Revising pocket - what are my options? (Photo)

Question

I am 57 and had augmentation 12 years ago.(450/492 cc) I will be replacing them with smaller (go from DD to full C). My breasts were wide set, even before my surgery, and they are worse now. I believe I have waterfall deformity now (and maybe capsular contracture.....can you tell from pics)? Can a Dr reduce the pocket from only the outside, to get more cleavage and less side boob? I will also have a lift, if that changes anything.

Gary M. Horndeski, MD · Answer

The technique I recommend is 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 and nipple sensation (in 95%) is maintained if not injured during your previous surgery. Later, fat transfers or small implants can be placed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Gerald Minniti, MD, FACS · Answer

After removing the current implants, the surgeon would need to revise the pocket, specifically by making it's dimensions smaller. This is done by suturing the inner scar capsule together along its perimeter, making it's volume smaller. This is typically reinforced with an absorbable mesh. This will enable smaller implants to sit exactly where you want them. Once this is performed, you would likely benefit from a revision breast lift (not a periareolar type, but a full lift). This will tighten up the lower pole of the breast and improve your biopsy dent.

Connie Hiers, MD, FACS · Answer

I do agree with going smaller since these are a bit large. Your lateral pocket can be tightened internally so that the pocket is smaller and the implants do not fall so much to the sides. A lift should be able to be done at the same.

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