Inframammary Fold Collapse?

my breast implants were replaced in June after 21 yrs left side had collapsed due to free leaking silicone my doctor reattached the mammary fold to my rib bone.( very painful) right side was fine just had leaked inside itself, so he just replaced the implant he did not use any drains one month after surgery the right mammary fold collapsed he just keeps saying he does not know why, but says he did not attach it to my rib bone like the other side because it did not need it what is your opinion

Doctor Answers 5

Implant Replacement Collapsed

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Thank you for your question. When there is a gel leak, different approaches are sometimes needed to remedy the situation. If the cosmetic result is fine, then thank your doctor for making a good decision. Surgical decisions are all about the right decision for the specific location, which may be different than the opposite side. If they are a Board Certified Plastic Surgeon, they have had extensive training to treat this kind of situation. I hope this helps.

Fold Issue

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Inframammary fold issues can be a problem especially with larger implants. A proper evaluation of the problem really needs to be addressed in the office during consultation to give an adequate response.

Right Fold Collapsed after Remove and Replace

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   If the right side just underwent remove and replace, then the fold should not have collapsed unless a larger implant was selected or unless extensive removal of silicone granulomas or capsulectomy was performed, which may have been necessary.  If you had capsular contracture before surgery and this was holding the implant higher, then removal of that tissue may very well cause the fold to collapse after years of unrecognized tissue laxity. 

   At any rate, the right fold can be repaired.

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Implant bottoming out

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Bottoming out or inferior displacement of the implant violated the infra-mammary line.

The cause of downward migration of the implant can be of several reasons.

1: too big of an implant

2: surgical error of destroying the inframammary line (violation of the fascia holding the inframammry line)

3: Unrecognized preexisting low infra mammary line

4: very lax tissue

these are some of the reasons. correction can be done by several methods

sutures at the inframammary line. This has a high recurrence

Capsule used as a plap to support the sutures. Use of acellular matrix to support the repair.

Samir Shureih, MD
Baltimore Plastic Surgeon

Inframammary Fold Collapse?

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Some photos would help, since I am now quite comprehending the problem. You use the term collapse to describe a leaking implant, which I understand. But I don't get what has happened to the fold. Please consider reposting this question with a photo attached, preferably from before the recent surgery and now. Thanks, and best wishes. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon

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.