Revision solution - what would be the best way to fix this? (Photo0

Question

7 months post op and this is what I’m dealing with, is this bottoming out? Double bubble? Animation deformity? The implants have dropped so low. I’m so stressed out over this and just know I’m going to need a revision. Any advice would be appreciated!! What would be the best way to fix this? 415cc UTM Was told I didn’t need a lift originally… now I’m wondering if I should’ve.

Gerald Minniti, MD, FACS · Answer

You needed the lift, that's why the surgeon placed the implants so low, in a vain attempt to lower your native inframammary fold. Surgeons that make that error are either incompetent or simply were not trained to perform breast lifts, ergo not a board certified plastic surgeon. Regardless, you need a new surgeon. You have all of the what you mentioned: bottoming out, double bubble, and severe animation deformity. The fix is this: Pocket re-sizing via capsular tightening and reinforcement with resorbable mesh ('internal bra'), followed immediately by a breast lift. You'll have beautiful breasts.

Paul E. Chasan, MD, FACS · Answer

Thank you for your question. I have been in practice over 28 years with an emphasis on revision breast surgery. Your surgeon placed implants to low and underneath the normal breast ligament in an attempt to avoid performing a breast lift.  It is clear by your anatomy that you needed a breast lift from the very beginning. You would need to perform an internal bra procedure-capsulorrhaphy as well as a breast lift.  I wrote the very first paper on capsulorrhaphy over 20 years ago.  You should be able to have an excellent result.  Best wishes to you.

Harry T. Haramis, MD, FACS · Answer

Unfortunately, your implants appear below the breast fold. Revision with reinforcement of the fold is likely needed. This may require mesh support.

You do not appear to need a lift, just reposition the implants higher.

Further discussion with your plastic surgeon for best options is recommended.

Connie Hiers, MD, FACS · Answer

You have bottomed out from the weight of your implants. I suggest going somewhat smaller and using mesh for an internal bra to give you more support as the inferior pocket is tightened. Please discuss this with your surgeon.

Mark Eberbach, MD · Answer

Thank you for your photographs. I’m sorry for your poor outcome. At this point, I feel your best option is to stop with a bad decision.

I personally would plan for explantation, a repair of the pocket, and then, perhaps a delayed breast lift with secondary augmentation, and a small implant.

I think trying to repair such a broken anatomy in one setting with augmentation might yield similar results.

Jason Pozner, MD · Answer

The implants have dropped below the fold. I would correct with Galaflex mesh. Can use the same implants

Mats Hagstrom, MD (license on probation) · Answer

It looks like your implants are sliding down on your chest wall. I suggest getting a few in person second opinion consultations to get a better understanding of why your breast look the way they do. There are generally three variables that determine the quality of a breast augmentation. The first dissipation candidacy for the procedure in the first place. The second is the choice of implants regarding size shape, and type. The third variable is that correct placement of the implant in an anatomically correct position. Positioning the implant also includes making sure that’s stable long-term and doesn’t slide down due to gravity or contraction forces of the pectoralis muscle. Correcting bottomed out implants is not an easy or straightforward. Procedure and patience should look for providers who have a proven track record dealing with this condition.
Best,
Mats Hagstrom, MD

Revision solution - what would be the best way to fix this? (Photo0

Answers (7)

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