Thank you for your question and photo. I've treated your exact scenario several times. It sounds like you have a pectus shape (caved in shape) to your sternum. With large implants and possible over-dissection medially, these implants "fall" medially resulting in what you are experiencing. To help restore your cleavage, I recommend the use of a tissue matrix like strattice (porcine source) or SERI (silk tissue scaffold) to create a barrier to prevent the implants from touching medially. In addition, placement of narrower implants or slightly smaller implants will help as well. This revisional surgery takes me about 2 hours and can be safely performed as outpatient surgery. Please visit with a board certified PS experienced with revisional breast implant surgery to learn more about your options. Best wishes,
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recommend a new technique called Implant Exchange with Mini Ultimate Breast
LiftTM.Using only a
circumareola incision it is possible to reshape your breast tissue creating
upper pole fullness and elevate them higher on the chest wall.Your breasts are too close together and were over
dissected or the implants are too large.You will need smaller implants and medial plication to prevent them from
Gary Horndeski, M.D.
You should seek consultation with a board certified plastic surgeon. A complete history an physcial examination is necessary for a complete and accurate diagnosis and therefore a precise and optimal plan of correction. You current implants and current implant pocket are relevant to the solution, for example. Also it is important to know why the surgeon with whom you initially consulted declined to offer you surgery.
Options available for treatment include pocket change, implant change (including changing to a different shell, gel and/or shape) and pocket support with a material such as Alloderm or Strattice.
So yes, I suspect that there is a satisfactory solution to your concerns.
Position can be improved
Thanks for your question and your photo. An exam and review of your current implants is necessary to accurately comment. I think that exchanging you to a lower profile and potentially smaller volume implant will help. The pocket itself might need support by an acellular dermal matrix like Strattice. Hopefully you can find someone who is an ASAPS member Board Certified Plastic Surgeon to help you. Best of Luck!
Revising Breast Implants and a Caved-In Chest
There are several options for you. All of these will probably involve exchanging your current implants for smaller implants. The capsules of each breast will likely also need to be modified with either a tightening or adding extra support. The best option would be to seek out an experienced Board Certified Plastic Surgeon in your area. I would recommend asking the office if the surgeon has experience with Breast Reconstruction as well as Breast Augmentation.
What do I do to fix my implants if my chest is "naturally" concave"?
There are several options for revision of your augmentation. You may benefit by changing your implant size and / or profile, as well as revision of the breast implant pocket. If your implants are presently on top of the muscle they can be moved under the muscle, the capsule can be revised, and an acellular dermal matrix or SERI surgical scaffold can be used to help maintain implant position.
I would recommend that you consult with board-certified plastic surgeons experienced in revision of breast augmentations. An in person consultation will be required to determine the best method to help you achieve your goal.
What do I do to fix my implants if my chest is "naturally concave"?
Thank you for the question and picture. Yes, there is a solution. I think that you will benefit from capsulorraphy surgery; this operation will serve to help prevent the breast implants from moving towards the sternum. Internal sutures used to “close off” the medial aspect of the breast implant capsule along with judicious opening up of the capsule capsule ( capsulotomy) should improve your situation significantly. Sometimes, the use of acellular dermal matrix as an additional layer of support along the medial aspects of each breast, may also be helpful. Especially when the tissues involved are thin, this additional layer may help prevent recurrence of the breast implant malposition. This operation will also help to center the position of the nipple/areola complexes on the breast mounds. Of course, careful selection of breast implant size/profile will also be important. You may find the attached link, dedicated to this type of revisionary breast surgery, helpful to you. Best wishes.