What is the best suggestion to fix my deformed breast after implant removal? (Photos)

Question

Any ideas what to do other than fat transfer? Indention (scar tissue) due to implants not falling properly and having capsular contracture. Implants for 2 years, then removal and now deformed. Help.

Gary M. Horndeski, MD · Answer

Many women after dissatisfied with implant removal only because of the hanging skin, empty appearance and often require a lift. The technique I recommend is a lift using The Bellesoma Method. This will reshape your breast tissue creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained, if not injured during your previous surgery. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

David Parizh, DO · Answer

Your nipples are indicative of grade 3 Otis is. They need to be placed in their anatomical position. Fat grafting is an adjunct to help with upper pole fullness or “cleavage”. A breast lift will help position your nipples and can be used to excuse the scar tissue. Implants are another tool you can use to add volume and create more upper pole fullness. There are also many autologous (your own tissue) options for breast reconstruction. The answer is based on your needs, your aesthetic goals (size) and your affinity for avoiding implants which has to do with recovery and downtime. It’s important to go to a plastic surgeon who has all these tools and design a custom approach for your needs. Best of luck in your search.

Adam Tattelbaum, MD · Answer

Thanks for your question and the photos. I am sorry to hear you have had issues with your implants. What I see here is breasts with good volume but droop, skin laxity and contour irregularity because the tissues are relaxed after the implant volume was removed. The most powerful tool to lift, tighten and reshape this breast would be a a full breast lift. You would have to go over details with our PS about risks especially given previous implants-- this can add complexity.
I don't thing fat grafting alone would give you what you want, but once the breast is reshaped it may be  possible if you still want to be larger.
Hope this helps and best wishes.

Daniel Barrett, MD · Answer

Dear decor,
breast revision surgery is the most difficult plastic surgery procedure performed. Botched breast surgery alters normal tissue planes and laxity, the ability of breasts to heal properly, and leaves scar tissue that dramatically affects the level of difficulty of the corrective surgery.Many patients come in to correct poor outcomes from their initial surgeries. The most common problems are due to implant malposition, bottoming out of the implant, poor scarring, and incorrect implant size.While the type of revision required will depend on the result of the previous surgery and the desired result of the patient, some revisions involve extensive pocket repair that may or may not need specialized external bras.If you are considering breast surgery revision, you should speak with a board certified plastic surgeon and have yourself properly assessed. Only after a thorough examination you will get more information and recommendations. Also, you have to make sure that your surgeon understands your breast augmentation goals.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Ram Kalus, MD, FACS · Answer

Thank you for your question and photos. In order to determine how to best help you it would be necessary to evaluate you in person, but I am fairly certain you can derive a significant improvement with revision surgery.

Your indented scars may be relayed to a mismatch between your implant volume and your breast skin envelope.

An experienced board certified plastic surgeon who regularly performs implant based breast reconstruction should be able to advise you on all of your options.

Michael J. Yaremchuk, MD (license resigned) · Answer

I wonder if the surgeon also removed the capsule along with your breast implant. Leaving the scarred capsule behind can still leave the breast with an altered look, so if this was not done, this would be my suggestion. Then, I would recommend a mastopexy to lift the nipple and remove excess skin. Depending on your desired size, you could do fat grafting for volume augmentation at the time of this mastopexy

Robert Oliver Jr., MD · Answer

You can tell from your preop photos that your problem wasn’t implants “not falling” (they’re exactly where they should be with a partial under the muscle augmentation), but rather that you needed a mastopexy in the first place. You now have a tethered scar from your periareolar incision and show the breast ptosis you likely had all along. To correct this you will need to convert to a superior or medial pedicled mastopexy (breast lift). Fat grafting isn’t going to help here really.  In this context, you probably want to consult with a plastic surgeon whom does a lot of revisional breast surgery as the potential for sub optimal result is fairly high here if it isn’t well planned out.

Darryl J. Blinski, MD · Answer

Unfortunately your explanting surgeon did not reconstruct you with lift and fat grafting. Best to see a few boarded plastic surgeons.

What is the best suggestion to fix my deformed breast after implant removal? (Photos)

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