Dec, 2009 I got 325cc, silicone, smooth, round implants, through armpit, under muscle. Dec 2010 the nipple on left breast started to point downwards and implant shifted much higher. Received Implant revision in April 2011. No cc. Pocket made lower to allow implant to drop.Very happy with new position and nipple alignment.Have now lost upper fulness on revised breast. Surgeon said I have lost fulness due to some of the capsule being removed. Suggested textured tear drops to correct this problem and regain fulness?
Breast Implant Revision - Revise with Teardrops or Will Capsule Eventually Mature and Even out to Match the Other Breast?
Doctor Answers (5)
Anatomical Breast Implants for Revision?
Thank you for the question.
I have concerns with the use of anatomical (teardrop) shaped breast implants given that they potentially can shift/rotate changing the shape of the breasts. This situation may necessitate further surgery to correct. I would suggest you discuss other options with your plastic surgeon and/or seek additional opinions.
Teardrop breast revision
Unfortunately the most commonly used type of implants (high profile) and the most common type of placement ( submuscular/dual plane) cannot deliver the natural 'tear drop' effect or cleavage that you desire. Leaving the origination of the pectoralis major medially intact in submuscular placement ensures that the implant cannot be medial enough to look natural, and a flat plateau is left centrally. There are also big problems associated with anatomic implants placed in conventional planes( they work well in subfascial carefully designed pockets). This is why I use a very unique methof of breast augmentation that I call 'cold-subfascial augmantation.' the placement of the implants is not 'above the muscle' or subglandular, nor is it submuscular or dual plane. A very strong layer of connective tissue is meticulously and atraumatically dissected from the pectoralis major muscle and this tissue is used to shape and support a lower profile implant into a gentle tear drop shape. It is the surgical dissection and not the implant itself that gives shape to the breasts. The results sit like natural breasts and do not move like submuscular implants do with arm motion. The fascia also supports the implant giving it relative protection from gravity and aging.
All the best,
Rian A. Maercks M.D.
Breast Implant Revision - Revise with Teardrop Shaped Implants?
RE: "Dec, 2009 I got 325cc, silicone, smooth, round implants, through armpit, under muscle. Dec 2010 the nipple on left breast started to point downwards and implant shifted much higher. Received Implant revision in April 2011. No cc. Pocket made lower to allow implant to drop.Very happy with new position and nipple alignment.Have now lost upper fullness on revised breast. Surgeon said I have lost foulness due to some of the capsule being removed. Suggested textured tear drops to correct this problem and regain fulness?"
Your original surgery was complicated by capsular contracture which pushed the implant upward resulting in a low pointing nipple. Once the scar was removed and released in April 2011 the implant took its normal position in the breast. Even if the implant is placed directly behind the nipple and upper pole fullness is achieved, as gravity pulls the implant down (faster with larger implants) the lower pole of the breast is stretched out and as the implant settles into the stretched breast the upper pole fullness is lost. The solution is NOT a textured tear drop implant UNLESS it is a cohesive gel implant currently unavailable in the US but available in Europe (? Australia). The upper poles of these implants do not collapse BUT they are stiffer, require a very accurately dissected pocket and are prone to rotation. Other tear drop implants offer only a higher leak rate and rippling of the skin.
If you want to stay with round implants you may need a revision surgery with a support hammock creation using Strattice to hold the implant in its original position and prevent the sag. Another two benefits are the sling covers the implant rippling and hides them better as well as largely decreasing the rates of capsular contracture.
Dr. Peter A Aldea
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Breast implant revision
Teardrop implants would not give you more upper fullness, but possibly less. Not to mention the risk of the implants turning in their pocket. I do not think you have less fullness in the upper pole due to the capsule removal, unless the surgeon removed a bunch of your breast tissue along with the capsule, and there is no reason to do so. Once the implant is released from its constricting capsule, it relaxes down into the breast as it should. It is possible that the right breast is being constricted a bit in comaparison, not as much as the left side was, but enough to result in more upper pole fullness on the right so that you are perceiving that the problem is on the left. Perhaps a release on the right side and larger implants (that will give you more upper pole fullness) are the better answer.
Teardrop Implants Not Likely To Correct Lack Of Upper Pole Fullness
I am not a fan of teardrop implants in general and most of my experience with them has been in removing them and replacing them with round implants. If your concern is lack of upper pole fullness, you certainly should see greater improvement with a round implant. You mentioned some shifting with your original implant. If this occurs with a teardrop implant, it can result in a very unusual appearance.
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.
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