How long to wait to get my left breast fixed? Is Oct 31 to soon to upgrade to high profile? I have 450cc low profile. (photos)

Had a breast lift, reduction, implants on 7/21/16. Day 4 stitches underneath the implant broke. The implant fell it shifts around my whole left side of chest. I am going to a new plastic surgeon to get it fixed what is the recommended wait period. That I should wait in order to get the left side fixed? Is Oct 31,2016 to soon? Will I need a new lift also? This surgeon recommends high profile would this weigh my breast down faster? I have low profile 450cc under muscle now.

Doctor Answers 8

Low implants after lift/aug

Your implants are extremely low and both sides need to be elevated to a much higher position on your chest - please be sure the plastic surgeon you choose can show you many revision photos like yourself tp be sure you get the result you desire.

Massive weight loss patients have more challenges

as you are experiencing.  Anchor approaches are more predictable in your situation as your pocket must be elevated and this will require internal sutures and even possibly acellular dermal matrices.  I am not sure by what you mean by your sutures breaking, unless your initial pocket was too large and your surgeon had to secure the fold at the time of your procedure.  I'm not sure what procedure was used but my recommendation would have been for a concomitant reduction, using the inferior flap as a way to help secure your implant better and a larger implant.  But this is water under the bridge at this point.  Best wishes in achieving a durable result.

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

Revision Surgery

With the amount of extra skin involved you should have a revision of your breast lift that involves the anchor incision. Internal sutures placed at your inframammary fold would anchor this landmark to your chest to help prevent the implant from bottoming out. A supportive bra should be worn around the clock for three months after surgery to encourage those sutures to hold and heal in place. Unfortunately, with the quality of your skin you are still at a high risk for those permanent sutures not holding. I don't see any reason why you would have to wait to have this revision surgery. The profile of the implant doesn't effect weighing down the breast as much as the size/volume of the implant. The bigger the implant, the more chance of the breast being weighed down. 

Allen M. Doezie, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 32 reviews

Complex Revision Surgery

Hello,

Putting in high profile implants will not help your problem. Your issues are associated with implant malposition, and you can see your current implants looked great initially. You need an ABPS certified/ASAPS member surgeon expert in revision breast surgery to perform a capsulorrhaphy with mesh to reposition your implants. HP implants have a higher risk of malposition, textured implants have a lower risk. Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 79 reviews

Extremely complex breast problem because of poor tissue elasticity

You appear to be a massive weight loss patient and as a consequence of weight gain and loss, you have very poor tissue strength. I agree with the others that a T scar pattern would have been my choice but strong inframammary crease support is critical because your own creases are too weak. You need a crease reconstruction and I personally wouldn't advise going bigger (and heavier) until that totally heals. Please understand that yours is not like other situations, more complex by far, and may need more than one more surgery to get to the goal result.

How long to wait to get my left breast fixed?

I hope you are getting both sides revised as that will be necessary for symmetry. I believe most of us would have chosen a different procedure for you using an anchor lift as the skin excess is quite large and the anchor lift removes more skin rather that relying on the skin to remodel (that is unlikely after massive weight loss). As to timing....there is no need to weight any longer, there would be no benefit in that. Larger breast implants weigh more, of course, but a 450cc implant weighs the same whether it is moderate or high in profile. 

Ronald V. DeMars, MD
Portland Plastic Surgeon
5.0 out of 5 stars 24 reviews

Breast lift, reduction and implants - need extensive revision

Thank you for asking about your breast lift and reduction.

  • I am sorry you have run into such a problem with your surgical result.
  • Your first surgeon created a lovely shape for you -
  • But I don't think s/he took into account what appears to be massive weight loss.
  • In cases like this a vertical lift won't work well - excess skin must be removed.
  • Also it appears the breast crease wasn't strong enough to hold the implants or it was disrupted at surgery.
  • I suggest repair both breasts at the same time.
  • Three months is early - usually we wait six months because you still are likely to be swollen.
  • if the size feels right, then you should be able to use your existing implants - 
  • Your new surgeon is right to change them to a high profile if you want the 450 volume but that volume in a low profile is too wide to fit your chest.
  • Above all, the excess skin and breast crease must be dealt with to create a skin envelope that fits you and is strong enough internally to hold an implant in place.
  • Otherwise you will need internal support material as well.
  • This procedure must be thought through and planned carefully or it will not be your last procedure.

Always see a Board Certified Plastic Surgeon. Best wishes  - Elizabeth Morgan MD PHD FACS

How long to wait to get my left breast fixed?

I am sorry to hear about the complication you have experienced.  Although there is no "standard" when it comes to waiting time,  it may be advantageous to wait for a longer period of time to allow for the breast implant capsule to mature (hopefully thicken);  this may allow for a stronger "repair".  Again there is no specific "science", it may be best to wait at least six months to one year  before proceeding with this type of revisionary breast surgery.  Waiting may also be beneficial in that the right breast may continue to change and, may also benefit from revisionary breast surgery.



 As you likely know, revisionary breast surgery to correct  breast implant bottoming out which will likely involve capsulorraphy (internal suture repair). Sometimes, depending mainly on the patient's history and physical examination ( especially patients who have loss skin elasticity with significant weight loss), 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 this type of revisionary breast surgery. 

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

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.