Options to correct deformity after breast explant? (Photo)

Question

Breast explant and capsulectomy 5 months post. I'm happy with the outcome of my left breast but the right one is folded over by what seems like an adhesion just under areola. I know that I don't want to stay this way and also don't want replacement implants. What are my options for fixing this issue without implants?

Jed H. Horowitz, MD, FACS · Answer

hello oceanratts  This occurs when the breast fold is in the correct position, however, the length of the tissue between the nipple and the fold stretches. This may be due to the patient’s soft tissue inelasticity and/or the size or shape of the implant that is used. Skin laxity can change with age, pregnancy, weight changes, or heredity.Correction of this problem usually includes skin excision as part of a mastopexy (breast lift/reshaping).
It may be necessary to use ADM to further support the breast tissue if too thin. #deformity #post-op

Kenneth Hughes, MD · Answer

Based on your picture this can probably be fixed with fat transfer to the breast, an in person consultation with a board certified PS would be best. Good luck!

Jeffrey D. Wagner, MD · Answer

This is a difficult and not uncommon problem after explantation, especially if infection or a seroma occurred.  I'd recommend you consult with an experienced breast plastic surgeon.  You may require combinations of scar massage/release, mastopexy, fat grafting, or vascularized tissue transfer to improve the size/shape of the left breast.  Of course, replacement of an implant might be a simple option as well.

John Michael Thomassen, MD · Answer

You would need to undergo a surgical procedure to release the scarring that is causing this fold and maybe use fat grafting to make up for any lost volume in the lower pole.  Massaging the breast in the meantime can help.

Nelson Castillo, MD · Answer

Thank you for sharing your question and photographs.  Without the use of implants I would advocate opening your previous incision site, releasing any scar tissue that may be "tethering" your tissues and perform fat grafting to the area to improve the soft tissue quantity.  Hope this helps.

Benjamin J. Cousins, MD · Answer

Thank you for your post and photo. It is best to see a Board Certified Plastic Surgeon in your area who can examine you and discuss with you a variety of options including massage, fat grafting, breast lift and others.Sincerely,Dr. Benjamin J. Cousins MD Board Certified Plastic Surgeon

Robert Whitfield, MD · Answer

There certainly can be issues regarding the healing after implant removal.  I have sen this improve with scar massage.  If there is a persistent area then it can be treated with fat grafting.  Lifts can be discussed as well.

Eric Desman, MD · Answer

Indeed it looks like you have some scarring causing the tethering. Obviously this needs to be confirmed with an exam at a Board Certified Plastic Surgeon's office. Fat grafting will likely be a good adjunct to help with the final outcome.

Camille Cash, MD · Answer

If it is determined that scar tissue is causing the deformity it can be released surgically.  At that point you may wish to also consider some fat grafting to improve overall shape.  I recommend meeting with a board certified plastic surgeon in your area for a consultation.

Steven Wallach, MD · Answer

It looks like you developed some scarring that has pulled in you breast a bit.  Best to be evaluated in person.

Options to correct deformity after breast explant? (Photo)

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