Three breasts surgeries and nearly $30k later, and I'm still having the same problem. 2 out of 3 of those procedures were 'corrective' surgeries to fix this bottoming out/indentation issue. Supposedly there is an 'internal bra' in place to correct the bottoming out issue, yet just a few months after my 3rd corrective surgery my right breast has bottomed out again. What should I do? Should I remove the implants entirely and fat graft to my breasts? This has become so expensive and discouraging
Answer: Defining the internal bra for correction of bottoming out There is some confusion about what an internal bra is, so it is important to know what you have had done in order to make a recommendation. I define an internal bra as the addition of a layer of support with a material such as Galaflex mesh or ADM such as Strattice. It is not simply suturing the capsule, which is correctly called a capsulorrhaphy. The confusion arises because some surgeons call a capsulorrhaphy an internal bra if they use permanent sutures, but that doesn't add the type of support you need. I doubt you would be happy with explantation and fat grafting.
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Answer: Defining the internal bra for correction of bottoming out There is some confusion about what an internal bra is, so it is important to know what you have had done in order to make a recommendation. I define an internal bra as the addition of a layer of support with a material such as Galaflex mesh or ADM such as Strattice. It is not simply suturing the capsule, which is correctly called a capsulorrhaphy. The confusion arises because some surgeons call a capsulorrhaphy an internal bra if they use permanent sutures, but that doesn't add the type of support you need. I doubt you would be happy with explantation and fat grafting.
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Answer: What To Do You might benefit from downsizing the implant to a smaller volume but more implant height (a lower profile smaller implant). You may just have too large of implants for the soft tissue support that you currently have. Large implants can continue to create stretch deformities of the nipple-to-fold distance and/or "bottom out" the inframammary fold due to force of gravity/stretch over time. I would truly see an expert in breast revision surgery in order to ensure that you get a very comprehensive plan.
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Answer: What To Do You might benefit from downsizing the implant to a smaller volume but more implant height (a lower profile smaller implant). You may just have too large of implants for the soft tissue support that you currently have. Large implants can continue to create stretch deformities of the nipple-to-fold distance and/or "bottom out" the inframammary fold due to force of gravity/stretch over time. I would truly see an expert in breast revision surgery in order to ensure that you get a very comprehensive plan.
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April 17, 2023
Answer: Displacement of implant One of your implants is sliding down what creates visible asymmetry; it happens more frequently with large implants like in your case. Lifting and fixing inframammary fold on that side would create symmetry and prevent further displacement, migration of the implant. You may also consider smaller imlants? In person consultation with a board certified plastic surgeon is recommended. Good luck.
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April 17, 2023
Answer: Displacement of implant One of your implants is sliding down what creates visible asymmetry; it happens more frequently with large implants like in your case. Lifting and fixing inframammary fold on that side would create symmetry and prevent further displacement, migration of the implant. You may also consider smaller imlants? In person consultation with a board certified plastic surgeon is recommended. Good luck.
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April 6, 2023
Answer: Addressing bottoming out Thanks for your question, I’m sorry to hear how discouraging this must be for you. Fat transfer is not a smart or wise idea for 30-50% of the fat will inevitably die. Clumps of dead fat may be felt on a self-monthly breast exam or show up on a mammogram and affect the screening and give the patient unnecessary worry. You may have a capsular contracture, but I am unable to confirm that from pictures alone. It is not uncommon that implants move or malposition over time. Implants are NOT safe devices and they’re full of problems.
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April 6, 2023
Answer: Addressing bottoming out Thanks for your question, I’m sorry to hear how discouraging this must be for you. Fat transfer is not a smart or wise idea for 30-50% of the fat will inevitably die. Clumps of dead fat may be felt on a self-monthly breast exam or show up on a mammogram and affect the screening and give the patient unnecessary worry. You may have a capsular contracture, but I am unable to confirm that from pictures alone. It is not uncommon that implants move or malposition over time. Implants are NOT safe devices and they’re full of problems.
Helpful
October 4, 2023
Answer: Explant with Bellesoma Method Your implants are too heavy for the skin envelope to hold. At this time, I recommend explantation and lift using The Bellesoma Method. The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained if not injured during your previous surgery. Later, fat transfers can be performed if additional volume is desired.
Helpful 1 person found this helpful
October 4, 2023
Answer: Explant with Bellesoma Method Your implants are too heavy for the skin envelope to hold. At this time, I recommend explantation and lift using The Bellesoma Method. The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained if not injured during your previous surgery. Later, fat transfers can be performed if additional volume is desired.
Helpful 1 person found this helpful
