will vary accordingly to what you desire. If there is considerable muscle distortion, an open approach would be suggested to help release the muscle and bands creating this. If you don't mind that and just want it smoother, fat grafting will fill in the depression. If it can be done in the office, costs are much less but in my practice, whenever I am going to be looking at the implant, that requires an operating room. Scar quality will improve with time and avoidance of sun exposure.
You don't say how long ago you had your surgery but I think it can be improved whether or not totally is tough to say.I would go through your same incision to revise the scar and try to release the fibrous bands that are creating the crease,At the same time perhaps a little fat injection may help as well.
Correction of a double bubble deformity is best treated by an internal approach, not excision of skin. A combined approach to release the fibrous bands creating the deformity and support to prevent recurrence provides the best outcome for success. Fat transfer can improve tissue thickness but is unlikely to correct your deformity as the sole intervention.
I'd say that it was rather unfortunate that you had a skin excision to repair this. This can be repaired quite effectively by internal capsulorraphy with or without some type of ADM. I prefer Belladerm or Alloderm over Strattice (Pig Skin). But usually just suturing internally will correct this type of problem. The scar should be excised and re-repaired at the same time. I've attached a video where I am repairing symmastia, but I describe capsulorraphy. Hope that helps.
Thank you for your pictures. Your breast contour issue cannot be fixed with fat grafting. I would recommend one of the following treatments
- Removal of the implants altogether.
- Using your old implants or possibly smaller new ones with Stratus to support the left implant internally.
- Pertaining to the scar just excision and three closure for better scar characteristics.
Earl Stephenson Jr, M.D., DDS, FACS
Repair of this problem can be accomplished with one of two approaches, or a combination of these. They are to use an internal sling to reconstruct the breast fold and if necessary adding fat transfer to improve the shape.