Cortisone Injection in Breast Implant Incision Cause Thinning of Breast Tissue Among Other Problems? (photo)

Question

I had BA almost 1 year ago (July 18th will be a year.) I had Mentor Silicone Smooth Mod+ Profile Submuscular implants. I went from a 34B to a 34D. The healing process seemed to go according to plan. However, the incision scars (above crease) remained red, puffy and became itchy. About 2 months ago I went back to my PS and he gave me cortisone injections in each incision. Scars did not get better. Rippling in both breasts appeared as well as a bluish window -lower poles. Is this the cortisone? PS said it was a fold in implant. Scars were prominent after 8 mos. Went to PS and got cortisone. Breasts have progressively gotten worse.Scars remain, skin turned bluish and skin thinned, rippling.. PS revised left implant by removing sutures and tightning skin where it looks like implant is bubbling thru scar.

Richard H. Tholen, MD, FACS · Answer

Thanks for including photos; I believe they show several issues, one of which appears to be steroid-induced scar thinning (in your incision). But you also have very thin tissue coverage over your implants, which is totally unrelated to steroid injections in the augmentations scars.

	By your description, you still had evidence of not-yet-mature augmentations scars that were likely hypertrophic ("red, puffy, and itchy") even after 1 year of healing. Steroid injection is appropriate to treat hypertrophic scars, but there are pros and cons to this choice--one con is that some scars thin, soften, and stretch more than anticipated (strength and dose of steroid have a role here), causing the "bubbling" in your incision. Excessive thinning of the incisional area can lead to tissue breakdown and implant exposure, which means the implant becomes bacterially-contaminated and must be removed.

	Some PS may consider scar pads or other options before steroid injections, or at least starting with a very weak dose and minimal amount of steroid, as an alternative to help  decrease the risk of this "big-deal" issue.

	As to the rest of your result, your extremely thin tissues (lack of breast tissue and fatty layer) do not cover your implants well. If they are indeed below the muscle, then your muscles are quite thin also, and/or you have developed capsular contracture. Steroids in your incision have nothing to do with this aspect of your present appearance. In fact, if you are indeed a hypertrophic scar-former (genetics; nothing you can do about that), then you may well have a naturally-higher potential for developing a tight or thick scar around your implants (capsular contracture).

	You may want to consider more than what has already been done--scar revision for the steroid-induced thinning--thank your PS for performing this revision BEFORE your implant became exposed, or this would have been an even bigger disaster. But at this point you still have what appear to be high, tight, contracted breasts in need of additional surgical intervention. If your surgeon is not an ABPS-certified plastic surgeon, consider consultation with one of more experienced ABPS-certified plastic surgeons about your present situation. Best wishes! Dr. Tholen

Garrett A. Wirth, MD, MS, FACS · Answer

Your question addresses different issues. I do think that you might have achieved a little scar thinning with the steroid injection, and possibly some scar widening because of it. On the other hand, I do not think the rippling is due to the steroid injection, but more so due to the size of the implant, and the lack of overlying breast tissue. The continued changing shape shape of the breasts is also of concern. I recommend that you go back sooner rather than later and continue to work with your surgeon to address these issues. Although there are options to help you, it is best to do this during a full face-to-face consultation, rather than to try to address this in this forum. Please make sure you work with a board-certified plastic surgeon.

Robert Brueck, MD · Answer

This is very common with steroid injections and when the underlying tissues are thin it can pose soem problems.I would recommend scar creams or silastic gel sheeting or perhaps even a smaller implant.

Darryl J. Blinski, MD · Answer

GREAT posted photos. Very hard to blame the steroid injections for tissue thinning and a ripple in the silicone (if it truly is silicone). You will need revision surgery either a cellular dermal matrix placement (quite expensive) or fat gratifying to protect the implant Are you sure you b are sub muscular? You need second opinions in person.

Steven Wallach, MD · Answer

Your tissues are very thin and the scar is difficult to see well.  Sometimes a smaller implant can work out better along with strattice to fill in the lower pole a bit.

Cortisone Injection in Breast Implant Incision Cause Thinning of Breast Tissue Among Other Problems? (photo)

Answers (7)

Answer: Cortisone Injection in Breast Implant Incision Cause Thinning of Breast Tissue Among Other Problems?

Answer: Cortisone Injection in Breast Implant Incision Cause Thinning of Breast Tissue Among Other Problems?

Answer: Implant issues

Answer: Implant issues

Recommended reading

Everything you need to know about Breast Implants

Our mission is to create a world where every investment in modern beauty is Worth It.

Cortisone Injection in Breast Implant Incision Cause Thinning of Breast Tissue Among Other Problems? (photo)

Answers (7)

Answer: Cortisone Injection in Breast Implant Incision Cause Thinning of Breast Tissue Among Other Problems?

Answer: Cortisone Injection in Breast Implant Incision Cause Thinning of Breast Tissue Among Other Problems?

Answer: Implant issues

Answer: Implant issues

Browse related questions

Recommended reading

Everything you need to know about Breast Implants

Our mission is to create a world where every investment in modern beauty is Worth It.