How to Avoid Breast Implant Extrusion?

asked 3 years ago by imadvice in New York
Latest answer by Steven Wallach, MD
Question viewed 2,994 times
Tags: exchange, extrusion

Hello doctors,

I am planning to have a re-operation due to a couple of problems. I have very thin skin, and currently I can feel a 'knuckle' (the edge of my breast implant) at the lower pole of my breast, right underneath my areola. I asked my doctor about using a smaller implant and he said it will create asymmetry. I am really worried about once again not having enough skin coverage and extrusion... I have read about using Alloderm from other forum but would want to avoid that... What are my options?

12 answers to How to Avoid Breast Implant Extrusion?

Thinning of lower breast with implants

It is difficult to tell if you are speaking of thin tissues or bottoming out of the implants. Palpability of the implants, particularly saline, in this individuals is practically inevitable. This in and of itself is not a long term problem and can be stable for many years. However, progressive thinning is a sign of impeding extrusion and this needs to be evaluated. The reasons for this are many. You will need an experienced surgeon to determine the exact cause of this. The treatment will... more

Otto Joseph Placik, MD
Chicago Plastic Surgeon

The more you do...

IMadvise, There is some information that is lacking. Are your implants currently in the submuscular (under muscle) or subglandular (above muscle) position? If they are above muscle, then they can be moved to under the muscle to provide better coverage and prevention of extrusion. Alloderm, or its newer alternative, Strattice can indeed be effective in providing better implant coverage. Keep in mind that the more surgery you do on your breasts, the more scarring, tissue thinning and... more

Kenneth R. Francis, MD
Manhattan Plastic Surgeon

www.francisnyplasticsurgery.com

Several options

There are several options, but is all depends on your current implants and quality of your skin. If you include a picture, we may be able to give you more specific advice. If your implants are subglandular (above the muscle) then you can have them placed below the muscle for more coverage. Despite what many people are saying, the Alloderm can be helpful, not as a substitute for skin or tissue coverage, but as an extra layer of support for the implant. Good luck.

David Shafer, MD
New York Plastic Surgeon

Feeling a "knuckle" after breast implants very common in thin tissues

Hello, I think your situation is shared by many women who are very thin. Despite submuscular placement, the implants are not completely under the muscle and you can feel the implant imperfections. What you describe is more common in moderate profile implants and I would recommend switching to high profile implants. If you are very thin, both silicone and saline can "knuckle" so we would recommend the high profile implants in either case. Augmentation with implants is not... more

Francisco Canales, MD
Santa Rosa Plastic Surgeon

Avoiding implant extrusion depends on many factors

If your implants are above the muscle, a pocket change below the muscle should help diminish rippling. Different implants, as answered nicely by other surgeons here, may help as well: saline to silicone gel: higher profile. If you have and want saline, make sure they are correctly filled and can be overfilled about 10 - 15% to help eliminate rippling.

Michael S. Beckenstein, MD
Birmingham Plastic Surgeon

You want your breasts to look and feel right.

Hi! The great majority of women can get a good result, even with very thin tissues. The issue is not really extrusion. Actual breast implant extrusion after breast augmentation is extremely rare; I have never had this complication in a series of about 1500 breast augmentations. (I have had other complications!) So I wouldn't worry about this. I rarely use Allloderm in revision breast augmentation, but it does sometimes have a role in reinforcing an atrophic area. The way to make your... more

George J. Beraka, MD
Manhattan Plastic Surgeon

Options for implant palpability

There are not too many options for palpable implants in the lower pole. Alloderm is an option to provide another layer of thick tissue to camouflage the implant.

Steven Wallach, MD
Manhattan Plastic Surgeon

Alloderm, alloplastic materials not the answer

Implant extrusion is a very rare event. I have done 1000's of implants over the years and have only experienced 3 (thank God!). Interestingly, 2 were delayed (occurring > 1 year after implant, and the 3rd, after about a week. In any of my 3 cases, Alloderm would not have made a difference, and may have made things worse, as a foreign material in place in the face of infection, is way worse (why infected implants usually need to be removed). Th knuckle you feel is not uncommon, though... more

Scott E. Kasden, MD
Dallas Plastic Surgeon

Some options

Your solutions will depend on your exam and what your current implant is. If you have saline, the most simple solution will be to use silicone gel implant and likely a smaller implant than what you have already. The larger the implant, the more tissue stretching it will cause and more implant visibility. If your implant is above the muscle, then going below the muscle will help. Use of dermal substitutes like Alloderm can be helpful in a select few patients but do increase the cost of the... more

Bahram Ghaderi, MD
Chicago Plastic Surgeon

Candidate for implants?

Breast augmentation with implants is an imperfect operation and you have to be able to accept the imperfections you choose. It may be rippling, or capsular contracture,or in your case visible folds. Not all women are good candidates for implants and you may be one who is not. Haivng said that, all women with some breast tissue has an ideal size that "fits" their breast. In your case, if you were to remove your implants and shape the breast, your breast will be of a certain size and... more

Robin T.W. Yuan, MD
Beverly Hills Plastic Surgeon

Few options for thin tissues

Hi there- It sounds like the tissues available for implant coverage are very thin... Without knowing more and examining you, it is difficult to give firm recommendations, but here are a few thoughts.. First of all, if your current implants are saline filled, I would consider silicone, as they definitely have a lower risk of visibility or the ability to feel them through the skin. If this is available to you, it's probably the simplest thing to do. If your current implants are on top of your... more