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Breast Revision Surgery Ohio

Re-do / Revision of Previous Breast Enhancement Surgery

Midwest Breast and Aesthetics Surgery Redo Breast Surgery OhioAesthetic surgery of the breast is a challenging and technically demanding art. There are no widely accepted methods or technologies available to determine the volume of breast tissue. Therefore, the surgeon must rely on his or her perception of size and symmetry when adding or removing volume from the breast. Furthermore, the breast is a dynamic structure and subject to the forces of gravity and can be significantly affected by the changes that occur with scarring, aging, and activity, making results quite variable over time. Because of these many variables, unfavorable results after aesthetic surgery of the breast can occur – thus the need for breast revision surgery.

Capsular Contracture

When implants are placed under the breast and/or muscle, it is natural for the body to form a thin capsule of scar tissue around the implant. Infrequently, this process can progress to form a thick scar that can make the implanted breast feel very hard. More severe cases of this change, called capsular contracture, can lead to scarring that causes visible changes in the shape and contour of the breast and significant pain for the patient.   Some factors have been associated with a lower rate of capsular contracture. For example, it is generally reported that saline implants are less likely to have contracture compared to silicone devices. Furthermore, implants that are either totally or partially under the muscle may also have a lower rate of contracture. Typically, the only correction for capsular contracture is with surgical intervention. There are different surgical options such as replacement of the implant, removal of the scarred capsule, and repositioning of the implant into a position that is beneath the muscle. Even though these interventions may correct the problem in the short term, capsular contracture can recur if an implant remains in the pocket, making removal of the implant (explantation) the most likely option for a cure in recurrent cases.

Dr. Kocak is a wonderful and skilled Plastic Surgeon. He was warm and professional and his office staff was equally caring......

He's very knowledgeable, honest, kind, and sincere. He made me feel comfortable......

Highly recommend Dr. Kocak. The whole team from front office to Doctor are caring and very professional. They put me at ease on my first visit and were honest, incredibly knowledgeable and detailed with explaining the procedure......

He wants the best for his patients and make sure his patients are informed so that they can make the right decision for them. The staff, as well as Dr Tiwari, are very nice and always helpful......

He is a great surgeon. He answered all my questions. He was very easy to talk to. The procedure went well and my recovery was short and less painful than I thought. The staff is great and made me feel very comfortable! I highly recommend Kocak, he‚??s ......

Dr. Tiwari is an excellent board certified plastic surgeon......

I had a great experience with Dr. Tiwari. He is amazing at what he does, he made me feel beautiful again. His staff was super friendly and welcoming. I am so pleased with the quality of care, the staff and the results......

Dr. Kocak is an amazing doctor. He has the best bedside manner of any doctor I've ever been to. Dr. Kocak is truly an artist in what he does. I highly recommend him. His staff is very well-mannered and expert in what they do......

Dr. Kocak is wonderful! I recently had a breast reconstruction surgery with Dr. Ergun Kocak and it was one of the best decisions I have ever made. I am so contented with the result. He was reassuring every step of the way and explained everything to me and made......

Dr. Kocak & Dr. Tiwari performed my DIEP reconstruction when I had my prophylactic double mastectomy due to having a BRCA1 mutation. Their excellent surgical skills are equally matched by their compassion, accessibility, and dedication to their patients. Their confidence and guidance led me ......

Dr. Kocak and Dr. Tiwari are amazing surgeons.  They are caring, thorough, easy to get in contact with for questions and all around great doctors.  After many years of painful, deformed implant reconstruction I chose to have the DIEP flap reconstruction, Drs. Tiwari and Kocak did a great job......

Symmastia

Symmastia occurs when the skin between the breasts is elevated off the breast bone (sternum). Normally, this skin is held in place by connective tissue between its deep surface and the bone that is deeper down. From a surgical standpoint, breast augmentation requires that pockets, or spaces, be created beneath each breast. If these pockets are created too close to the midline of the body, or if the implants cause the skin to become so tight that they lift off the sternum, symmastia can occur.   Correction of symmastia can be very challenging. If the implants were placed under the breast, but over the muscle, moving the pocket to a position that is deep to the muscle may be beneficial. More recently, the use of acellular dermal matrix (a biological mesh that can serve a matrix for scar and tissue ingrowth) has shown promise when used as an adjunct to support the repair. Whatever techniques is chosen, successful, long-lasting correction of this issue can be difficult and it is best to avoid its occurrence with careful implant selection and meticulous surgical technique at the initial implant operation.

Breast Asymmetry

For most individuals, the breasts are not identical in size nor in shape. Breast enhancing surgeries, such as breast augmentation, mastopexy, and breast reduction can all be controlled to decrease these differences in size and improve symmetry. However, if an asymmetry is not dealt with at the time of these surgeries, it is possible that it will be exaggerate by the enhancement surgery and consequently more noticeable. When asymmetry is severe, corrective surgeries can be helpful to reduce the discrepancy in size and shape, potentially improving the balance and appearance of the breasts. These surgeries depend on the type of asymmetry and the patient’s goals, but usually involve replacing an implant with a different sized one, correction of small volume and contour abnormalities with fat grafting, nipple repositioning with mastopexy, or a combination of the other operations discussed throughout this site.

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Dr. Tiwari, Ten months ago all I could think about was getting rid of these cancer cells. You walked me through everything else I also had to think about and, today, I am not only cancer-free and "normal" looking but healthier and more fit than in many years. You and your team are amazing - truly ......
I just got home from my check up with Dr. Chin. I have been given The ok to have my tattoos done and revisit her in a year. My reconstruction Battle started in April 2012. Originally in Nebraska, my husband was transferred to the Dayton area and two months after that Midwest Breast came into my life......
I'm now 7 weeks out from my capsulectomy, and even though I had a few unexpected complications, I don't regret it for one moment! Dr. T is an amazing doctor, and he worked miracles considering what he started with. Not only does it look better, I feel so much better! Thank you to Dr. T and his ......
Thank you so much. Everyone has been so kind. Maggie always has that warm and inviting smile! Dr. Kocak, made me feel confident on my choices. His bed side manner was comforting, reassuring and most of all compassionate! I was scared, lonely and most of all lost. I realize this is his job but, for ......
My RESULTS are WOW. My breasts look really natural and are the perfect size, They look and feel totally natural. I would highly recommend my doctors and suggest that people do not just take my word for it, shop around and compare so you can see for yourself. - SA......
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Breast Implant Malposition

Implanted devices that are used for breast augmentation rely on the surrounding soft tissue to keep them in a proper position during the immediate days to weeks after surgery, while the body forms a capsule around the implant. It is critical at the time of implant placement that the surrounding anatomy is not disrupted as the implant pocket is created. Structures such as the inframmary fold (lower breast crease) and the skin over the sternum (discussed above under symmastia) serve as critical boundaries in maintaining proper implant position over time. When an implant shifts, it will most often move down and outward. This type of malposition is challenging to fix in a way that will be durable over time. The surgical technique often involves rebuilding the lower part of the implant capsule and may require reinforcement with biologic mesh (acellular dermal matrix). Implants can also remain too high on the chest. Such high-riding implants are typically caused by inadequate division of the lower attachments of the pectoralis muscle in cases where the implants are under the muscle. Implant malposition can also be caused by increasing scar tissue around the implant, or capsular contracture (discussed above).

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To learn more about breast augmentation, you can schedule an appointment online or
you can call 855-687-6227



Copyright 2014 Midwest Breast & Aesthetic Surgery. Dr. Ergun Kocak*, Dr. Pankaj Tiwari*, Dr. Bianca Chin*. All Rights Reserved. | Disclaimer
*All doctors are certified by the ASPS, ABPS & ASRM.
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