I had breast implant TUBA procedure on June 10, 2009. Immediately after surgery (next day), my right breast looked like the implant had dropped (not a lot but a noticeable bubble was present). My surgeon said that to correct the problem, I need to wear an underwire bra 24/7 for 6 weeks and the pocket should heal in the right place. Is this a good way for the problem to be fixed or should it be surgicaly repaired?
Underwire Bra for 6 Weeks to Correct Dropped Implants?
Doctor Answers 11
Problems with a TUBA augmentation
There are several problems with the TUBA procedure and you have encountered one of them. It is not easy to be as precise in the pocket creation from so far away as compared to an incision in the crease or around the areola. Your surgeon may have needed to lower your crease to fit in the implant but this opens the possibility of a double bubble or a bottomed out implant. In the early phase of recovery an underwire bra may splint the crease in a proper location and save the day. You should wear it 24/7 for 8 weeks and avoid all activities that bounce the implants up and down like running.
If this doesn't work you will need a pocket repair with an incision on the breast or in the crease because revisions like this can't be redone through the TUBA approach. Good luck with this!
Double Bubble fix
It's only been about two weeks since your TUBA, so this non-medical, non-surgical solution is probably worth a try. Do be diligent with wearing the underwire bra, which acts much like a splint for a sprained ankle, allowing the tissues to heal in the optimal position. I agree that avoiding exercises, which cause pressure on the lower pole (the area of skin between the nipple and the fold), should be tabled for the same amount of time.
If this doesn't work and you need a surgical revision or capsulorrhaphy (pocket repair), it should be done either through a periareolar (nipple) or inframammary fold approach. The TUBA and Transax approaches don't lend themselves to revisional procedures. Good luck.
One of the disadvantages of performing a TUBA is that you do not have precise control of the implant pocket . A band or tight bra may help reset the fold in place....but it may not. It couldn't hurt to try it. I suggest that if you need a revision, you have a more traditional approach ( inframammary or periareolar).
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Solving low implant
This is a low risk, possibly effective, methodespecially if you start it immediately post-op. You should just want and see. Implant position is not necessarily stable as the pocket forms, scar is deposited, and the capsule contracts or stretches so there is some ability to manipulate the position. If it is not successful, then you might need to go to plan B or surgical correction (through a different incision) if it is "bad" enough. These are the disadvantages of the TUBA approach (i.e. lack of control under direct vision and inability to correct many problems through the same incision).
Problems with TUBA procedure
The approach you describe does have a small chance of working considering that you are still in the very early stages of healing. While the fold location may be raised, thus correcting your problem, by wearing an underwire bra, you do have a chance of the implants healing in a pocket which is too high. Unfortunately, the best and most definitive approach to treat this is to have the position of the implant revised surgically, but you never know and surgical could always be done later if this conservative approach does not work. Good luck
Underwire bra for poorly positioned breast implant after TUBA
As much as I would like to tell you that this might correct your problem, I really think that the chances of success are very, very slim, because for the little bit of support that external compression via the wire provides you, there is a much stronger force pulling the implant down to the lowest point in the pocket (gravity).
I can tell you that even when I correct poorly positioned implants surgically, this downward force is formidable, and can only be overcome with meticulous technique and extra-strong repairs.
I'm afraid the bra will end up being a waste of your time- but would also not suggest operating right away. The chance of success when you do go back to repair the problem are much higher if your capsule has matured- wait until you are 3-4 months out from the initial surgery.
External compression may be helpful
A non surgical method such as wearing a tight fitting bra to set and develop the inframammary crease is a good option at two weeks. The capsule around the breast implant really forms during the first 3 - 4 weeks. It is possible that this tight compression may help you set the crease. It is certainly worth a try and if not successful then a surgical procedure to raise the crease will be needed.
Underwire bra will not correct dropped breast implants
I am sorry to say that wearing an underwire bra after the TUBA or any other type of breast augmentation will not correct dropped breast implants or bottoming out of a breast implant.
The problem is that the breast implant surgical pocket is too low, the tissues beneath the breast tissue are open and the presence of the breast implant prevents the open tissues from healing and closing the pocket.
A surgical procedure to close the breast implant pocket will be required. No external method such as taping or wearing a compressive bra will work, in my experience (25 years).
Personally, I would not attempt a correction for 3 months to give the tissues time to heal. Also, a capsule will form around the implant whoich will be useful in correcting the problem.
A permanent suture can be used to close the capsule and pocket and lift the breast implant to a higher position.
The TUBA procedure to my understanding invalidates your breast implant warranty. This procedure is fraught with potential problems.
Be certain that your surgeon has had experience with the revisional procedure. It is tricky and must be done correctly for success. A permanent suture must be used and the capsular tissue should be sutured to the rib periosteum along a very specific anatomical line that defines the inframammary crease-see reference below.
The implant will settle lower
If the pocket is dissected lower on one side, it will most likely heal that way. This is a problem that can occur with the TUBA procedure but to be honest, it can happen with any augmentation procedure, just more commonly with TUBA.
I would follow your plastic surgeon's instructions but if it heals too low, the only solution will be an incision on the breast to repaire the pocket.
Best of luck.
I am afraid the underwire bra is not going to help.
I hate to be the bearer of bad news, and of course you should not consider further surgery for several months anyway. But I have a pretty big experience with breast augmentation in Manhattan, and my experience tells me you will probably need a revision.
After breast augmentation, the breasts should look great right away. We put the patient up in a sitting position (you are still under anesthesia, of course) BEFORE the end surgery. This way we can tell for sure if the breasts look symmetrical, and if the shape, size, and position are just right. If not, we keep working and look again, until they do look great. This way, there is no guess work.