Do I need to decrease cc size? Capsulorrhaphy? With mesh or not? Opinions please

Question

I need a revision, I'm almost 1.5 yrs po from breast lift + 485 and 520 cc under the muscle HP silicone implants. My PS recommends a capsulorrhaphy but doesn't seem concerned with my size. He also mentioned galaflex possibly. Adding pics to get opinions on if size is too large for me and what revision would be best. I was bottomed out in both breasts by 3 mo po appointment and my ps didn't bring up my bottomed out breasts after I told my concern about rising scars

Gary M. Horndeski, MD · Answer

485 and 520 cc implants weigh over 1 lb each.  The weight of your implants has stretched out your skin envelope resulting in bottoming out.  These implants are too large for you to accommodate, will continue to fall and GalaFlex will only be a temporary solution.  You would benefit from explant, lift and possible fat transfer.  The technique I recommend is explantation 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, nipple sensation and the ability to breast feed are maintained, if not injured during your previous surgery.  At the same time or later, fat transfers can be performed if additional volume is desired.Best Wishes,Gary Horndeski, M.D.

Gerald Minniti, MD, FACS · Answer

Hello,Although your implant choice (very large, ball shaped, and presumably smooth) puts you at high risk for what happened to you, your body has demonstrated a predilection for smaller implants. So yes your implants are too big (for you), and not using Galaflex mesh would be fool hardy, especially if you stick to your current implants. Your revision surgery is tricky, and if your surgeon isn't expert in revisions, you should visit a few others for a second opinion. Best of luck!

Robert P. Schmid, MD · Answer

Thanks for your question, & including your photos, they really help! Based upon your photos and my experience of doing thousands of breast augmentation surgeries, I’d say that you certainly don’t need to increase your cc’s. I’d leave the same implants in & simply do an inferior capsulorrhapy (tightening your implant capsule on the bottom) while also doing a superior capsulotomy (breaking open the implant capsule on top so that the implants will migrate superiorly). I don’t think that you’ll need Galaflex or any other ADM. best of luck to you!

Leland Deane, MD, FACS · Answer

Yes, you've bottomed out and the nipples are quite high. There is asymmetry as well. These changes are probably at least partially due to over-dissection to accommodate overly large implants. You would need a smaller implant, in my opinion, and reshaping of the breast capsule. Skin excision might be necessary. Alloderm support can be effective too but only if the above maneuvers are done too. Best of luck.Leland Deane MD FACS

Larry Weinstein, MD · Answer

It looks like the implants you have are a bit large for your frame, also the nipples are fairly high relative to your mound. An inframammary fold reduction could fix this with slightly smaller implants. Good luck...

Do I need to decrease cc size? Capsulorrhaphy? With mesh or not? Opinions please

Answers (10)

Answer: Secondary surgery

Answer: Secondary surgery

Answer: Smaller size breast implants

Answer: Smaller size breast implants

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Everything you need to know about Breast Implant Revision

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Do I need to decrease cc size? Capsulorrhaphy? With mesh or not? Opinions please

Answers (10)

Answer: Secondary surgery

Answer: Secondary surgery

Answer: Smaller size breast implants

Answer: Smaller size breast implants

Browse related questions

Recommended reading

Everything you need to know about Breast Implant Revision

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