I have problems with double bubble and muscle flex deformity that have not improved despite corrective surgery. After a second opinion from another doctor, the new surgeon suggests smaller implants above the muscle. Today I Mentor 500cc plusprofile coh2 textured. I have rippling in the cleavage area on one breast. The new implant would be Mentor plusprofile approximately 300-375cc. Should I choose smooth or textured implants? What are the pros and cons of smooth implants?
Smooth or Textured Implants for Someone with Muscle Flex Deformity? (photo)
Doctor Answers (4)
Double bubble deformity
Thanks for your question. It would appear that your double bubble deformity is related to animation with muscle contracture, and this could be modified by placing implants submam marry, I would also consider using textured implants to help reduce the contracture rate. I am less concerned as to the brand of the implants used. Smaller sized implants always help as well when trying to deal with capsular contracture and bottoming out. Let your Plastic Surgeon continue to give guidance about this
Good luck to you.
Frank Rieger M.D. Tampa Plastic Surgeon
You have a good plan
If you place the implants above the muscle the contraction deformity will be corrected. I would also go with a smooth silicone implant. The double bubble can be corrected at the sam time.
Over or under the muscle when you have contraction deformities
is a difficult decision. Before proceeding, I would want to know what kind of "corrective" surgery you had and because if you haven't had the dual plane technique and capsule work to improve the level of your implants, that seems like a reasonable alternative to changing implants and the pocket. The dual plane technique divides the muscle completely and elevates the tissue off of the muscle as well. If you believe you are too large and wish to downsize and cannot tolerate any movement of your implant, then your plan sounds reasonable. In my experience, I find textured implants to fail more than smooth implants and I do not believe it will make a difference in your situation. In my hands, smooth implants are revised much less and are much more forgiving when trying to massage your implants to better symmetry. Best wishes in achieving your goals... your surgeon should be able to help guide you through this and understand what the revision policy is, if there is one.
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Conversion to Sub glandular Breast Implant Position?
Thank you for the question and pictures.
Based on your description, I would advise you not to trade one problem (pectoralis muscle flexion deformity) for another (breast implant rippling). This is what may happen if you remove your breast implants and place them in the subregional position. This is especially true given that you already described rippling in the cleavage area on one breast. Instead, I would suggest maintaining the breast implants in the sub muscular position, but releasing the scar tissue/ muscle inferiorly. This must be done very carefully to avoid postoperative implant malposition. In my opinion, there are many advantages of maintaining the implants in the dual plane (sub muscular position), even if some ( less severe) muscle distortion remains.
I hope this helps.