What Causes Implants to Change Shape and Get Bulges 2 Years Post-Op? (photo)

i had my implant surgery 1yr9mos ago,i went from A to a D, the implants are Mentor smooth moderate profile saline and are over the muscle(even though i wanted them under)I absolutely loved them. i may not have had much but definitely had some of my own breast tissue,but now feels like nothing is between the implant and skin, assymetry is getting worse, my left breast is significantly firmer than the other and has a visible "ridge" down the top then goes flat then big bulge

Doctor Answers 7

What Causes Implants to Change Shape and Get Bulges 2 Years Post-Op? (photo)

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Above muscle implants are sometimes more prone to upper pole rippling as well as capsular contracture.  Based upon your photos, you may have both of these issues.  This is usually a problem that can be improved, but not without surgery.  I would seek the opinion of a board certified plastic surgeon to go over your options---there are multiple.

Castle Rock Plastic Surgeon
5.0 out of 5 stars 36 reviews

What Causes Implants to Change Shape and Get Bulges 2 Years Post-Op? (photo)

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Based only upon the posted photos you appear as a capsular fibrosis and ripple effect. Seek in person evaluations. 

Breast Implants Changing Shape

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You may have very thin breast tissue so the implants are more noticeable. You may also be developing a capsular contracture.

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 76 reviews

Implants and ridging

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Being that they are under the gland, there is noticeable rippling.  The tissues look a bit thin and you  may benefit from having the under the muscle.  You may also have a capsular contracture on the tight side.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

You have minimal breast tissue to cover the implants

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You main issue is the lack of soft tissue to cover the implants. The placement of the saline implants above the muscle and mild capsular contracture has made the situation worse. Your options are to replace implants with silicone gel implants, add fat to increase soft tissue and place the implants under the muscle.  

Kamran Khoobehi, MD
New Orleans Plastic Surgeon
4.7 out of 5 stars 152 reviews

Capsular contracture

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As Dr. Pousti indicates, you are likely developing capsular contracture or hardening. As the capsule thickens and shrinks in this process the breast feels harder and the ripples become more evident. In addition to the treatments Dr. Pousti mentions, one other option to consider is fat grafting over the implant. This can be effective if the capsular contracture is still relatively mild and effectively will thicken the tissues over the implants and help conceal the rippling. Even if not successful, having thicker tissues will be of benefit should you require more extensive surgery to change implants, remove the scar tissue etc.

Finally complete replacement of the implants with fat grafting is also possible, but will require multiple stages. Unfortunately even if you do change the implants to under the muscle etc, you are still at a higher risk of recurrence of capsular contracture.

Changes of Breasts after Breast Augmentation?

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Thank you for the question and pictures.

I'm sorry to hear about your dissatisfaction after breast augmentation surgery.

Although difficult to make a diagnosis based on history and pictures alone,  I think you may be dealing with encapsulation (capsular contracture)  of the left breast implant. this process may explain the firmness of this breast  as well as the worsening asymmetry. Both implants appear to have significant rippling present.

You will benefit from in person consultation with a board-certified plastic surgeon well-versed with revisionary breast surgery. Revisionary surgery may involve options such as capsulectomy,  exchange of saline to silicone breast implants,  change of breast implant pockets to submuscular position and/or mastopexy surgery ( if necessary).

 I hope this helps.

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.