I seem to be having an issue with my breast implants and I wanted to ask you your opinion on what I should do for a third surgery! Here are two pictures of my implants. The picture where the implants are close together is when I am sitting up and the picture where they are separated is laying down. Please help! I have HP 425cc o/f to 475cc. I have had a bilateral capsulorrhaphy as well.
Breast Implant Revision Issues. What Can I do? (photo)
Doctor Answers (11)
Breast implant revisions can correct implant malposition
Thank you for your question and for providing the photos. As Dr. Blinski pointed out, we do not know exactly what bothers you. From my perspective, looking at your pictures but not having examined you, the implants appear too large for your frame. The second issue may be that the implant pocket is too close to the center, which may be creating what we can synmastia. Do you feel the implants are too close together? The third issue seems to be that the right implant is too far to the outside when you lie down; in other words, the pocket on this area is too wide. We do not where the capsulorraphy was done. In a situation where the implant is shifting off to the side, I will usually recommend a capsulorraphy with reinforment with Strattice and changing to a smaller implant. Another option is to change the implant pocket. Synmastia can also be treated by pocket change. These can be complicated to fix and you should be prepared to have smaller implants or else the repair may not work. Hope this helps. Tracy Pfeifer, MD
Lateral drift of a breast implant
There are several factors which can make the breast implant fall off to the side:
- The lateral pocket or capsule is too wide or has become stretched by the weight of the implalnt
- The slope of the rib cage as it comes off of the sternum, the greater the slope the more likely the implant to fall off to the side
- Normal breasts fall off to the side
A lateral capsulopexy may be beneficial but recurrence will be relatively high, could consider the use of Strattice as a hammock to suspend the breast.
Breast Implant Revision Issues. What Can I do?
If you would like more separation of the breasts when sitting and less separation when lying down, there will be a multitude of considerations that should be discussed in detail in a consultation. Find a plastic surgeon with ELITE credentials who performs hundreds of breast augmentations and breast augmentation revisions each year. Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.
Kenneth Hughes, MD Los Angeles, CA
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Breast Implant Revision
Thank you for your email and photograph. It will be difficult to give you good advise without an in person consultation. Your implants look overly large for your frame. I would suggest a smaller siz,. a lift to deal with stretched out skin and a pocket revision for positioning. If you keep having disappointing surgical results, you may need a very different approach to achieve what you want. Good luck!
Implant Exchange with Mini Ultimate Breast Lift
Your implants are in front of your muscle, are too large and asymmetrical. You would benefit from a new technique called Implant Exchange with Mini Ultimate Breast Lift. Using only a circumareola incision it is possible to exchange your implants, reshape your breast tissue creating upper pole fullness, elevate them higher on the chest wall and more medial to increase your cleavage. Aligning the areola, breast tissue and implant over the bony prominence of the chest wall gives maximum anterior projection with a minimal size implant. Smaller silicone gel implants placed retro-pectoral are more stable long term, look and feel more natural, less likely to ripple or to have complications that need revision.
Gary Horndeski, M.D.
Breast Implant Revision Issues. What Can I do?
All the expert responders are assuming you have specific issues. BUT you did not give specific comments of what are your concerns!
Correcting oversized dual plane implants with symmastia to a beautiful natural appearing breast augmentation.
There are several problems with your breast augmentation most notably the implants are much too big for your frame, you also have symmastia- your breasts should not touch eachother and splay with muscular action. This is quite common with dual-plane techniques. You also need an implant that fits within the confines of your ideal basewidth and renewed support as it looks like there is only stretched skin and thin tissue covering the implants.
I commonly correct these problems by converting to the Cold-SubfascialTM plane in which the strong pectoral fascia is used to correct and support a beautiful and natural appearing shape. In my opinion this is the only way to create a long lasting and safe supported aesthetic breast in your case. The Cold-Subfascial techniquer is the only technique I am willing to offer in my practice because the dual-plane and other techniques create unnatural results like your current presentation. references on the web and youtube are included below.
All the best,
Rian A. Maercks M.D.
Breast implant revision can really help.
I see a number of issues which can be improved:
1) breast implants too close together, which makes nipples point toward the arms.
2) One implant moves and the other one doesn't.
3) One nipple is higher.
4) Implants a little too big.
Breast augmentation revision capsular contracture
Difficult to tell with the information provided but it looks like you have capsular contracture probably to some degree on both sides. If this recurred after your 2nd procedure your best bet is to place new implants in a new pocket either under the muscle if you are on top, or in what is called a neo-subpectoral pocket if you are already under. You might also consider going to a gel implant which should give a more natural appearance for the same number of cc's.
Unilateral capsular contracture can create asymmetry.
The picture looks as though the left breast has a capsular contracture which holds the implant in an unnatural position even when recumbent. The right breast implant seems to move around more naturally.
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.