How Successful is Creating a New Pocket Vs Sutures for Breast Implant Revisions?

5'3 100lbs 350/375cc mod+ silicones I have lateral discplacement (according to my new PS it is from sleeping on my stomach) and horrible keloid scars. I am going in for a revision any instead of sutures my PS wants to create a new pocket... I cannot find many who have had this done. Any advice or experiences?

Doctor Answers (5)

Lighten the load

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Unfortunately, your implants are too large for your chest. You will continue to have problems despite further revisions. 350 to 375 cc implants are in front of your muscle, will continue to descend inferiorly and laterally and require revision. Any attempts to reverse this will result in failure because gravity is unrelenting. After multiple operations, you will understand that your body cannot handle this large of a load. I suggest an alterative procedure. Exchange your implants with smaller ones and perform a simultaneous lift. Using only a circumareola incision it is possible to reshape your breast tissue creating upper pole fullness, elevate them higher on the chest wall and more medial to increase your cleavage. Through the same incision, implants can be exchanged. Aligning the areola, breast tissue and implant over the bony prominence of the chest wall maximizes anterior projection with a minimal simze implant. Small silicone gel placed retro-pectoral look and feel more natural, are more stable, less likely to ripple or have complications needing revision. Best Wishes, Gary Horndeski, M.D.


Texas Plastic Surgeon
5.0 out of 5 stars 126 reviews

How Successful is Creating a New Pocket Vs Sutures for Breast Implant Revisions? Asked by skinnylove

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Are your implant above muscle? If Yes than place under but the lateral pocket still needs to be closed either way. You could use ACDM but very expensive. 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 62 reviews

Revisions for implant displacement...

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I love it how surgeons can blame patients for how their results turned out.  Sleeping on your tummy, in my experience, does not displace implants because everyone tosses and turns when sleeping.  Regardless, your left implant does slide more to the side but overall, you still look pretty good.  Do you really want to undergo the revision and accept the risks and costs to be more 'perfect', even though your breasts will continue to change with time?  If you decide you HAVE to have the revision, new pockets help limit the movement but additional suturing must be done to prevent your implant from finding the original pocket.  And it also depends on your capsule quality.  Know your doctor's revision policy as well as you may need it if things don't end up where you expected them to.

Curtis Wong, MD
Redding Plastic Surgeon
4.5 out of 5 stars 16 reviews

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Options for lateral breast implant displacement

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Many cases do well with suturing the scar capsule (called a capsulorrhaphy) but it depends on the tissues being strong enough relative to the size and weight of the implants. This is the sort of judgment that requires an in-person exam to predict. Creating a new pocket can be done, and I am presuming you are describing what is known as the "neo-subpectoral" plane. The most secure way to hold the implant up and in is with a graft of material such as Strattice, but this is not needed in every case.

Richard Baxter, MD
Seattle Plastic Surgeon
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Sutures for lateral implant shift

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Actually your photos are not all that bad and some lateral shift is natural and expected. Breasts just don't sit upright when you lie back, and if they do they look like implants. Still if you are unhappy many will use lateral sutures to close the pocket in, and they work quite well. Others may disagree, though we will use a new pocket for issues with capsular contracture and not for the displacement you have.

Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 29 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.