I Feel Saline Implant Valve

Question

I have Mentor Saline HP Smooth Round 380 cc Implants filled to 450. They were placed by INF approach and placed dual plane. I can palpate a ridge, approximately the size of a quarter to the right of my nipple on my right breast and it's smooth in the center. I have already had several consultations with PS's and I have been told that I have bottomed out and have lateral displacement as well so I need revision surgery but was just wondering if this is normal?

Andrew P. Trussler, MD · Answer

Implant palpability is the most common difference in saline breast implants as compared to silicone breast implants. The deformity you are feeling may represent the breast implant valve. This could be alleviated with a change of breast implants from saline to silicone. please refer to a board certified plastic surgeon for this problem.

William Bruno, MD · Answer

This can happen with saline implants in certain cases. You may consider converting to silicone implants which do not have valves. Your tissue also may have thinned out which is contributing to the valve's prominence. A board certified plastic surgeon can outline a surgical plan for your revision.

	Best wishes,

	Dr.Bruno

Richard Baxter, MD · Answer

From your description it sounds like the implant has flipped back to front, since the valve is a small bump but on the back of the implant there is a patch about the diameter of a quarter with a ridge around the edge. More important is that if you can feel it, your tissue coverage is very thin despite the implant being under the muscle. You may wish to look into the option of a Strattice graft, which makes a sort of internal bra. This would support repair of the lateral displacement and bottoming out while also adding coverage.

Tom J. Pousti, MD · Answer

Thank you for the question.

	Yes it is possible in the rare  patient to feel the implant valve associated with saline breast implants. 

	Also, as you describe, one of the most common complications after breast augmentation surgery is implant mal-position. This occurs when the implant is in an incorrect position on the chest wall. This may include incorrect position of the implant superiorly (&ldquo;riding high&rdquo;), inferiorly (&ldquo;bottoming out&rdquo;), medially (&ldquo;symmastia or uni-boob&rdquo;) or laterally (falling outward into the axilla).

	Revisionary surgery may be useful and often involves the use of internal sutures ( capsulorraphy)  or opening a breast implant pockets (capsulotomy)  as the patient specific circumstances warrant.

	 I hope this helps.

David Bogue, MD · Answer

In thin individuals with overfilled saline implants, the valve can sometimes be felt. As for the bottoming out and lateral displacement, it sounds as though your overall tissues are not supporting the implants very well. Consider the use of a dermal matrix (Strattice) to provide an "internal bra" for longer term support. If your muscle has window-shaded and the overlying breast tissue is quite thin, the Strattice can also help camouflage the implant valve. Switching to gel implants will also eliminate the valve issue. Best of luck.

Darryl J. Blinski, MD · Answer

Feeling the anterior valve is the norm in slender individuals. As for re operation you posted no photos so can not advise.

Barry L. Eppley, MD, DMD · Answer

It is possible you are feeling the valve of the saline implant or you may be feeling scar tissue that has attached to the valve. Either way, your remaining breast tissue must be fairly thin to be able to palpate it. There is no harm to the implant or your breast because it can be felt. Given that you may be considering revisional surgery for implant repositioning, it may be wise to consider changing to silicone implants. Silicone implants are not manufactured with valves in them since they are prefilled. Given that you can feel the saline implant valve, it is likely you may be able to feel some implant rippling as well or will so in the future if further breast tissue thinning occurs.

Steven Wallach, MD · Answer

Saline implants have exactly waht you describe a valve that is the size of a quarter where you will feel it below the nipple or to the side.  Silicone implants do not have this.

John P. Di Saia, MD · Answer

Hello,

	 

	It sounds like the tissue coverage you have is thin. Your implants are likely too large for that coverage. A change to gel might solve the problem to an extent as well as downsizing your implants. You need to be evaluated to ascertain your options.

	 

	Best Regards,

	 

	John Di Saia MD

Peter E. Johnson, MD · Answer

The valve on a saline breast implant is on the back side, and even if the implant has turned over it should be very difficult to feel the valve. Your breast must have thinned over the overfilled saline implant. A silicone gel implant will be a better choice if you choose a revision.

	Best of luck,

	peterejohnsonmd

I Feel Saline Implant Valve

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