I've had textured silicone implants for 6yrs and have been very happy with them.(290cc over the muscle->from no breasts to a small C).However after breastfeeding and sleeping with an underwire bra,the left implant seems to have come loose/detached.It is now visible under the skin and more mobile than the other one,which still looks great.I was told the only way to repair this is to replace the implant.What is the technique and where is the new implant placed?How can I be sure the new implant adheres?Can I keep my present size?Thanks,I'd really appreciate your opinions!
Detached Breast Implant: How is It Replaced?
Doctor Answers 7
Textrured breast implants
It is difficult to say what is really happening in your situation.
Textured implants rarely become detached unless a fluid cavity develops around them. Your body once attached sticks to it like velcro. However, there are different types of texturing processes.
In all likelihood, it is far more common that the breast has aged over the implant with nursing and is now falling off the implant. We sometimes call it the "snoopy deformity" and you may want to look that up online. However, that does not sound consistent with your description.
If a new implant is placed, you may require a suction drain to "suck" down the tissues around the implant and promote adherence.
If you were pleased with your original surgery, as it sounds you were, return to your surgeon who likely has experience with long term management of problems with this implant if he/she used them routinely in their practice.
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Time for a submuscular conversion
Without a photo it is impossible to say for sure, but it certainly sounds as though you need a revisionary operation with new implants placed under the muscle on both sides.
Texturized implants more likely to give contour problems afte breast augmentation.
Texturized implants are more likely to give the contour problem you describe than smooth walled implants. The rationale for using textured implants was to decrease capsular contracture rate. We now know that this is not true. The failure rate of texturized implants is higher than smooth walled as well.
An operation is necessary to fix your aesthetic problem. I would recommend switching to smooth walled because of the reasons above. You may keep the same size. Whether or not you need a lift is a matter to discuss with your plastic surgeon. What to do with the other size, if it is presently a good result, is debatable as well.
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Implant mobility and palpability
If you are having problems with palpability of an implant in a subglandular plane, you may want to convert it to a submuscular plane and possibly use smooth walled implants.
Put the implant under the muscle
You have what sounds like an implant sitting under very little breast tissue with either a bit of capsular contracture or a "rock-in-a-sock" deformity (doesn't sound pretty I know, but it paints a visual). By putting the implant under the muscle, you prevent this by having more coverage over the implant as well as securing it against the chest. Textured implants may be a fix as well, but be aware of a potentially higher rate of rupture/deflation with textured implants. Good luck!
You may need a breast lift in addition to new implants
From your description, you may need a breast lift (mastopexy) in addition to new implants. The implant can be placed either above the muscle or below the muscle. This can be done through your previous incision. If you also have a lift, they you will need to have an incision that goes around your areola and a vertical or possible horizontal incision in your breast crease. Good luck.
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