Is Explantation the Best Option for Bottomed out Implants?

I had 2 failed bottoming out and lateral displacement revisions. My Breast Implants are 350cc. The problems is in the first surgeon, not implants. My second surgeon attempted everything: sutures, implants replacement, but all failed again.

Do you think that after 1 year my damaged breast tissue will be total healed and ready for augmentation with happy ending?

My surgeon wants to explant, to make a capsulotomy and rolling the capsules to create new folders, then I need to wait 1 year to heal and then reimplant.

Please, help me! Thank you in advance!

Doctor Answers (5)

Breast explantation for bottomed out implants

+3

As one who never saw ANY of your photographs, never examined you, either now or before you had all these operations and had not stood in the footsteps of either one of your plastic surgeons, my response MUST be generic in nature.

From :: "Do you think that after 1 year my damaged breast tissue will be total healed and ready for augmentation with happy ending? My surgeon wants to explant, to make a capsulotomy and rolling the capsules to create new folders, then I need to wait 1 year to heal and then reimplant." It SOUNDS LIKE you had a larger implant with either an over-dissection of the lower portion of the breast pocket or placement of the implants via an inframmary incision. Either way, the success of the operation will depend on creating a stable shelf or balcony for the implants to sit on.

Allowing time to heal things is a long honored adage in Plastic surgery which was verbalized by Harold Gillies in the 1920's.

Yes - it MAY lead to the creation of more scar tissue which MAY be better used to create a stabler shelf on which the implant may sit. But, it does NOT guarantee that it will work.

Personally, I would ask your Plastic surgeon if he is familiar with Alloderm or Strattice.

I think that the use of Strattice would allow you to have one procedure that has the HIGHEST likelihood to keep your implants where they are supposed to be.

Good Luck.


Memphis Plastic Surgeon
5.0 out of 5 stars 63 reviews

Explantation to treat Bottoming Out?

+1

Thank you for the question.

Your  surgeon's  recommendation is certainly one option that may achieve your goals. The other option is capsulorraphy  with or without the use of allograft along with immediate reaugmentation of the breasts.

I hope this helps.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 781 reviews

Ttreatment options for bottom out breasts

+1

IT sounds as if your current surgeon has a sound surgical plan to treat and manage the bottomed out breasts.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 48 reviews

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Options for "bottoming out"

+1

Explantation with interval maturation of a reinforced inframammary fold, as you describe, is a conservative approach, which can't really be criticized.  However some women are unwilling to wait a full year, at least in this country.  A novel approach, which is still in its infancy, is the use of ADMs (acellular dermal matrices) to recreate the inframammary fold and support the implant by providing an inferolateral "hammock", which is sutured to the base of the breast, as well as the lateral edge of the chest wall muscle.  These biological mesh are expensive and have been best observed in the breast reconstruction literature.  I would ask your surgical consultant about this technique, which can be combined with a neosubpectoral pocket relocation, if your native breast flap isn't too thin.  Good luck.

Lavinia Chong, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 40 reviews

Repair bottoming out

+1

Without knowing exactly what the other surgeons did for you, I can not tell for sure what to do for you. But, usually explantation is not necessary to fix bottoming out. Usually reconstructing or repositioning the fold is all you need done.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

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