Do you think the 580cc or 610cc will be placing to much stress on the internal bra sutures. (photos)
Doctor Answers 6
Stress on Internal Sutures?
Not only do you have synmastia, but your implants are also bottomed out. These problems would imply that your tissues are not strong enough to support the implant. Correction of synmastia is not an easy revisionary procedure and will often require the use of reinforcing materials such as Strattice if the tissues are thinned and weakened (as is usually the case). Recurrence is not unheard of. Trying to increase your implant size by 180-210 cc is asking for trouble. Gel implants are more forgiving than saline implants but there are limits. You cannot exceed the base dimensions of your breast by large amounts without dramatically increasing your risks of other problems. In the long run you would be better off by accepting a more modest cup size then run the risk of recurrent synmastia or other problems down the road.
Symmastia repair and exchange to larger implants??
I personally would repair the symmastia and not change to such a dramatically larger implant to reduce the risk of recurrence. Regards,
Jon A Perlman MD FACS
Certified, American Board of Plastic Surgery
Extreme Makeover Surgeon ABC TV
Best of Los Angeles Award 2015, 2016
Beverly Hills, Ca
Stress on bra sutures.
IMO you are focusing on the wrong primary issue..size. The first concern for me would be to correct the symmastia whether using internal capsulorraphy or allograft material. Once this is done, then I focus on the size and dimension of the implants to fit your new corrected pocket. To me the most important issue is how to protect you from having the same issue in the future. You look like you keep your body in shape and are thin so be careful with the size you choose. Hope this helps and not confuses you more.
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It would be wrong for anyone to recommend a larger implant to be placed simultaneous to a symmastia repair or malposition surgery for a complication attributable to an oversized implant in the first place. So the answer is any implant larger than the one you have will put additional stress on the repair and increase your risk for recurrence. And in fact, going smaller would increase the probability of success. Other than that, you look to be a good candidate for a neosubmuscular pocket, perhaps more reliable than a capsulorrhaphy with or without mesh.
Best of luck!
Why complcate your procedure
by adding volume to your implant? Focus on fixing the medial poles and enlarging the pockets lateral to provide you the chances for the best outcome possible. If you still truly need a larger size, implant selection can be more accurate as your medial pockets are not to be disturbed once they are healed after symmastia surgery.
Best breast implant for me; revisionary breast surgery?
Thank you for the question and pictures. I think that you will benefit from the planned revisionary surgery. In my practice, I would also suggest that you address inferior breast implant displacement ( bottoming out) during the revisionary breast operation. I generally select breast implants size/profile once the necessary repairs have been made (fix the "foundation" first), careful measurements have been made (dimensional planning) and careful consideration has been given to the patient's goals. I tell patients undergoing this type of revisionary surgery that safety (avoidance of complications such as recurrent implant displacement) should be everyone's first concern. Size concerns are secondary.
In my practice, I have had the most success with these types of revisionary operations utilizing capsulorraphy techniques along with the use of acellular dermal matrix (to support the attenuated tissues along the medial/cleavage and/or lower breast poles).
You may find the attached link, dedicated to this type of revisionary breast surgery, helpful to you as you learn more. Best wishes.
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.