Hi there, I am writing this on the behalf on my girlfriend who gave me permission to use her story and post her pictures. She had silicone implants done and immediately after surgery we noticed she had a rather prominent medial indent in one of her breasts. Her surgeon is giving her the major run around. Will this go away eventually on it's own? Is it scar tissue, an adhesive band and shouldn't he have taken this down during surgery? Should she have to pay for a revision or should it be comped?
Indent in Breast After Implants. Was It Surgeon Haste/Error and Possible Remedy? (photo)
Doctor Answers (8)
Indent from breast augmenation
I see your friend is very thin and chose a full C cup breast. In very thin patients the precision of the pocket created is extremely important. Thin patients do not have very much tissue and the pocket has to be created perfectly or the patient may see a dent ( if inadequate pocket creation) or a protrusion ( too much pocket creation) if the pocket is not perfect. Her dent appears to be a combination of two things. One may be inadequate medial pectoralis muscle release. The second is that her right breast has fallen more than the left and this dent could be a traction crease from the implant. Some silicone implants crease or ripple more than others so it would be important to know what type of implant she received. These issue become less apparent if she did not go as big. Given the size she went, she should have better cleavage but I see a one and a half to two inch gap between the breasts. This may be due to inadequate medial pectoralis muscle release as well as displacement of the implant inferiorly and laterally. She should bring these issue up with her PS.
Breast assymetry after augmentation surgery.
Yes there is a dent but it could be caused by many things, including your friend's anatomy The implants are under the muscle, which is a good thing because of her thin frame. Perhaps the muscle was taken down too much, or not enough, or there was a bruise in this area, or it is her anatomy, or ..... My point is that it is difficult to know without examining the patient, and she would be advised to go back to her surgeon for further evaluation. There are ways to correct this, however. That is the good news.
Yes, there would normally be a fee for further surgery if needed.
Good luck to your friend.
Frank Rieger M.D. Tampa Plastic Surgeon
Indent in Breast After Implants. Was It Surgeon Haste/Error and Possible Remedy?
I am answering to inform your friend she needs to be seen in person to be examined. But a before posted photo helps. The medial in den could be her anatomy, poor dissection, scarring or capsule or a combination. We can not answer to you or her over the internet. I might consider fat grafts to indented area. Yes a fee in in order.
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The indent you are referring too may be due to several different things or none at all. One possiblity is inadequate release of muscle, 2) soft tissue thinning from surgical dissection, or possibly 3) non of the above. An evaluation in person is important.
Medial Pole Indentation after Breast Augmentation
The placement of breast implants in women with little breast tissue that are thin-skinned may well develop rippling and indentations over the bottom half of the breasts no matter how well done a breast augmentation is. (you did not say whether she had saline or silicone implants, whether they were above or below the muscle, or when the surgery was done) Such medial pole indentations may be reflective of an innate tissue deficiency, the type of implant used and its location or the need for further pectoralis muscle release. This is reflective of neither surgeon haste or error but an inherent risk of breast augmentation surgery.I would suggest that you give the result up to 3 months to settle down and see the final result before determining if what you are seeing now will be sustained. That is the time to discuss what is the next stepo with your surgeon.
Dent on Breast after Breast Augmentation
Preoperative pictures would help to analyze this. The dent appears to be at the pectoralis major and breast junction, and there may not be an easy fix for this. I would have to examine you to determine if there is an animation defect present. Judging from the immediate postoperative picture, there was a relatively wide gap between the breasts. This makes the first operation you had more difficult as well. The right implant pocket could be adjusted upward but this may not fix the problem. The muscle border can freed from the gland, but this may only be a temporary fix. Fat grafting may help in this situation. However, if you are early in the recovery period I would wait at least 3 months before considering revision. Kenneth Hughes, MD Los Angeles, CA
Indent in Breast After Implants
Thanks for your question.
It would be helpful to know a few more details, such as how long ago the surgery was, and whether the implants are above or below the pectoral muscles.
If it is early in the post-op period, it is likely that as the capsule forms around the implant, that this irregularity will improve, and perhaps become unnoticeable.
Info about the position of the implant in relation to the pectoralis would make it possible to narrow down the possible cause.
As to revision charges, each office has its own policy, Commonly there would be a fee for OR and anesthesia, but no professional fee.
Indentation after breast augment
You haven't said whether the implants were placed above or below the muscle. When a patient has thin skin cover, this is much more of a risk. You should raise this with the plastic surgeon in a non-judgmental, inquiring way. Review the office's financial policies to determine whether a revision will be included; generally, plastic surgeons will revise at no charge within a reasonable time after surgery but the patient will have to bear the anesthesia and facility fees.