Where's my Nipple Going? (photo)

After 2 severe cases of capsular contracture, both came on less than 6 weeks post surgery, on Dec. 26, 2012 I had both implants removed and full capsulectomy. The last implants were placed submuscularly. The surgery took 3 hours, it was very bad. Now 6 weeks post-explant and my breasts seem to be getting sucked into themselves! When I flex my chest muscles, they look like they cave in even worse. What's happening and is there anything I can do to get my old little breasts back?

Doctor Answers (12)

Scars at six weeks.

+3

At six weeks your scar production is peaking. This is a normal part of healing. Massage can encourage scar remodeling, and help free your nipples. The current problem is that the scar is gluing your skin to the muscle.

If you where already a year out, then further surgery would be needed to correct this problem. The good news is that is takes a full year for a scar to fully mature. During that time the scar tissue will thin and become softer. The bad news is that it may not fully release, but at this point, time is on your side.

Discuss options with your surgeon, but do not have any surgery until the scars are fully mature. Even six months may be intervening too early, and may prevent your body from taking care of the problem. The downside of more surgery, as you might guess, is the formation of more scar and resetting the "it takes a year for the scar to mature" clock.


Walnut Creek Plastic Surgeon
4.5 out of 5 stars 7 reviews

Changes after implant removal

+3

I am sorry about your experiences with breast implants. After removal of the implants and capsulectomy, you have stretched out skin/tissues that need time to retract. It appeared that your skin was fully stretched out with prior breast implants. It will take time and your skin may not retract completely to look like your pre-surgery shape. I would recommend that you wait at least 6 months, preferably one year before rebuilding your breasts.

Best Wishes, 

Stewart Wang, MD, FACS
Los Angeles Plastic Surgeon
4.5 out of 5 stars 24 reviews

Breast Contour Problems after Breast Explantation

+3

     Wait at least 3 to 6 months after breast implant removal for full contraction to occur.  You can consider fat grafting to improve the contours in the future.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 237 reviews

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Breast implant removal and capsulectomy

+2

This can happen after the type of surgery you had.  It sounds like it was a tough case and the capsule was difficult to remove.  What is happening is because of the scarring that is taking place inside your breast.  The bad news is that it may be worse but the good news is that it may then start getting better.  I would give this at least a year to settle and you should stay in close contact with your surgeon.  If it is still a problem after Mother Nature has done her magic, you may need something like a scar revision on fat transfer.  Be patient. 

Lisa L. Sowder, MD
Seattle Plastic Surgeon
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Breast Implant Removal

+2

Thank you for your question.  I'm sorry to hear that you have had difficulty with your breast augmentation surgery.  Your pictures are very helpful and demonstrate what can happen when large implants are removed.  The implants have created a space in the breast and they have stretched out the breast tissue.  With the implants out, that space has to close down and it is pulling the nipples and areolas in towards the chest wall.  Over time, scar tissue will soften and we often recommend that patients wait for 6-12 months to allow that scar tissue to soften maximally.  There are ways to improve your breast contour.  Talk to your plastic surgeon about fat grafting and breast lifting, where the tissue can be added or rearranged to help reposition the nipples.  Good luck!

 

Brian C. Reuben, MD
Salt Lake City Plastic Surgeon
5.0 out of 5 stars 14 reviews

Scar tissue from muscle to areola area

+2

Hello,

Thank you for the question and photo.  The appearance of your areolas after implant and capsule removal is not uncommon.  With time they may improve and if not to the degree that is satisfactory to you fat grafting may be of particular help. This would also allow you to increase the volume of your breasts.

All the best,

Dr Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 98 reviews

Nipple/Areola Cave-in after Breast Implant Removal?

+2

I'm sorry to hear about the complications you experienced with breast augmentation surgery. At this point, besides  ongoing  patience, time and massage, there is not much that you can do. It will take several additional months for the skin to fully contract back;  hopefully during this time the scar tissue will also become less adherent and the nipple/areola appearance will improve.

Occasionally, external suction devices ( for example a “nipplette" device) may be helpful down the line. This device is usually used to help support the nipple  after correction of nipple inversion surgery;  you may find more information about the device online.

 Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 793 reviews

Changes after implant removal

+2


I am sorry to hear about your problem with breast implants. After removal of the implants and a capsulectomy, the skin/tissues is stretched out and the internal scar is retracting. It appears that your skin was very stretched out with the breast implants. It will take time and your skin will improve, but it may never go back to how it was before your surgery. I would recommend that you wait at least 6 months, preferably one year before rebuilding your breasts. Most likely a smaller implant will help the final shape, but you should discuss this with an experienced board certified plastic surgeon. Good luck.

Steven L. Ringler, MD, FACS
Grand Rapids Plastic Surgeon
5.0 out of 5 stars 30 reviews

Where's my Nipple Going?

+2

Sorry to read about what you are going through. It is quite likely that as the scars mature the appearance will improve. 

The one thought that may not have been suggested by your own surgeon is the use of the BRAVA system, which applies suction to the breasts. The device is somewhat cumbersome, and is usually used for modest breast enlargement, and more often these days in preparation for fat grafting to the breasts, which may also be of benefit to you.

Discuss these with your surgeon. You can google BRAVA to get some info on your own. All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.5 out of 5 stars 34 reviews

Removal of Breast Implants

+1
There are some cases that require permanent removal of breast implants after unsuccessful attempts at breast augmentation revision. The explantation surgery needs to be individualized in every case. Specifically, the extent and the location of capsulectomy is not the same in every case. Removing too much capsule can create breast deformity after removal of the implant. The appearance of the breast can be significantly improved with fat grafting. There are different methods of doing fat grafting in these type of cases – some times serial procedures, some times external expanders, like Brava system. An experienced surgeon would be able to determine the best approach.

Boris M. Ackerman, MD
Newport Beach Plastic Surgeon
5.0 out of 5 stars 33 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.