Explant and capsulectomy gone wrong? Why aren't any of the 1,000's of pictures I viewed about this looking like mine? (photo)

Question

I had my breast implants removed with capsulectomy after 8 years and the incision is around my areola. I have looked at a 1,000 photo's of this process and not one of them looks like mine. It seems like he actually stitched under my nipple to the back inside of my breast so that fluid can't fill in that space. I didn't expect my areola to be permanently tacked down creating this horrifying dent or gap. I don't think my front is suppose to be stitched to the back?

Gary Lawton, MD, FACS · Answer

This appearance is typical of implants that are removed for infection.  I don't think there was any stitching like you suspect.  Sometimes this type of retraction occurs.  After the situation has stabilized (6 moths or more), surgery may help to improve the appearance.

Jed H. Horowitz, MD, FACS · Answer

What if
you choose to leave the #BreastImplant out?
This is a consideration for women who have had repeated encapsulation of their
implants, silicone related concerns, other chronic and recurrent problems
related to their implants. The shape and size of the breast will be
unpredictable after explanation. The breast will be smaller and possibly sag
more. Patients who already have ptosis (drooping) should think about mastopexy
at the time of explanation.

#NATURALBreastAugmentation can be performed with fat grafting. This requires
liposuction to obtain the fat, and then the fat is transferred into the breast
tissue. It is usually possible to achieve at least one half cup size increase.
Additional fat transfer procedures to increase your volume can be done
subsequently.These are some options that may help your condition

David J. Wages, MD · Answer

Thank you for your question and photo.  Once the implants are removed the space can fill up with fluid and then the body may reabsorb it over time.  Many times it can look like a deflated balloon or in your case a crushed can.  It is reasonable to give this at least 6-9 months to improve on its own.  If it is not improving then you may need to consider revision with a breast lift procedure.  I would recommend you talk to your surgeon or seek another opinion from a Board Certified Plastic Surgeon who has
experience with breast surgery.  Good luck.

Michael J. Brown, MD · Answer

Hi,

Thanks for posting your question. I am happy to try and help you. It is
important to remember that a board certified plastic surgeon will be your best
resource when it comes to an accurate assessment of your situation, and
concerns.

Having said that, you should go see your plastic surgeon. Online
consultants are not the appropriate source of information for you; your plastic
surgeon should be your resource when it comes to postoperative care.As for your photo, these types of retractions are rare but do occur, there are solutions to improve this. It will require therapy, and additional surgery. The surgery will involve releasing some of the scar tissue and then performing fat injections into the breasts. This degree of problem will likely require more than one surgery to improve this result.As for the surgeon, this is not the plastic surgeon's fault. It is better to look for solutions than trying to blame someone else for this unfortunate situation.

Best wishes,

Dr. Michael J. Brown 
Northern Virginia Plastic Surgeon

Steven Wallach, MD · Answer

Implant removal can sometimes cause the breast to retract a bit funny. It may not have been from any stitching internally.. Best to give it time to settle down and follow with your surgeon.

Rick Rosen, MD · Answer

It looks like you may benefit from a mastopexy or uplift. You appear to have a reasonable amount of breast tissue and probably had large implants removed. The central area "stuck down". Give things some time, and hopefully will settle down, but if not you "may" need a re-exploration, release of scarring and a mastopexy. But an examination is needed. If you do not get the answers you want, you may want to see another plastic surgeon in your area for a second opinion.

Alan M. Engler, MD, FACS (retired) · Answer

I'm very sorry for the results you have at this point.  In general, the larger the implants, the longer they were in place, they thinner your skin, the more changes you had over the period they were in place (pregnancies, weight gains and losses, etc) the greater the likelihood that you will wind up with a result like this.  This is most likely the effect of an excess of skin versus the space created when the implants were removed.I doubt that your surgeon specifically did the maneuvers you suggest; more likely is that there was a void (from where the implants were) and that the tissue attached on its own.  You should speak with your surgeon to get the specifics of what was done.Often, the appearance softens over time.  If it does not you may want to consider having a breast lift to revise your current result.  You should of course be seen in person by a board-certified plastic surgeon for a full evaluation and discussion of the options.I hope that this helps and good luck,Dr. Alan EnglerMember of #RealSelf100

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Explant and capsulectomy gone wrong? Why aren't any of the 1,000's of pictures I viewed about this looking like mine? (photo)

Answers (7)

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