I Had Revision Surgery 2 Months Ago Due to a Pretty Bad Capsular Contracture on my Left Breast. Now, that same breast appears to have bottomed out. I feel bad about going back to my PS since he really went out of his way to help me with the the revision surgery (it didn't cost me much at all). What should I do?
Capsular Contracture, Now Bottoming Out. What Can I Do?
Doctor Answers 10
Bottming out after capsule release may need revision
“bottoming out” is the term used to describe the condition which occurs when the breast tends to look as if it has descended on the chest wall after previous surgery, whether the surgery involved implants, a lift, or a reduction. In the case of “bottomed out” implants, sutures can often be placed in the lower pole of the breast to re-elevate the breast on the chest wall. This is called a capsullorraphy and can achieve excellent tresults in the correction of “bottomed-out implants.
I would talk to your surgeon about it it fyou have bottomed out after having a capsular contracture treated.
Bottom Out After Capsular Contracture Treatment
It sounds like you have a great doctor patient relationship with your current PS. I would go back and visit with him/her. Sometimes the pathologic scar tissue (capsule) holds up the implant. After a total capsulectomy, an implant may bottom out. there are several options to correct this:
1. sutures to reinforce the fold (capsulorraphy) (however, there is a higher risk of recurrence with this particularly if you have thin tissue or a larger implant
2. I have had great success with the use of AlloDerm or Strattice in the definitive correction of bottomed out breasts.
Please visit your Plastic Surgeon to learn more about your options.
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Vosmetic surgery may require one more revision: how do I bring this up with surgeon?
Even though you may feel bad, I am sure your surgeon would want you to be happy. IF it is bottomed out, he/she will likely want you to get a great result. When patients are understanding as you are, it makes this uncomfortable process alot easier on everyone. So let him/her know that you were pleased to have the capsular contracture corrected but that youwould like to get the result better and you are willing to take the risk. Offer to pay for operating room and other expensies to meet him/her at least half way. Also offer to do a testimonial.
Best to stay with your original Plastic Surgeon if possible
Even though you feel badly, your original plastic surgeon is probably the best way to go, since he/she knows you and your body the best. There are many variables that can impact both bottoming out and capsule formation-- and your original plastic surgeon as the best knowledge of what has already occured.
Bottoming Out of Revision Breast Surgery
I appreciate your respect for your plastic surgeon. What you should do is visit him or her now because at eight weeks they may recommend non surgical remedies ( underwire bra). If you wait longer the recently operated breast may only be able to be corrected with surgery. If you want a better consensus from the surgeon community in this forum then pictures would be helpful.
Capsular contracture and implant bottoming out
This might be a good application for acellular dermal matrix products such as Strattice. The graft can define where the supportive fold of the breast will rest, and can act as a 'firebreak' to disrupt capsular contracture around your implant. The material is expensive. Check in with your plastic surgeon and see if he/she has experience using this product.
This is an unfortunate reality with breast implants. Capsular contracture is, by far, the greatest risk of having implants. Bottoming out is repaired via an additional revision. Sometimes a dermal matrix (tissue implant) is required to suspend the implant into its appropriate position. I would definitely go back to your PS. Hopefully he/she will be as generous again.
"Bottoming Out" after release of scarring around Breast Implants
Regarding: "Capsular Contracture, Now Bottoming Out. What Can I Do?
I Had Revision Surgery 2 Months Ago Due to a Pretty Bad Capsular Contracture on my Left Breast. Now, that same breast appears to have bottomed out. I feel bad about going back to my PS since he really went out of his way to help me with the the revision surgery (it didn't cost me much at all). What should I do?"
It sounds as if in the process of removing the scar tissue around the implant the lower attachment of the breast to the chest wall were loosened as well leading to the bottoming out. If this is the case, it is unlikely to improve without surgical correction.
I would approach your surgeon since he is obviously a stand up guy and see what he proposes.
Dr. Peter Aldea
Multiple breast implant pocket problems
It is unfortunate to have this problem but it has happened to every experienced plastic surgeon. It is frustrating for you and your doctor but they want to help you get the best result your body will allow so stick with them on this. You will need another surgery to fix the bottoming out.