Process for Revision of High Implants?

I had 325 moderate profile Mentor implants placed through the armpit and under the muscle about 7 months ago. They are still very high. I have been told that the muscle needs to be released and that my pocket needs to be cut a little lower and wider (towards the outside of my body). Assuming I want to stick with a revision through the armpit, is this an easy process? What is the general revision process and recovery time?The more detail, the better.

Doctor Answers (10)

Revision of “High Implants”?

+2

Thank you for the question.

Revision of “high implants"  involves lowering the breast implant pocket ( release of scar tissue and/or  muscle). I think it is much better to approach this issue through an  infra areolar  approach as opposed to from a longer distance infra axillary  incision. 

Generally, this operation involves less recovery than the initial sub pectoral dissection ( given that the expansion of the sub pectoral space has already occurred).

Please make sure you're working with a well experienced board-certified plastic surgeon,  well-versed with revisionary  breast surgery.

Best wishes.


San Diego Plastic Surgeon
5.0 out of 5 stars 794 reviews

Breast Augmentation Revision in Los Angeles

+1

Insertion of breast implants through the armpit or axilla has a much higher chance of having high rising breast implants due to the fact that it might be difficult for the plastic surgeon to fully release the lower attachments of the pectoralis chest muscles. It is possible to revise the position of your breast implants throught an axillary incision but an incision at the edge of the areola would definitely be safer.

S. Sean Younai, MD, FACS
Beverly Hills Plastic Surgeon
4.5 out of 5 stars 29 reviews

Transaxillary Revision Breast Augmentation

+1

Dear petitegirl5,

Revision of high riding breast implants typically involves lowering the breast implant pocket including release of the existing capsule and/or muscle.

I have performed breast implant revision including correction of implant malposition through periareolar, inframammary, and transaxillary approaches.

I perform all of my transaxillary breast implant procedures (whether primary or revision) using a small camera called an endoscope. In my opinion, the endoscope is important because it allows the implant pocket to be created and/or revised under direct vision, which facilitates precise dissection, the stopping of all bleeding, and complete release of the lower border of the pectoralis muscle. This helps to avoid the problems of high riding implants and to minimize the chance of capsular contracture.

Warmest wishes,

Larry Fan, MD

 

 

 

Larry Fan, MD
San Francisco Plastic Surgeon
4.5 out of 5 stars 10 reviews

Revision breast augmentation

+1

Revision breast  surgery for too high implants can be performed through either an infra-mammary incision, peri-areolar incision, or through the axilla.  The procedure is the same and the outcome would be equally effective, depending on the surgeons skill and comfort level with the surgery.  One approach is not any better than the others.  If going through the axilla, the implants usually have to the ruptured in order to remove them, whereas using the other approaches the implants can be salvaged and put back in.  The most important factor is not the approach, but the surgeons skill at revision surgery. 

Robert M. Jensen, MD
Medford Plastic Surgeon
4.5 out of 5 stars 21 reviews

Breast augment revision

+1

You are correct that you will need further release of the muscle at the bottom of the breast. It's just a little more complicated than that because the front surface of the muscle needs to be released for 1-2 centimeters from the back surface of the breast tissue. I would listen to all the other doctors that have advised a periareolar approach. You should get a very good outcome.

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 13 reviews

Revision of breast augmentation via the armpit incision

+1

Patients who experience malposition of breast implants should consider a revision performed by an individual who is:

  1. Experienced with revision surgery of any kind and approach/incision
  2. Be able to show outcomes of revisions similar to the one being discussed via any of the incisions/approaches desired

In general, assuming that the original surgery was performed adequately,  it does not seem reasonable to adopt the same operative plan and expect a different outcome.  Revision of implant position via a trans-axillary approach is difficult but definitely possible.

Mario Diana, MD
Plano Plastic Surgeon
4.5 out of 5 stars 26 reviews

Implant revision

+1

Implant placement may require a revision. This is sometimes necessary through no fault of your own or the surgeon. The first consideration is who will do the revision. If the initial surgeon will do the revision I would recommend listening to what they have to say.  Often individuals with little experience with a particular approach will offer recommendations which may or may not be appropriate. Depending on the specifics or your case an axillary or different incision may be appropriate.

Jay M. Pensler, MD
Chicago Plastic Surgeon
4.5 out of 5 stars 10 reviews

Revision of breast pockets

+1
Revision of the implant pocket is required. This is better performed via a circumareolar or infra-mammary incision than via the axillary incision. Once a surgical plan has been made, your plastic surgeon will best be able to advise you of the recovery process, depending on the extent of work required.

Robert L. Kraft, MD
New York Plastic Surgeon
5.0 out of 5 stars 13 reviews

Process for Revision of High Implants?

+1

Sounds like you have a rare axillary incision outcome of high riders. Revision would be very difficult through the axillae. Recommend circum areolar or inframammary incision for better exposure. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 64 reviews

Revision of Axillary Breast Augmentation

+1

Hi there-

Unfortunately, it seems you have experienced one of the complications that is the primary reason I won't do trans-axillary breast augmentation... The good news is that I'm sure lovely breasts are still possible for you-

Considering what you've already been through, and the importance of getting it right this time, I would not recommend trying to achieve your goal through the armpit again. I think the risk is too high of you continuing to be unhappy and needing a THIRD operation- all because you and your surgeon were reluctant to make another incision.

Think of it this way- if you have this second operation through your armpit in order to avoid another scar, but your breasts are still funny looking, will you be happy?

Conversely, if you have a new, pencil-line scar under your breast or around your nipple, but your breasts are beautiful, will the scar bother you that much?

My opinion is that nothing else matters unless the breasts are lovely, and that the chances of ending up with lovely breasts when problems are approached through the armpit are very low.

Think about this carefully... and good luck!

Armando Soto, MD, FACS
Orlando Plastic Surgeon
5.0 out of 5 stars 114 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.