I have "down and out" impants(I have overdissected pockets) and 2 failed revisions-my 2 second surgeon used sutures(not permanent),but the problem starts again,then he changed the position, I was submuscular,now I`m subglandular.I have good skin,enought tissue,implants are not big-350 cc,but sutures didn`t work after 2 revisions.My surgeon wants now explantation for 1 year,will it works?I have no money for Alloderm and in my country surgeons has no practice with that, that will be risk.Thanks.
Lateral Displacement- 2 Failed Revisions
Doctor Answers 4
Correction of Breast Implant Malposition
I am sorry to hear about your persistent problems. You probably have the same problem after your implants were switched from the submuscular position to the subglandular position because the lateral pocket was not closed down adequately. An option that could have been used instead of a site change would have been to create a neo-subpectoral pocket; and the implants could have remained in the subpectoral position.
Alloderm or Strattice (Strattice may be a better option in this situation) will certainly work. But as you point out, both materials are expensive.
You may still have another option. A capsulorrhaphy (capsule plication) with permanent sutures should be an adequate solution for implant malposition if the tissues are of good quality. It is unfortunate that absorbable sutures were used initially. This is probably the primary way these malposition problems have been managed before acellular dermal matrices were available.
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Breast implant displacement
You have three options
1: do nothing. will get worse with time
2: remove implants, no replacement for 6-12 months
3 Repair with alloderm, can also use dermis from you
4: Try repair again with sutures and capsule flaps
Lateral Displacement of Implants
Thank you for the question.
I am sorry to hear about the problems you had with breast implant malposition. Even in the best of hands, breast implant opposition prompts can be stubborn and recurrent.
I would suggest avoiding any further surgery until you find a surgeon who is very experienced with breast revision surgery. Otherwise you may end up repeating history again.
Revision surgery will likely require capsulorrhaphy, near image capsulotomy and possible use of allograft.
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I would just live with the situation for now, save up the money for Alloderm or Strattice and then have a revision using either Alloderm or Stattice. You may have to travel and it may be expensive but in my opinion, this would give you the best chance for a long term fix of your implant position problem.
Lisa Lynn Sowder, M.D.
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