dr. William Burden

An internationally renowned plastic surgeon with years of experience with revisional breast surgery.

Dr. Ennis

Dr. L. Scott Ennis

World renowned plastic surgeon recognized by the International Society of Aesthetic Plastic Surgeons (ISAPS)



Dr. Ennis has given many talks to international groups of surgeons on complex revision breast implant surgery and is known as an expert in the field of revision augmentation surgeries. Dr. Ennis has been able to successfully perform corrective surgeries for patients who have been through multiple previous revision surgeries by other surgeons and frequently has patients travel great distances to have their previous breast surgery corrected by him.

Dr. Ennis is an internationally recognized and renowned plastic surgeon specializing in breast surgery and complex breast revision who is devoted to achieving the optimal outcome for every patient. Dr. Ennis has been recognized by the International Society of Aesthetic Plastic Surgery with membership in the society. An exclusive recognition requiring at least 2 other internationally recognized surgeons to nominate him for membership, ISAPS membership is drawn from some of the world most elite surgeons in 73 countries on every continent.

Reasons for Revision Surgery

The 2 most common problems following breast augmentation and reconstruction with an implant are:

  • Capsular contracture
  • Undesirably palpable implant ("rippling")

The doctors at Destin Plastic Surgery perform submuscular breast augmentation near Pensacola, Mobile and Montgomery, which has 2 major advantages over subglandular placement of the implant:

  • Decreased rate of capsular contracture
  • More tissue to cover the implant to prevent the implant from being easily seen or felt
Before & After Breast Implant Revision

Before & After Breast Implant Revision

This patient had very little breast tissue and underwent a subglandular breast augmentation with saline implants by an outside surgeon. The implants were removed using the underarm (transaxillary) approach and new saline implants placed through the same incision.

Capsular Contracture

Capsular contracture is the term used to describe the formation of scar tissue around the implant which, when thickened, can make the implant feel hard and round. Although the implant itself remains soft, the scar tissue "squeezes" the implant, which makes the implant itself feel hard. In the submuscular position, the rate of capsular contracture is decreased in general from 15% to 3%. That's a significant difference.

This patient had previously undergone a breast augmentation by an outside surgeon and developed a right breast capsular contracture (left column). She subsequently underwent a right breast capsulectomy at Destin Plastic Surgery to correct the contracture (right column).

Rippling

"Rippling" occurs when the implant shell is easily felt beneath the skin. With subglandular augmentation, studies have shown that the chance of rippling is 3 times greater than with the submuscular, or under the muscle, position.

Additionally, a patient with very little breast tissue will benefit from changing breast implant type to a silicone implant instead of a saline implant as illustrated below.

This patient had very little breast tissue and underwent a submuscular breast augmentation with saline implants by an outside surgeon. The patient was unhappy with the rippling that occurred when she leaned forward. She subsequently underwent an implant exchange from saline to silicone at Destin Plastic Surgery and as you can see in the right hand picture, the rippling was significantly improved.

This patient underwent a subglandular (above the muscle) augmentation and several subsequent revisions by an outside surgeon prior to presenting to Destin Plastic Surgery. At our office, she underwent an endoscopic implant exchange from over the muscle to under the muscle. Note the tremendous improvement in the shape and contour of her breasts.

This patient also underwent a subglandular (above the muscle) augmentation and subsequent revisions by an outside surgeon prior to presenting to Destin Plastic Surgery. Here, she underwent an implant exchange from over the muscle to under the muscle by Dr. Ennis. Note the tremendous improvement in the shape and contour of her breast in the bottom row of photos after the revision.

Bottoming Out or "Double Bubble"

Bottoming out is the term used to describe an implant that drops too low (also known as implant malposition or a "double bubble"). Many patients who have experienced this problem complain that their nipple is too high and will show out of the tops of bathing suits. This happens because the distance between the nipple and the bottom of the breast is too long. This may be corrected with a small incision underneath the breast and sutures placed along the bottom of the breast to tighten the fold and reposition the implant into the proper position to re-center the nipple over the implant. This will significantly improve the appearance of the breast and clothes as well as bathing suits will fit much better.

This patient underwent an augmentation several years ago by an outside surgeon and subsequently developed a double bubble on the right side. She underwent an implant exchange from saline to silicone and a right breast capsulorrhaphy at Destin Plastic Surgery to correct the double bubble.

This patient underwent a left breast capsulorrhaphy at Destin Plastic Surgery to correct the bottoming out by raising the implant significantly improving the appearance of the breast.

A double bubble occurs when an implant drops too low or when the implant drops down behind the natural fold of the breast rather than forward into the breast. This creates 2 folds with an unnatural appearance.

Depending on the patient's breast, it may be corrected by tightening and raising the fold or with a breast lift (mastopexy). Dr. Burden or Dr. Ennis can further discuss which option may be best for you during your consultation.

This patient underwent an augmentation several years ago by an outside surgeon and subsequently developed a double bubble on the right side. She underwent an implant exchange from saline to silicone and a right breast capsulorrhaphy by Dr. Ennis at Destin Plastic Surgery to correct the double bubble.



Advanced Techniques for Bottoming Out, Rippling & Synmastia

Both Dr. Burden and Dr. Ennis have used advanced techniques for revisional breast surgery and breast reconstruction using ADM (acellular dermal matrix). Both surgeons have attended advanced training courses in the use of ADM and have incorporated ADM into their treatment of breast deformities.

ADM is used to correct severe cases of bottoming out by providing a sling to hold the breast. ADM is also used to add tissue coverage to allow implant rippling to be less visible and oftentimes completely corrected.

ADM can also be used to treat or correct synmastia (implants crossing the middle of the chest.)

Before & After Breast Implant Revision

Before & After Breast Implant Revision

After augmentation by an out-of-town surgeon, the patient had a good result. With time, the implant dropped due to lack of support by the surrounding tissue. ADM was placed to act as a sling to support the breast implant. Larger silicone implants were used to replace the saline implants. The results are shown 6 months after surgery.

Dr. William R. Burden, MD, FACS and Dr. L. Scott Ennis, MD, FACS are known for their experience and dedication to staying in the forefront of leading technology in plastic surgery in Destin, Florida. They use breast implants for primary breast augmentation and also perform many breast surgery revision procedures. Drs. Burden and Ennis not only treat many patients from the Florida panhandle including Panama City, Pensacola, Fort Walton Beach, Tallahassee, Dothan, Atlanta, and Birmingham but also from around the world. Many people travel from Europe, South America and Asia to Destin to seek out their services.

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