Franklyn Elliott, M.D.

All breast implants have a finite lifetime. However, it is impossible to know what that lifetime is in any set of breast implants. Both saline-filled and gel-filled implants can leak. If a saline implant leaks, the patient knows immediately because the water leaks out and is reabsorbed by their body. Thus, detection of a saline implant leak is easy. The treatment is to simply remove the implant and replace it. If a silicone gel implant leaks it is often only detected by mammogram, and requires new implants as well. Current breast implants appear to have a lifetime of well over 10 years, probably closer to 20-40 years, but the exact length is unknown given the relatively recent nature of the procedure’s invention.

If a breast becomes infected due to complications from an implant, the implant almost always has to be removed. However, breast implants can be preserved in the face of an infection that is just beginning. These cases are judged individually as each patient’s health history and case will necessitate a different plan. If the infection is addressed in a timely manner and approached by an adequately experienced breast revision surgeon, a positive solution can almost always be achieved.

Whether the breast is reconstructed with a patient’s own tissue, such as with a TRAM flap, or with a breast implant, complications can occur. Dr. Elliott has extensive experience with both forms of breast reconstruction procedures and has seen and managed complications of all types after breast reconstruction. These complications may involve the breast itself or the abdominal wall if a TRAM flap has been used.

Radiation of the breast or chest wall is relatively common after breast cancer detection. While radiation is a very important component in fighting breast cancer, it also has some negative aspects, including hardening of a breast implant if one is in place and relative poor healing of the breast or chest wall skin. Dr. Elliott has managed many problems like these over the years, and has successfully developed and/or refined treatments for these difficult problems.

Dr. Elliot’s reviews and results show that the incidence of abdominal wall weakness or hernia following a TRAM Flap breast reconstruction is around 3%. However, this may not be true for all surgeons, which is why Dr. Elliott has seen many patients with abdominal wall weakness over the years. Repair of this problem requires surgery in which Dr. Elliott inserts a mesh material for additional abdominal wall support.

Breast asymmetry is a common natural occurance in both males and females. In fact, most people have slight (usually non-noticeable) differences in the appearance of their breasts. Breast asymmetry can also occur after breast surgery. Asymmetries can occur with or without breast implants. There are a myriad of techniques including liposuction, breast augmentation, and breast lift (mastopexy) that can be utilized to make the breasts more symmetrical and the patient more pleased. Dr. Elliott has a lot of experience with these types of problems and feels confident that most patients will achieve an excellent result.

Symmastia refers to a complication in which the breasts are too close together in the midline of the chest. This can occur if breast implants are placed too close together at the time of operation. Separation of the implants and breasts themselves can be fairly difficult; however, Dr. Elliott has extensive experience with the capsular work that is needed to separate the breasts and has achieved excellent results with breast revision surgery of symmastia patients.

Implant displacement / misplacement is similar to symmastia, and indeed, symmastia is an implant placement problem. Implants can also be misplaced or displaced to the lower part of the breast or to the sides / lateral part of the breast creating an over-sized space between the breasts. Either displacement problem creates breasts that do not look natural or pleasing to the patient. Dr. Elliott has extensive experience with these problems and uses various capsular techniques to relocate the breast implants into proper position for a successful result.

The position of the nipples on the breasts can be too high after breast reduction or breast reconstruction. In either situation, the nipples can show with low cut blouses, shirts, or with bathing suits. The nipples can be moved using a surgical procedure, but if the implants have “bottomed out”, or sunk to the bottom of their surgically created pocket, they will need to be surgically repositioned to resolve the illusion of the nipple being too high.