How come 15 months post op, my silicone gel implant on my left looks as if its sagging really bad making it look terrible compared to my right? I hate it so much, to the point where i regret getting them done. I cant even wear a bathing suit with out other people noticing that they are no leved correctly. What should i do, please help...
Why Does my Implant Look Bad?
Doctor Answers (13)
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Why does my implant look bad?
It appears that you have suffered a "drop out" or inferior malposition of your left implant as the implant has stretched the tissues on that side. That is why it is lower and the distance between the nipple and the inframammary crease has elongated. Assuming that your right breast is soft (and not being held higher by a capsular contracture (or tight scar tissue squeezing the implant) and therefore does not need intervention, the treatment is to reposition the left breast higher up on the chest. Keeping it there is the problem, as you are fighting gravity. Some surgeons would try to suture the old pocket closed, but there is some recurrence risk as the sutures may pull out. Some surgeons would dissect a new "neo-subpectoral" pocket, close down the old pocket, and I have had good success with this. Some surgeons would recommend using an "acellular dermal matrix" or dermal substitute such as Strattice to help support the tissues, especially if your tissues are thin, but be aware that this material is very expensive and does add two to three thousand dollars in cost to the procedure. Discuss this problem with your surgeon or get additional opinions. But be reassured that the problem is fixable.
Why is it over 1 year after your breast implant surgery the implant shifts or moves. No doubt the weight of the implant and gravity have caused your skin to stretch in the lower pole of your breast and now your implant is sitting too low on your chest wall. You are complaining now, so I will assume it was in good position initially after your procedure. Why does this happen and why not to the right breast as well?
I DON'T KNOW, BUT I AM WORRIED
I have seen at least 6 women recently who have the new silicone implants where this exact phenomenon has occurred. There may be a problem with the silicone implants that is now just surfacing.
You will need a revision surgery to re-position your left implant to a higher position on your chest wall. Please return to your original PS so he can help you. I don't know how to prevent this from occurring again.
Besides what the other doctors have correctly noted, it also appears as if you have large implants. I find that the larger they are, the more problems you can have.
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Implants have bottomed out
It appears as if your breast implants have "bottomed out". This can be corrected with a revisional surgery, bringing the breasts to the same level and symmetry. Typically, revision surgeries following breast augmentation reposition the breast with nice results.
Based on your pictures, I agree that it looks like the implant on your left has bottomed out. You will likely need an additional surgery to help reposition the implant to help achieve a better symmetry.
Breast Implants - Why does my implant look bad?
It looks like your left implant has "bottomed out."
I cannot, of course, say for sure without being able to examine you and, also for sure, you should talk to your PS about this. Assuming that that is the case, there are several choices in terms of what can be done surgically (I don't think that there's much that can be done without another surgical procedure).
First, the implant can simply be elevated into its ideal position and the bottom portion of the "pocket' (the space where the implant is) can be sutured with a series of sutures (stitches) that should help support it in place while it heals. There is a certain rate of recurrence with this, but it's the simplest approach and has often been successful. A new pocket can also be created, but you'll still have the issue of blocking off the bottom of the pocket.
More recently, the addition of acellular dermal matrix (ADM) has been suggested to rebuild the lower portion of the pocket. Used commonly in breast reconstruction cases, it is a valid option here, although it is expensive and, as with all procedures, there are potential downsides to this, too.
In sum, I think you'll need another procedure to elevate (and maintain the elevation) of the left implant. You should research the options and then speak with your PS.
I hope that this helps, and good luck,
Left Implant Has Bottomed Out
It appears from your photograph that your left breast has " bottomed out." This is when the implant pushes past the natural fold of your breast for whatever reason. This is usually easily correctable by reiniorcing the inferior pole of the breast and the fold internally with either your own tissue capsule or some synthetic material such as Strattice. I would go see your plastic surgeon and discuss it with them. The surgery is generally straight forward, easy to do in experienced hands, and is a pretty stable result. It is worth it to achieve better symmetry and balance. I hope this helps.
Revisionary Breast Surgery Recovery
So sorry that you are feeling this way...You may want to consider revisionary surgery to correct the “bottoming out” of your breast implant on the left side. Bottoming out involves inferior migration of the implant. This causes the nipple areola complex to appear too high on the breasts. Also, the distance from the areola to the inframammary fold is too great. It is the loss of internal implant support can cause a slow downward migration of the implants. This is a known potential risk of breast surgery, unfortunately. This is corrected by “raising” the inframammary fold using permanent internal sutures (capsulorrhaphy). Go in and speak with your plastic surgeon and see what he/she recommends. Capsulorrhaphy procedure is a difficult one and you need to make sure your surgeon has experience performing this procedure.
Asymmetry post augmentation
Thank you for the photo which demonstrates your deformity. I suggest that you call your original Plastic surgeon for his/her evaluation. Bottoming out requires surgery to correct. If you do not feel comfortable with your original surgeon's plan, ask him for a referral to another plastic surgeon who may feel more comfortable in re-operative breast surgery. Good luck
Revision breast augmentation works.
1) The fold under your left breast is about an inch and a half lower than the right fold. That's the main problem. This can have several causes, but what is relevant to you is that it can be fixed. The left fold need to be raised with internal sutures. Some people recommend using grafts like Alloderm, but we have not found that necessary.
2) Also the left breast looks a little larger. This can be corrected too.
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