Thank you for posting photos and providing the details of your breast augmentation. As others have pointed out, returning periodically for filler injections is not ideal. Fat grafting, performed by a board-certified plastic surgeon, may be the best option. The first step is to have a plastic surgeon conduct a physical exam to determine the specific cause of the dents you describe. It's possible that surgical revision is the only way to correct the issue.
A good physical exam is needed for an accurate recommendation. I suspect that you may need a little smoother release at that point. Fat grafting is a great option. You may need some correction of the pocket, I can't really tell that well in photos. Since your surgeon has stated they can't fix it I would recommend a second opinion. Be sure this is a board certified plastic surgeon. There is also a training program in Detroit.
Thank you for your question about your breast augmentation.
- the cause of the indentation is from scar tissue or from the pectoral muscle.
- Surgery is the only way to correct it -
- Either by revising the pocket or putting the implants over the muscle.
- (Revising the pocket can cause the problem to return).
- Fat injections over the indentations can conceal it -
- But given your surgeon's response, you will need a different surgeon probably to help you.
- Always see a Board Certified Plastic Surgeon.
Best wishes. Elizabeth Morgan MD PHD
As with anything in surgery, there are many opinions as to the cause of the problem and potential solutions. In this case I would like to add one more of both. It appears to me that your implants are a little too close together, and more specifically, it appears that your Right implant is too close to or possibly even crossing the midline. This could be from over release of your pectoralis muscle and the dent superiorly appears to be where your muscle remains attached. If on examination, your implants Do Not cross midline, then I'd like ly recommend releasing the superior Pectoralis Muscle origin from the breast bone area to round out the pocket. If however, they implant can cross midline, then I would recommend using Strattice to reconstruct a smooth medial pole.
You are witnessing scar tissue that is closing this part of your submuscular pocket. Filler is not the right way to fix it. This pocket can be reclaimed with surgery. However it is very likely to happen again.
If it bothers you, have surgical correction. Follow your surgery with compulsive implant massages and hope that pocket does not close again.
These dents are not likely to disappear. While fat grafting and fillers are an option, you also have the option of changing the plane of the implant to a prepectoral position (above the muscle). this may alleviate your problem permanently.
You would probably do better with a fat transfer than trying to add filler every 9 to 12 months. The procedure could be done in the office under local anesthesia.
This is something that can develop as the tissues stretch against the central muscle insertion. Fat grafting may soften this a bit.
I think as your breast augmentation has matured, your skin has stretched a bit and your implants have settled and evacuated the area that is now a dent. I would give it some more time to make sure the implants do not settle any more, if they did, a capsule repair and implant elevation would be needed. If they stay where they are, I agree with the first doctor answer that a little lipo and fat graft to the area could give you a permanent fix. Good luck.
I think fillers are in my opinion not the best choice.i would consider getting some liposuction and using the fat removed from liposuction to fill in the depressions.this I think would be a better choice.