ChongMD

I have been using Sculptra in my practice for 5 years; both my patients and I have seen great results in the cheeks, temples. The "no go" zones for me are the "tear troughs" and around the mouth; both of these areas have a common factor a muscle, which is a sphincter and skin which is very specialized. The lower eyelid skin is just too thin to camouflage "nodules" and the perioral area is too mobile and can encourage the development of "nodules". Good luck.

Both the manufacturer and I do not recommend Sculptra for the hollows under your eyelids. The skin is very thin and the underlying muscle is a sphincter, so the chance of nodules or lumps is very high. This area of the "tear trough" is best addressed by one of the Hyaluronic acid products, Restylane or Juvederm. Good luck.

If you are choosing explantation, I would interpret this as removing the implant and the scar tissue, which is causing the deformation of the breast +/- pain. Complete capsulectomy is traditionally accepted as necessary, prior to staging another attempt at implantation, usually 3-6 months later. At that time, some PS recommend a neosubpectoral pocket, where the implant is removed and a new space is made, surgically, between the breast-skin flap below and the pectoralis-skin flap above. The implant is then placed, in this pocket, while the old space is closed off. This would be the time to try an Alloderm sling, just in the inferolateral quadrant. You can visit www.LifeCell.com to see how the procedure is done. I am in PS so my experience with Alloderm is relatively small, but agrees with larger, academic series in that the rate of symptomatic capsular contracture, which requires further reoperation is <3%. Good luck. Keep my posted.

Don't be depressed. Discuss your dissatisfaction thoroughly with your surgeon and come in with photos of your "ideal" breast. You can find patients who have similar characteristics to you on LoveyourLook.com or LookingYour Best.com, which are sponsored by the two implant manufacturers. A word of caution: you may need to consider a lift to reshape the excess breast skin, which has resulted from post-lactational changes. Good luck.

... associated with a lesser rate of capsular contracture. The data is still small but comes mostly from our breast reconstruction patients who are having immediate direct to implant + Alloderm slings. Keep posted.