Bottoming out breast deformity post implants and lift. Post-revision questions. (Photo)

Roughly 3 months post-op been progressively getting worse since 5 weeks post-op...I had 495cc Sientra silicone (gummy bear) implants placed under muscle. I realize that I will likely be heading towards a revision and will discuss that with my PS in two weeks. My questions are, how long do I need to wait for a revision? Also, what is the recovery like after the revision? Will it be similar to the first augmentation as far as waiting period to lift things and return to a normal lifestyle?

Doctor Answers 5

Bottoming out breast deformity post implants and lift. Post-revision questions.

I am sorry to hear about/see the problems you are having after breast augmentation surgery. I think your concerns are appropriate; your breast implants do seem to sit quite low on your chest wall, consistent with breast implant displacement ("bottoming out”).

 

I think you will benefit from revisionary breast surgery which will likely involve capsulorraphy ( internal suture repair) and/or breast lifting surgery. Sometimes, depending mainly on the patient's history and physical examination, I will also use additional supportive materials such as acellular dermal matrix or biosynthetic mesh. This procedure serves to reconstruct the lower poles of the breasts and prevent migration of the breast implants too far inferiorly. Associated issues with positioning of nipple/areola complexes should improve with this operation.  



Make sure that the plastic surgeon who does this procedure for you can demonstrate significant experience with revisionary breast surgery. 

I hope this, and the attached link (dedicated to corrective surgery for bottoming out concerns), helps.

Split muscle technique to correct animation deformity

Your animation deformity and bottoming out/double bubble are two aspects of the same problem. It can be corrected by converting to the split muscle plane (not dual plane) along with capsule revisions. Several examples and resources on my site.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 47 reviews

Breast aug, revision, sientra, bottoming out

Thank you for your question. Typically having bottoming as shown in your photos is going to require a revision procedure. If you were my patient, I would place an ADM or Strattice along the lower pole to hold the implant in place. I also typically in my patients try to put in a slightly smaller implant placed in order to have less stress or weight on the lower pole of your breast.  It looks from your photos that the fold (lower portion of the breast) has been disrupted. By placing the Strattice, this can help correct this deformity. I would agree with talking to your plastic surgeon about your concerns. I am also in Ashland and would be happy to see you for a consultation in person to help address your concerns further.

Margo Herron, MD
Medford Plastic Surgeon
5.0 out of 5 stars 14 reviews

I would do it now

From your photographs, if you are my patient, I would recommend that you proceed at any time with a revision of the bottom of your capsule. With the animation deformity that appears to be on the left side I would probably recommend a large piece of Strattice attached to the muscle and down to the bottom of the capsule to act as a hammock and prevent inferior migration of the implant again. The same procedure would be done on the right side as well. Depending on what needs to be done the instructions of what to do and not do will need to be given to you by your plastic surgeon. Best of luck.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.7 out of 5 stars 44 reviews

Revisions for breasts and tummy procedures

are usually done after waiting 6 months but some surgeons may proceed sooner, depending on what the problem is.  You should write down all of your concerns so that everything is covered and addressed to your satisfaction but it appears you can benefit from revisions to produce perkier and more rejuvenated outcomes.  Recovery from revisions will vary, depending on what is done and your surgeon is best equipped to let you know what to expect from what procedures you will be having done.

Curtis Wong, MD
Redding Plastic Surgeon
4.8 out of 5 stars 32 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.