This started happening about 2-3 years ago and has progressively gotten worse. The right side feels like a normal breast, however on the left side there is a spot on each side (by my side, and in between) where it looks like the bag shifted and the edges are now poking out. I had them put under te muscle, but everyone that looks at them says that the left side looks like its over while the right looks like its under. What could be causing this? Would it be best to switch to silicone gel?
My Breast Implants Are 7 Years Old. On the Left Side the Bag is Protruding, Should I Switch to Silicone?
Doctor Answers (5)
Protruding Implant and Fixing with Silicone?
What you are describing sounds like you have thinned tissues on the outer (lateral) side of your breast. You may also have some implant malposition, meaning that the implant is displaced too far to the outside. Simply replacing the implant with a silicone implant will not fix the problem because it does not address the issue of thinned tissues.
When an implant is placed under the muscle, it is not completely covered by muscle. The lower and outer parts of the implant pocket are covered by fascia. If the tissues have thinned over time, or if you have a large implant, which will thin your tissues, then you need more than just a silicone implant to correct the problem. Likely you need to have the thinned tissues reinforced with some implantable material such as Strattice.
These types of revisionary implant problems can be very complicated and you should see someone who has lots of experience in managing implant problems.
Fixing a Breast Implant visible Ripple
All breast implants ripple and for this reason to make these ripples as invisible and impalpable as possible they need to be paced under as much soft tissues as possible. In your case you may not have had sufficient tissue over the impant or surgical changes resulted in of such overage. The ideal repair n your case would depend on the exact scenario in your case and may require a surgical pocket modification with possible placement of a biological barrier (Stattice) or fat grafting to increase the amount of coverage on the implant.
Peter A Aldea, MD
Implant folds, switching to silicone
If there is a thin spot in the capsule and cover, a fold can develope and protrude into it either below or to the side of the breast most commonly. A silicone gel implant can also do the same thing and switching the implants may not be the whole solution. You may have to adjust and repair the breast pocket to prevent the folds from showing through. Under the muscle will hide the implant best.
Best of luck, peterejohnsonmd.com
Web reference: http://www.peterejohnsonmd.com
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Switching from saline to silicone: tips and tricks
A silicone gel implant is likely to give you a better result, but only if several thngs are changed. I woould recommend switching to a subfascial plane with a technique I call 'cold-subfascial.' I would also strongly recommend enhancing the breast soft tissue enveolope with fat grafting to help restore the skin and oft appearance of the breasts. I hope this helps!
All the best,
Rian A. Maercks M.D.
Breast Implant Protruding; Treatment Options?
Thank you for the question.
Based on your description of rippling/palpability of the breast implant, exchanging to silicone gel breast implants may be helpful. However, this may not necessarily solve the problem. You may benefit also from additional work such as “pocket repair”; this involves internal sutures (capsulorrhaphy) to reconstruct the area where the implant is protruding through. You may also benefit from the use of a acellular dermal matrix ( allograft) to reinforce the area where the implant is palpable.
I would suggest in person consultation with a well experienced board-certified plastic surgeon; direct examination will be critical to provide precise advice.