Implant high - massage w/mesh? (Photo)

Question

Implant rupture in March 2024 w/replacement to HP silicone and bilat. capsulorrhaphy. Right breast was the one that ruptured and after revision bottomed out. Revision done September 9, 2024 w/mesh and popcorn capsulorrhaphy revised and now w/the revision to the right breast it's sitting high compared to the left w/ no mesh. PS recommends massage and no underwire bra. Will any of that help it relax to be similar to the left breast? Concerned my PS over corrected the bottoming out.

Gary M. Horndeski, MD · Answer

Creating symmetry is the hardest thing to achieve. From your photographs, it appears your implants are large and heavy. This has lead to additional mechanical loading that has resulted in bottoming out. One side has mesh and the other does not so you have asymmetrical support mechanism of your breasts. I recommend you wait 6 months before doing any other revisions. You may benefit from smaller implants.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Dana Goldberg, MD · Answer

Your photos are too close up to really tell anything. I can say that it is common for “bottoming out” repair to fall again, so it’s common for surgeons to slightly over correct. I sometimes encourage my patients to wear a bandeau or massage as your surgeon suggested. It’s early enough that there is definitely a chance of it becoming more symmetric with the other side. If it’s not, I urge caution about going back in. Revision can be unpredictable, so if they are close by 3-6 months after surgery, I recommend leaving well enough alone.

Connie Hiers, MD, FACS · Answer

You might get improvement with oral Accolate and external ultrasounds treatments to help soften the pocket since you are still healing from surgery. Please go back to your surgeon and discuss your concerns.  Your photos are limited since you do not show the full view of your breasts. I cannot be specific about your inferior pockets since they do not show.

Darryl J. Blinski, MD · Answer

Based on your posted photos that are too close up and do not show the full breast. I would recommend exchange the smaller implant with a larger implant, high profile and fat crafting after some Lipo to the inferior pole of that side. But best of virtual concert with to really see your breast. Expect feeder range from $8000-$16,000. Again best to virtual consult with.

Mark Eberbach, MD · Answer

Unfortunately, you did not provide adequate history or photos to answer this question.

Need pre op and post op from each surgery with views of the entire chest front and both sides.

Having said that you need at least 6 months to determine final resting place.

Mats Hagstrom, MD (license on probation) · Answer

Implants come with issues and the best way to minimize the chance of needing revision surgery is to have it done right the first time and avoid using excessively large implants.
Large diameter implants increases the chance of implants bottoming out, which is one of the most difficult situations to correct without needing more surgery.
 Continue following up with your surgeon or schedule in person second opinion consultations.
For second opinion, consultations come prepared bringing with you a complete set of all before and after pictures for each of your previous operations and copies of the operative reports for each of your previous surgeries. These are all part of your medical record that you can request from your providers office.
In order to give you a quality assessment we really need to understand the complete history, including every previous operation.
 Your current provider has a big advantage in knowing your history.
Patients either need to maintain continuity of care or switch providers, which is a big undertaking.
There is no yes or no answer to your question or easy solution other than wait-and-see and consider another revision if you’re not happy with the outcome. Provider selection is the most important variable end of the hands of the right plastic surgeon. The chance of undesirable complications or need for revision surgery is reduced.
Implant selection is also a really important part of the process, including the chance of needing further surgery.Mats Hagström MD

Implant high - massage w/mesh? (Photo)

Answers (6)

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