Breast Implant Revision: Q&A

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This is my 3rd Revision. Second Round of Strattice? Pocket Revision?

These are my breasts after a revision for a malpositioned implant on my left side. The surgeon added strattice to improve the skin thickness. I went down in size of implant also. There is now rippling and implant looks to me like it is bottoming out? Will another round of Strattice improve things? I am concerned because many of you think I should not mess with it anymore, yet as you can see it is very unattractive. One surgeon suggested larger implants with pocket revision?

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6 Doctor Answers | Asked by megabit in fl

Doctor Answers (6)
Community Comments (0)

Another round of revision may yield limited results.

One of the misconceptions about Strattice is that simply placing it eliminates rippling and malposition. It truly needs a "hand-in-glove" application. The implant needs to fill out the pocket precisely or rippling recurs. Unless a pocket tightening procedure was performed, a smaller implant will likely lead to more rippling. Also, in the photos, the medial and upper poles are rippling as well. In some difficult cases, Strattice in the upper pole is necessary to camouflage this as... more

David Bogue, MD

6 reviews

Boca Raton Plastic Surgeon

www.drbogue.com

Your pectoralis muscle is detached and pulling your left breast to the side

The solution is not to use strattice or alloderm. You need pocket revision and I would not go with bigger implants since you have very thin tissue. I would also do fat grafting to increase the thickness and use silicone gel implants. In some cases if patient does not want to deal with implants anymore, I have removed the implants and done fat grafting. please check my web site.

Kamran Khoobehi, MD

28 reviews

New Orleans Plastic Surgeon

Third revision, second with Strattice

Without a full examination but going by your history and these photos, it would appear improvements might be possible with a combination of changing size of implant, modifying the pocket, possibly utilizing additional Strattice and definitely utilizing fat grafting. I strongly recommend you seek advise and help from a plastic surgeon certified by the American Board of Plastic Surgery who additionally has a vast experience and reputation with successful revisional breast implant... more

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There may be a role for additional dermal matrix to thicken the pocket where the rippling is visible. A very slightly larger implant may also help. Is your pocket above or below the muscle? If it is not below the muscle, conversion to below the muscle may help in the cleavage area. There is something about the lower curvature about your breasts in some of the photos that looks like a slight mismatch between the implant position and your natural breast tissue; it is possible that a small... more

Revisionary Breast Surgery

Yes, it looks like you may need revisionary surgery with possibly larger implants, further pocket work and possibly the use of Alloderm for the rippling issues you are experiencing. I have helped many patients in similar situations. Revisionary surgery is tricky... make sure the surgeon you choose has experience with this type of surgery. Ask to see before and after photos of similar situations and even speak to other patients.

Are you "as good as it gets?"

I can see from your photos that you are exceptionally thin and this will always make implant surgery more complicated. One thing to consider is that there comes a time when it is "as good as it gets" even if it is not perfect. Too often, patients try to have repeated revisions trying to reach a result that their body just won't allow. You might be there.

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Breast Implant Revision: Q&A

This is my 3rd Revision. Second Round of Strattice? Pocket Revision?

Another round of revision may yield limited results.