Should I have a mastopexy revision after explant? (Photo)

Had a mastoplexy and implants 3.5 months ago....after vertical incision non closure my surgeon explanted 4 weeks ago. He attempted to close 3 times whilst implants were still in hence damaging my skin. I think there is a suture causing the contracture...should I get a second opinion for an immediate revision...I can't live with thus's worse than before I started...

Doctor Answers 4

No lift

Breast implant removal should be performed with complete en bloc capsulectomy without lift.  The capsule should not be left in place or the space will not heal.  In patients that believe that their implants are causing them illness, leaving the capsule behind will not result in any improvement in their symptoms. Because the removal of the capsule and lift performed together can compromise the blood supply to the skin, breast and nipple to a potentially devastating degree, they should never be performed together.  After the explantation with capsulectomy is healed, you can develop a plan for further surgery if it is warranted and is safe from a technical standpoint.  

Masto Revision

It appears from the limited pictures you have a purely vertical mastopexy incision pattern on both breasts, while the left breast appears to have a better shape than the right, being only 3.5 months out from a vertical mastopexy or reduction is still early in the post-operative period. The biggest downside to the vertical pattern is the resultant cone shaped breast the patient is left with for sometimes 5-6 months post-operatively. The upside is less scarring than the traditional boat anchor type incision. At this point seeking a second opinion from a properly trained plastic surgeon so he/she could examine you in person would be your best plan of action. Be sure that surgeon performs both vertical and anchor type mastopexies or reductions as they will be able to help you best(lots of surgeons in the united states do not perform pure vertical mastoepexies). As for replacing the implant or not, depends on how the breasts finally settle and if the volume you currently have is to your liking. good luck

#Explant #BreatImplantRemoval - mastopexy revision

Based on the photos you've provided, additional consultation(s) appear warranted.  Are both implants out?  If so, you can probably undergo a revision of the right, with conversion (perhaps) to an anchor-shaped incision pattern, without having to do anything else.  If not, then it may be worth putting an implant back in the right side for symmetry, although expansion of the tissue may be helpful.  Either way, it's difficult to handle this via this forum.  You should be seen by several board-certified plastic surgeons in person before you proceed with anything else.  I'm obviously very sorry for what you're going through.  Dr. Alan Engler, Member of #RealSelf500

Mastopexy revision

I'm sorry you have had complications after your surgery.  There is definitely room for improvement, so that's the good news.  At some point, reconfiguring your breast tissue and retightening of the skin will be helpful as well as some volume replacement.  This could involve placement of new implants, although you would probably do better with fat grafting to avoid a foreign body and focally replenish soft tissue in the lower parts of the breasts, particularly on the right side.Although you are probably anxious to get things fixed, this is not the right time.  Your breasts are still in an inflammatory state, and the scar tissue hasn't matured yet.  It would be wise to wait at least 6 months (preferably a year) from your last surgery in order to allow the tissues to soften, settle, and mature.  This will set you up for the best possibility of a good final result.  Your revision may require more than one surgery and should absolutely be performed by someone experienced and skilled in performing revisions.  Your original surgeon may be a good choice, or you may want to get a few other opinions depending on the situation.  I wish you the best with your future correction!

Robert Cohen, MD
Santa Monica Plastic Surgeon
5.0 out of 5 stars 39 reviews

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