10 months ago had a breast revision with capsulorraphy and 400cc hp. The right breast has a flat spot under the nipple and it’s not filling out the bottom of the breast. It feels and looks flat. The breast is relatively soft. Not as soft and full as the left one. I’ve seen my doctor at 6 months and was told to wait a year to see if it changes. I’m not seeing any changes or additional dropping to help round out the bottom. Any advice going forward?
Answer: Flat Spot Good morning!You have a little scar tissue in the capsule of your lower pole, which makes it flat, makes the breast not quite as soft as the other side, and prevents the implant from filling out your lower pole. At this point if you were my patient I would be having you massage three times daily and take Singulair and Vitamin E, but in all likelihood surgical removal of that part of the thickened, scarred capsule will be necessary for correction.
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Answer: Flat Spot Good morning!You have a little scar tissue in the capsule of your lower pole, which makes it flat, makes the breast not quite as soft as the other side, and prevents the implant from filling out your lower pole. At this point if you were my patient I would be having you massage three times daily and take Singulair and Vitamin E, but in all likelihood surgical removal of that part of the thickened, scarred capsule will be necessary for correction.
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March 23, 2019
Answer: The Problem With Periareolar Incisions Hello,Periareolar incisions lead to scarring inside the breast tissue, especially after multiple surgeries. This scarring can lead to a variety of contour deformities due to either tethering or tissue atrophy. In addition, performing breast implant surgery through this incision puts your implant at high risk for bacterial exposure, biofilm formation, and subsequent capsular contracture. Your photos may be deceiving, but it appears that the breast that has the contour defect is also sitting higher, suggesting capsular contracture. You will need to be evaluated to determine an accurate diagnosis and treatment plan, which should not include any further surgery through your nipple-areolar complex; any further surgery to treat the implant or it's surrounding capsule should be through an inframammary incision.
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March 23, 2019
Answer: The Problem With Periareolar Incisions Hello,Periareolar incisions lead to scarring inside the breast tissue, especially after multiple surgeries. This scarring can lead to a variety of contour deformities due to either tethering or tissue atrophy. In addition, performing breast implant surgery through this incision puts your implant at high risk for bacterial exposure, biofilm formation, and subsequent capsular contracture. Your photos may be deceiving, but it appears that the breast that has the contour defect is also sitting higher, suggesting capsular contracture. You will need to be evaluated to determine an accurate diagnosis and treatment plan, which should not include any further surgery through your nipple-areolar complex; any further surgery to treat the implant or it's surrounding capsule should be through an inframammary incision.
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March 24, 2019
Answer: Revision surgery Dear jmnelson5,
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March 24, 2019
Answer: Revision surgery Dear jmnelson5,
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March 27, 2019
Answer: Flattening of the breast following revision surgery The flattened appearance may improve but after 10 months I would expect you to see some sign of improvement. If indeed this breast is not as soft as the other breast you may have developed some capsular contracture. Mild or early capsular sometimes can be managed without surgery. I would recommend follow up with your surgeon.
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March 27, 2019
Answer: Flattening of the breast following revision surgery The flattened appearance may improve but after 10 months I would expect you to see some sign of improvement. If indeed this breast is not as soft as the other breast you may have developed some capsular contracture. Mild or early capsular sometimes can be managed without surgery. I would recommend follow up with your surgeon.
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March 23, 2019
Answer: My thoughts Would be utmost importance knowing the reason for the capsulorrhaphy you got, symmastia? side boob? bottoming out? combination of the former? In any case, a multipoint capsulorrhapy is the most difficult technique in breast revision surgery, parallels some of the difficult rhinoplasties, as an example, and not often you "nail" the result.IMHO your surgeon did his best, and he is to be commended for this, but:-the implants are set too high, because the submammary crease was not predictively placed considering the implants' dimensions-the implants, themselves, are oversized in width and height and exceed the limits of your anatomy-it is not visible in the pics but I know you suffer dynamic animation flex deformity and dynamic double bubble, because of the pectoralis muscle was not fully freed from your mammary skin (this is the cause of the sunken area you mention); had the implants been placed in the subfascial plane (which I use and recommend), this animation and the sunken are would have been gone-round implants? they are not bad but quite outdated and unwanted by patients, I still use them but 95% of my patients opt for anatomical ones without any hesitation or expressly prompt me to use themIn spite your surgeon did a great thing for you improving your result, I think there are great chances of a successful new revision to optimize your result.Seek the advice and hands of a serious professional who offers to you a time-consuming and expensive procedure; stay far from minimally invassive snake-charming procedures.
Helpful 1 person found this helpful
March 23, 2019
Answer: My thoughts Would be utmost importance knowing the reason for the capsulorrhaphy you got, symmastia? side boob? bottoming out? combination of the former? In any case, a multipoint capsulorrhapy is the most difficult technique in breast revision surgery, parallels some of the difficult rhinoplasties, as an example, and not often you "nail" the result.IMHO your surgeon did his best, and he is to be commended for this, but:-the implants are set too high, because the submammary crease was not predictively placed considering the implants' dimensions-the implants, themselves, are oversized in width and height and exceed the limits of your anatomy-it is not visible in the pics but I know you suffer dynamic animation flex deformity and dynamic double bubble, because of the pectoralis muscle was not fully freed from your mammary skin (this is the cause of the sunken area you mention); had the implants been placed in the subfascial plane (which I use and recommend), this animation and the sunken are would have been gone-round implants? they are not bad but quite outdated and unwanted by patients, I still use them but 95% of my patients opt for anatomical ones without any hesitation or expressly prompt me to use themIn spite your surgeon did a great thing for you improving your result, I think there are great chances of a successful new revision to optimize your result.Seek the advice and hands of a serious professional who offers to you a time-consuming and expensive procedure; stay far from minimally invassive snake-charming procedures.
Helpful 1 person found this helpful
