Breast Implant Revision: Q&A
Ask a QuestionBottoming Out 3 Years Post-BA, Worth The Revision?
I am 3 years post-op (300cc Mentor textured silicon sub-glandular). I think I'm bottoming out and there is some rippling. My PS says he would like to do a revise, with an internal bra and go sub-muscular. My question is: does this look awful and is it worth a revise? I am concerned about the scarring and the odds of it happening again. If I do, I want to keep the same size (at least), so how much more cc's should I go to make up for the sub-muscular placement?
Tags:
17 Doctor Answers |
Asked by
chi77
in Chicago, IL
+4
What to do about bottoming out
I can't really tell from the photo whether your rippling is in the upper half of your breast or not. Is it just ripples below? Certainly changing over to beneath the muscle would help rippling in the upper inner or upper outer portions of the breast, but if this is not a problem when your breast is better supported you may just need an operation to tighten the lower capule. This would give your implants better support and is a quick and simple procedure. What does your breast look like...
more
+2
Rippling and bottoming out, worth the scars for revision?
An inframammary scar could be used for surgery in a case like yours.
The problems to be addressed are what I would call very mild bottoming out, and rippling.
Your implants are textured and above the muscle. With thin skin, rippling is common with these implants because they stick to the skin, pull it in, giving traction rippling. Very little soft tissue thickness aggravates the problem.
Possible solutions, my preferences, are re-augmentation with smooth gel...
more
+2
Bottoming out of implants with rippling can be improved upon with surgery.
If you are happy with the current appearance of your breasts then don't have any additional surgery. If you don't like the appearance of the bottoming out of the implants then it can be corrected just as your surgeon described. Placing the implant beneath the muscle will help to pad and camouflage the rippling that you describe. This will not make you look smaller. This will likely give a pretty appearance to the top of the breast with a nice slope. I would recommend placing a...
more
Dallas Plastic Surgeon
You might also like...
Real Stories
Breast Implant Rupture - Removal of Implants and Insertion of New - Toronto, ON
I had my initial breast augmentation approx 22 years ago. I experienced a rather traumatic...
+2
Need for post-augmentation revision?
Are things stable now, or are they still changing? Are you okay with the way you look now?
A revision should open the medial pockets to improve the cleavage area. Inferior support with pocket plication or placement of a biologic membrane will raise the implants to a better position. You size looks good for your frame.
+1
Fix a Bottoming Out of Implants
I think you can stay with the same size implants, just covering the upper part of the implant with the muscle. An internal suture capsulorrhaphy should work well to move the implants both up and towards the center. I have not found the very expensive allograft internal support necessary with smaller implants such as yours. I would also advise you to consider smooth implants. The textured ones always seem to ripple more and no longer provide the benefits that texturing did 20 years ago...
more
+1
Breast Revision
Follow your Board Certified Plastic Surgeon advice and they will lead you to the bets options. Rippling with silicone is rare, but can occur.
+1
Revisional breast implant surgery
Most of the answers to your questions are in the answers given so far. In these situations it is helpful to break down the questions into separate issues and see how they would be addressed.
You don't have true "bottoming out". All the problems are related to thin tissue coverage over textured surface, subglandular implants. The rippling effect can be addressed by changing to smooth surface, round, gel implants. The visibility and contours of the implant would be...
more
+1
Fixing Bottoming out worth the revision
There are several ways to revise your breasts to reduce rippling and correct the bottoming out. If you like your size, I would stay in that cc range and switch to smooth gel. It is a relatively straightforward procedure and recovery should be easy with most options. I don't think you necessarily need to move to a submuscular location. Your surgeon will have the best advice knowing the specifics of your history and examination. It is worth it if it is bothering...
more
+1
Bottoming out may be treated with pocket change to subpectoral
From your photographs, you do appear to have bottoming out. Generally, changing from the subglandular to the subpectoral plane will allow a new pocket to be constructed with the implants in higher position. If you start with 300cc implants and want the same approximate size, a 375 cc implant would likely help. I don't think acellular dermal matrix is necessary in most cases where creating a new submuscular pocket is possible. Revisions are always complex, so be sure you do your discuss...
more
+1
Revisionary Breast Surgery
The need for revisionary surgery often times depends on how much the imperfections affect the patient. Based on your pictures, without the benefit of a physical exam, I agree that a sub-muscular re-augmentation along with capsulorrhaphy inferiorly is the operation that is most likely to give you the best long term result. When changing the implant position from the sub glandular to be some muscular position, sometimes skin excision (mastopexy) may also be necessary.
Best wishes.
more
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.
Comments (0)