Breast Implant Revision: Q&A

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Permanent Sutures for Breast Implants Pushed out to the Side?

I've had 350cc saline implants under the muscle for 2 years now, and have bottoming out. I'm muscular with little body fat, 5'2", 104 lbs. My implants have gotten further apart, and pushed out to the sides, with extremely visible side rippling. My implants look bottomed out from the side, and become very deformed anytime I flex. My doctor suggests I do silicone under the muscle, open up muscle in the center more, put permanent sutures around the sides and bottom, and go smaller. If my chest muscles flexing caused this, I think it will happen again even with sutures. Any suggestions?

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13 Doctor Answers | Asked by naturelover in california

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How to fix your rippling implants

If you are already rippling on the sides, the last thing you should do is go in front of the muscle. That would risk rippling all over. Maintain as much tissue coverage as you can! You do need to have a lateral capsulorraphy, which means closing off the outer pocket. BUT, you must understand that pockets can passively widen due tot he stretch of your tissues over time. But it shouldn't get to the point that it is deforming. My point is to emphasize to you that there is always a drift... more

Avoid pectoralis strengthening exercises following submuscular "under" breast implants

All the other surgeons have made excellent comments here that do not need to be repeated. However, I would strongly advise avodance of exercises that result in pectoralis major contraction. This generally inculdes: bench press, wide stance push ups (narrow stance are ok) and the "pec dec" or butterflies. You will be able to build up all the surrounding muscles without truly effecting your routine.

Otto Joseph Placik, MD

32 reviews

Chicago Plastic Surgeon

Rippling of breast implants

I would agree with many of the answers you've been given by the other doctors. 1) revision surgery with SILICONE implants, under the muscle, 2) consider slightly smaller implants, 3) enlarge the inner sides of the pockets, 4) partial capsulectomy, and closing down of the outer sides 5) correct the bottoming out by repositioning the implants and the fold beneath the breast. I have patients avoid bench presses, "flys", and pushups for at least 6... more

Modified muscle technique for implant problems

The problem you describe is a very common one in muscular women, and something in which I have a special interest. Every time you flex, the muscles push the implants apart and down, and whether the sutures are permanent or not this will continue to occur. You can prevent it by going above the muscle but then the rippl;ing is worse. One technique I have had success with is a variation on the subfascial technique called the split muscle technique. Here are some resources to check it out:... more

Breast Implant Revision

Breast revision surgery can be very complicated without guaranteed results. As far as the deformity you have with muscular contraction, that is the result of having the implant under the muscle. You are very thin and already have rippling, so I dont think it is an option for you to have had the implants placed in front of the muscle. That is the only way to avoid the "animation deformity". You are having bottoming out and the implants have gone to the side, so you need what is... more

Deformed appearance of breast implants

Hi naturelover. You describe several issues. First, many patients have rippling on the lateral sides. This is where we have thin tissue overlying the implant and thus this area is prone to visible rippling. Silicone implants ripple less than saline but they still ripple. The deformity when you flex happens in some patients and can only be corrected in my experience by placing the implant on top of the muscle. If you are very thin on the upper, inner aspect of your breast, as in you... more

Seconday breast revision

Your secondary revision should include implant exchange, revision of the infra mammary fold and the lateral breast fold. This could be done with sutures but also ideally with a sling of dermal substitute( like alloderm). This will act as a strong hammock that will prevent future sagging. It crucial in revision surgery to have a clear operative plan to avoid any future revisions. Since you are already under the muscle ,pocket exchange might not be very helpful. Muscle splitting will not help... more

It is possible

The deformation may occur anytime the implant is under the muscle, and you can't guarantee that it wont. Ripples may be due to the saline implant, or scar tissue bands that form in the capsule and hence deform the implant. Regarding the bottoming out and lateralization of the impalnt. Your muscles may be the reason, or the initial dissection may be the reason, or weakness of the tissue may be the reason, no one can really tell. Permanent sutures along with your own scar tissue will form... more

Implant problems and rippling

Placing silicone implants in may help with the rippling. Alloderm can also help TIghtening the pocket to fix the displacment of the implants may also help.

Steven Wallach, MD

12 reviews

Manhattan Plastic Surgeon

Suggestions

Without examining you, I would suggest that your implants are too big for you. Your chest wall is not flat but convex. The larger the implant relative to your chest, the more they will drift to the side or "fall off the chest." I suspect your implants are wide enough to be located far enough outside the perimeter of your normal breast and your thinness lacks coverage for the implants that you will have visible rippling and lack of support. Many of the problems that come with... more

Robin T.W. Yuan, MD

4 reviews

Beverly Hills Plastic Surgeon

Implant position and rippling

The concerns you describe are related to an implant likely too large for you body and having a saline implant. If you have an implant too large for you body the tissues covering the implant will get over stretched and become thinned out. Therefore, you will see the implant more. Saline implants will ripple and if there is not enough tissue coverage such as on the sides or bottom of the breasts, you will see the rippling. The ideal situation is to have a smaller implant placed and use a... more

Why implants have gotten further apart, pushed to the sides, with visible side rippling

Dear Naturelover, In response to : "...implants have gotten further apart, and pushed out to the sides, with extremely visible side rippling. My implants look bottomed out from the side, and become very deformed anytime I flex. ... If my chest muscles flexing caused this, I think it will happen again even with sutures. Any suggestions?" In MY opinion, it sounds like the saline implants you had put in may have been too large for you. IDEALLY, the choice of implant should not be as... more

Why have my implants gotten further apart, pushed to the sides, with visible side rippling?

Rippling and implant displacement are avoidable. The issues of visible rippling, and displacement of the implants down and out are related to implant placement. The most common "submuscular approach" is really only a partial coverage of the implant by the pectoralis major muscle. The muscle covers the implant above and to the middle, wheras the bottom and side have no muscle coverage. It is because of this absent muscle coverage that the implant can be displaced to the bottom and... more