What happened to my implants? Upset with results, revision and advice needed (Photo)

Question

I had very tuberous breast. I got a donut lift with 265cc implants under the muscle with mesh. The results looked okay at first but over time the implants shifted far apart from each other and now there is a crease on my right breast. When I lay down, my implants fall off to the sides near my armpits. I'm only one year post op and I already need a revision. What could have caused this and what do you think could be done to prevent it from happening again?

Daniel Barrett, MD · Answer

Dear ana789,
though rare, some women who undergo breast augmentation will develop a minor deformity known as a “double bubble,” in which additional folds appear underneath the breasts due to the implant accidentally shifting or contracting post-surgery. In most cases, the implant simply slipped too far down the chest wall and traveled behind the breast inframammary crease (the area where the lower breast meets the chest), instead of moving forward to fill the breast cavity. If left untreated, the lopsided implant will form unnatural indentations, resulting in an odd “four-breast effect” rather than the full, rounded chest the patient initially desired.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Gianfranco Frojo, MD · Answer

This is a poorly addressed tuberous breast deformity. There is a tethered peri-areolar (around the areola) scar on the right with a double bubble deformity due to inadequately release native inframammary fold tissue. I would recommend a breast revision with implant exchange, pocket work (capsule tightening/support), releasing scar tissue/native IMF, and a potential inferior mastopexy.

Gary M. Horndeski, MD · Answer

The mesh that was used was more than likely absorbable and after 1 year the support was lost from it. Your pockets are too large which has allowed the implants to displace inferiorly, laterally and also creating the crease. You will need another circumareola approach to plicate the pockets inferiorly and laterally and place smaller implants.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Sean Fisher, MD · Answer

tuberous breast correction is a difficult surgery. Based on your before photos and severity of your tuberous breast deformity it appears that your surgeon lowered your native IMF to allow for added space for the implants. When this is done, typically the old fold is released internally. However, the native IMF is a often very robust and can persist after surgery which appears to have happened in your case. Additional internal radial scoring may be needed to attempt to further release this area. 
Sean Fisher Aesthetic Plastic Surgeon

Connie Hiers, MD, FACS · Answer

tuberous breasts can be very challenging and usually need more than one procedure to correct. Your lateral pockets can be tightened so that the implants do not shift too far to the sides. For the breast with the crease, your more narrow-based breast, more tissue medially needs to be released. Using a tissue expander initially would have been helpful to widen this breast base.

Darryl J. Blinski, MD · Answer

Based on your posted, photos appears you now have a double bubble effect on one breast. One option for correction would be releasing the denting and crafting versus complete revision of breast and replacement implants in the dual plane position from sub muscular position. Best virtual consult with Silver could be determined which would offer the best option. Fees, respectively or $5000-$10,000. Again, best of virtual concert with.

What happened to my implants? Upset with results, revision and advice needed (Photo)

Answers (6)

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