What options do I have to fix my implant-caused deformity/tethering 3 years later?

Question

I have a significant deformity at my areola scar that was caused when my implants were placed & became more noticeable after their removal (3yrs ago). It is visible when I lift my arms up. My implants were placed above the muscle. I dislike the look of breast lifts both the scarring & the shape & do not want new implants placed. What other options do I have to fix this tethering? Thank you!

Donald R. Revis Jr, MD · Answer

Good afternoon,
There really isn't a better option than to have a breast lift, and during the lift your scars can be revised and improved.

Chul Hwan Seul, MD, PhD · Answer

Thank you for your question. I have two recommendations for solving your problem:
Recommendation 1 : Adhesiolysis (rigotomy) with fat grafting on the lower poles. Your Areolar scars can be improved by scar revision. Tethering caused by adhesions can be improved significantly by adhesiolysis (rigotomy) and fat grafting, but cannot be corrected completely.
Recommendation 2: Vertical incision mastopexy (removal of current scars) with fat grafting

Casey Anderson, MD, FACS · Answer

I think you best bet here is to have a revision surgery that involves a breast lift. That will allow the old scar to be removed and redistribution of your breast tissue into a nicer shape.

Michelle Zweifler, MD · Answer

Breast revision with breast lifting with vertical/ lollipop scars may help with the depression after implant removal.  Additionally, fat grafting to the breast helps with depression and adds volume to the breast.  Also Alloderm and other acellular dermal matrix soften the scar contracture.

Zoran Potparic, MD · Answer

Based on these photos, breast lift is the best possible option. You will end up with lollipop scar, but improved shape and more appropriate position of nipple/areolas. In person consultation with a board certified plastic surgeon with good reputation in breast surgery is recommended. Good luck.

Gary M. Horndeski, MD · Answer

The technique I recommend is a lift using The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness without implants, elevate them 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.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs.  It appears that the best option would be to pursue a revision breast lift to improve scarring and contour.

Ram Kalus, MD, FACS · Answer

Thank you for your question and photos. An examination in person would be required to precisely determine exactly what your problem appears to be and the best solution, but it would appear that you have some internal scarring and mismatch between your inner breast tissue and the skin envelope. Details of your previous surgery would be helpful but it is probably that your scars can be improved a the same time as tightening both breasts, repositioning both nipple/areolar complexes to a higher more aesthetic location, and improving overall breast shape. 
Please consult with an experienced board certified plastic surgeon who can advise you specifically. Be sure that your own sense of aesthetics seems to align with that of your selected plastic surgeon, based on his or her Before and After gallery. Best of luck to you.

Daniel Barrett, MD · Answer

Dear manda.panda22,
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

A lift would help reshape your breasts, removed excess skin, and can redo the scarring around your areolae.

What options do I have to fix my implant-caused deformity/tethering 3 years later?

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