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What Can Go Wrong with Silicone Completely Under the Muscle for Someone Who's Developed Capsular Contracture? (Photos)

asked 8 months ago by latina in miami
Latest answer by Rian Maercks, MD
Question viewed 469 times
Tags: capsular contracture, risk, saline to silicone, submuscular

After my first breast augmentation I developed capsular contracture. Then I had another surgery to correct it. I developed then a pos-op infection that required implant removal . Now, I just did another surgery :textured silicone 400cc and 425 ccs under the fascia. I have a lot rippling and my right breast(400ccs) looks bigger. I am considering doing ANOTHER surgery completely under the muscle. What can go wrong this time? I am VERY thin & almost no breast tissue left. :(

7 answers to What Can Go Wrong with Silicone Completely Under the Muscle for Someone Who's Developed Capsular Contracture? (Photos)

+2

Revision Surgery for Silicone Implants

HI,The problem is that you have relatively large implants for your size and very thin tissues. Completely sub-muscular implants will leave you with a double bubble, where the implant sits higher on the chest wall and the breast droops off of it. A dermal sling such as strattice is useful in this case. The implant would then only be partially sub-muscular and the lower pole would be supported by the strattice. I would also switch to smooth round implants because the textured implants tend to... more
Daniel A. Medalie, MD

Cleveland Plastic Surgeon
+2

Thin women and breast implants

Latina: I agree with Drs. Pozner and Baxter that textured implants and a completely submuscular plane are impractical for you because of the upper pole wrinkling. If you were to consider a 3rd revision, Strattice would be very useful both for implant stabilization as well as protective against recurrent capsular contracture. This type of a procedure always requires a drain for a few days. On the subject of drains, did your surgeon use them on your last case? The fact... more
Lavinia Chong, MD

Orange County Plastic Surgeon
+2

Strattice for capsular contracture

I agree with Dr. Pozner's advice here. Total submuscular is a very difficult thing to do without tissue expansion as is done for breast reconstruction. Strattice acellular dermal matrix will add support and coverage and appears to be very helpful in reducing the risk of capsular contracture.
Richard Baxter, MD

Seattle Plastic Surgeon
+2

Revionary Breast Surgery with Acellular Dermal Matrix

You have an understandably frustrating situation: contracture, then infection, then rippling. In a situation like yours i usually recommend that patients opt for the procedure with the most predictable outcome. The current gold standard procedure for your situation is to have your implants placed submuscularly with an acellular dermal matrix sling (or hammock) placed to hold the implant in place. Your implants are too large to be completely covered by your pectoral muscle... more
Gilbert Lee, MD

San Diego Plastic Surgeon
+1

Revising submuscular augmentation after multiple complications

At this point what you need is restoration of soft tissue coverage. I have had great results .in situations like this with a special technique of fat and stem cell micrografting. the secondary problem is that your implants are too low. Are you sure you had subfascial placement because your breasts do not look like typical subfascial results. It looks more like a neosubpectoral or a capsulorrhaphy. Looking at your pictures I would think that there is still virgin... more
Rian Maercks, MD

Miami Plastic Surgeon

www.rianmaercksmd.com

+1

Revision breast augmentation.

There are multiple issues of concern regarding your breast augmentation. You have shown a prediliction for contracture, you have larger implants, and your breast tissue is very thin as evidenced by the rippling in the upper poles. A dual plane placement of the implants (upper two-thirds under the muscle and lower third under the breast) will give a natural position to the implants on your chest, and the muscle coverage will significantly improve the upper pole rippling. The addition of... more
David Bogue, MD

Boca Raton Plastic Surgeon

www.drbogue.com

+1

Strattice with submuscular placement

The issue with complete submuscular placement is the difficulty in placing larger implants and the fact that they often ride very high. I think the best approach for you is submuscular placement of smooth silicone implants with Strattice for inferior (bottom) support and tissue coverage. The early data on Strattice shows little to no capsular recurrence and the submuscular placement will mostly elimnate the upper pole rippling.
Jason Pozner, MD

Boca Raton Plastic Surgeon

www.spsboca.com

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