How are pockets made smaller?

During breast augmentation revision surgery pocket modification may be required if the implant has descended too far inferiorly, the original pocket was created too large, or if the implant is being down-sized.
These types of modifications are usually done with sutures to raise the level of the inframammary fold or to decrease the size of the pocket. I usually use a permanent suture to perform these modifications, but some surgeons may use a dissolvable suture.

If the capsule around the implant is being left in place, then the suture may grasp the anterior and posterior capsule pulling them together – this is referred to as a capsulorrhaphy. This suturing may be done with interrupted sutures, or with a running suture. For more strength or purchase, the suture needle may be passed through the underlying chest wall fascia and muscle, and/or the overlying breast or subcutaneous tissue, to incorporate these tissues as well as the capsule. 

If the capsule has been removed, then the sutures are placed between the breast and/or subcutaneous tissue, and the chest wall fascia and muscle. In this situation patients can feel some more prolonged discomfort at the sites of the sutures; they may report an aching or pulling sensation with certain activities. This generally improves with time, but may take several months to resolve.

Speak with your surgeon, and I’m sure s/he will be happy to describe the type of pocket modification they plan to perform.

Best wishes, Ken Dembny

   If you are having pockets reduced due to implant malposition or the like, capsulorrhaphy sutures are usually placed to tighten the pocket and allow for better implant position, shape, and projection.  Kenneth Hughes, MD Los Angeles, CA

Thank you for the question.

 As you can imagine, it is not possible to provide you with precise information with the limited  information regarding your situation. However, generally speaking breast implant pockets are made smaller by using internal sutures to close off the “space”. This internal suture technique is called capsulorrhaphy.  These techniques may be helpful in correcting breast implant displacement problems such as bottoming out, lateral displacement,  symmastia or when removing/replacing breast implants with smaller breast implants.You may find the attached link helpful.

 Best wishes.