Louisville Doctors

PIP Victim is Sub Muscular Implant AND Capsule Removal my Best Option?

I am 38 have had PIP submuscular implants I think 220 for 6 years I want them removed and not replaced I have read a lot about the capsule and would like advice. Should I insist on capsule removal because of the possible contamination through the faulty toxic implants that may have been absorbed into the protective capsule? I am concerned that even if I have the implants removed I will still be at risk from the industrial silicon.

I would add that I don't think it's possible to "clear" your tissues of microscopic silicone whether the implants are intact or not and whether the implant is intact or not. It's certainly not possible to know that all silicone and risk is removed although there's no solid evidence to support the supposed specific risk of the "industrial silicone". Removing the capsule if it is normal looking involves a bigger operation with more risk of bleeding and scarring and no assurance that this will remove all risk or all microscopic silicone. However, if the patient is properly informed as to the increased risks and costs of removing the capsule as well as the inability to completely clear all silicone from the tissues even with the capsulectomy, I would feel that the patient could make this choice. 

Scott L. Replogle, MD

Denver Plastic Surgeon

Pockets Made Too Big Implants Move Around & Hang too Low, Can This Be Corrected Without an Uplift? (photo)

I had 450 implants 3 years ago and I have never been happy with them they are too big,and now move around but I dont really want an uplift due to scars. My surgeon has suggested new implants tightening the pockets as they have been made to big (when lay down they are under arm)and fat injections to the top of my chest area as they are bottom heavy. Can this work of do I need an uplift?? pls help

This is not an uncommon problem and does not have a simple and satisfactory solution for your concerns. I would agree with Dr. DeMars although this is not as simple as it sounds. 

I don't think your implants are too big, your breasts too low, and that the pocket for the implant was made too big. Your nipple position looks to be at the crease level (with the left side asymmetrically positioned) and the width of the implant fits the width of your breast. The problem is that the pocket (capsule) has stretched and is now too big for the implant such that your implants flatten and fall to the side lying down (just as natural breasts of your size do). The simplest way to solve this is to put in a wider/taller implant without altering the pocket/capsule. This can even be an implant that has less forward projection to offset the larger width volume. You definitely don't want to put in a smaller diameter implant as this aggravates the problem and adjusting down the pocket/capsule is not a simple maneuver, particularly when the implant would be too narrow for the breast width. It doesn't look like a lift will help much either. I would suggest a lower profile (smaller) implant with a wider base diameter as the simplest solution that doesn't need to actually make the total volume of the implant bigger. 

Scott L. Replogle, MD

Denver Plastic Surgeon

What Size Implant Would Be Best For My Figure? I Want A-C

I would like to know the size of implant that would be safe for my figure. I Am 5 Feet 6 Inches Tall and Weigh 105.I Would Like to Go from a 32A to A 32 C What Size

It's not an exact analogy but sizing an implant for your figure is sort of like sizing a dress or fitting your foot in a shoe. For an implant in a rigid position like a hip implant there is no leeway at all. It's all based on measurements. Breasts are much more accommodating but proper fitting is key for a predictable, natural, and controlled outcome. 

There is no simple way to measure overall breast size and think of it as one thing like a number of cc's. Volume is made up of three dimensions and the only one that can be reliably measured (and is needed) is the width of your breast upright with your arms down. About 3/4 to 1 cm is subtracted from this to determine the width/diameter of the implant which also determines the height of the implant for round implants. Your only choice is the forward volume (projection) which ranges from low to high (not called that in gels). Your tissues will accommodate the forward volume options if the width is correct and a low profile implant will make your breast look about a cup size bigger and a high profile implant will make your breast look about two cup sizes bigger with medium profile implants in between. If you are a mid A cup now then you will need a high profile saline or gel implant that matches the width of your breast to look like a mid C cup. The number of cc's is found by looking up your diameter implant in the high profile column. 

Scott L. Replogle, MD

Denver Plastic Surgeon