Can areola caved in after breast explant be fixed? (photos)

Question

I got my 400cc implants removed after 20 years. Now on one side, the areola is wrinkled up and sunken in. Is this fixable without putting in implants again. Is it possible to just remove and restitch sthe skin? I saw on other posts that fat grafting was an option, but I don’t have much body fat.

Darryl J. Blinski, MD · Answer

Best to virtual consult with... to see if you have at least 500 cc of fat? Best treatment is fat grafting in few sessions if needed. Fee for initial lipo and fat grafting $4,000 to that 1 areolar denting.

Mats Hagstrom, MD (license on probation) · Answer

Unless there is some thing unusual in your history these type of outcomes come from contracting scar tissue that distorts the contour of the breast. It would be important to know for example if you had any secondary breast surgeries or just one breast augmentation without provisions. It would also be very important to know if you had a capsular contraction. What is your capsule removed with the implant procedure called capsulectomy. Placing an implant by itself will not distort your breast but scar tissue internally can. To get your breast looking normal the scar Ti needs to be removed. Was the breast implant removed following the same incision as the primary augmentation?
Most likely you have a capsular contraction and need a full capsulectomy which would’ve been much better to do during the explantation. Perhaps your doctor did a partial capsselectomy?
I don’t think fat transfer is going to fix anything. It could add some volume to your breast but most likely going back in and trying to remove all or as much as possible of the square tissue is your best option. That is not as easy to do once the implant has been removed. Taking out the capsule is easier done with an implant in place. A surgeon can put in a temporary implant during surgery to stretch out the capsule and make the capsulectomy a little easier. Temporary implants are called sizers.
Different plastic surgeons have different approaches and different levels of skill when it comes to handling implant removal and capsule work. Doing a complete intact capsulectomy is time consuming meticulous and can be challenging especially through a small incision.
I’m guessing you had an areola based incision?
Finally, what it doesn’t necessarily change the situation it is always a good idea to have before and after pictures despite how many years you have the implants available for surgeons to view when assessing your current situation. it would be helpful if you had your before and after pictures for the last surgery to see if perhaps you had a capsular contraction that may not have been disclosed to you. A capsule contraction makes the implant feel hard and distorts the shape of the breast.
If you’re going to have another procedure then you should look long and hard for plastic surgeons whose practice is devoted almost exclusively to breast surgery. for example Dr. Tom Pusty in San Diego is a plastic surgeon who is extremely good at breast surgery.
Best,
Mats Hagstrom MD

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Can areola caved in after breast explant be fixed? (photos)

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