Breast implant revision options - are there risks with mesh?

Question

Had a revision last year that included increase in size, switch to silicone, inferior capsulorraphy on both sides and scoring my breast crease (had a double bubble). Breasts look good, left side sits lower, maybe capsulorraphy didn't hold. I also have lots of itching, burning and pain, especially on my left side and pain in the muscle near my clavicle. Dr wants to downsize implants and do capsulorraphy on left again, but wont use mesh. Are there risks with mesh? Any ideas about the pain?

Gerald Minniti, MD, FACS · Answer

Your revision last year sounds like a Dr. Seuss 'push me pull you' situation. He performed an inferior capsulorrhaphy (to treat double bubble) but also increased the size of your implants and scored the breast crease area (where he just tightened with the capsulorrhaphy), both of which would increase double bubble and drop out. The use of mesh for implant support is well established and revision breast specialists use it every day. Time to move on.

Richard Baxter, MD · Answer

An internal bra should be considered when a capsulorrhaphy doesn't hold, because that is a sign that the tissues need reinforcement. There are two options commonly used: Galaflex mesh and Strattice (Acellular Dermal Matrix.) I would consider using Galaflex in a situation like yours and have found it to be very reliable.

Daniel Barrett, MD · Answer

Dear FLmom123,
breast revision surgery is the most difficult plastic surgery procedure performed. Botched breast surgery alters normal tissue planes and laxity, the ability of breasts to heal properly, and leaves scar tissue that dramatically affects the level of difficulty of the corrective surgery.Many patients come in to correct poor outcomes from their initial surgeries. The most common problems are due to implant malposition, bottoming out of the implant, poor scarring, and incorrect implant size.While the type of revision required will depend on the result of the previous surgery and the desired result of the patient, some revisions involve extensive pocket repair that may or may not need specialized external bras.If you are considering breast surgery revision, you should speak with a board certified plastic surgeon and have yourself properly assessed. Only after a thorough examination you will get more information and recommendations. Also, you have to make sure that your surgeon understands your breast augmentation goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

It sounds like you need smaller implants that are less heavy on your tissue. With smaller implants, the nerves are not stretched so much and you may have less pain.  Mesh can be very helpful in some women, but does have more foreign material and increases scarring internally.

Breast implant revision options - are there risks with mesh?

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