Lateral implant displacement. Can revision be done under local sedation?

Had 500-cc implants replaced with 325-cc, over the muscle silicone, almost 3-weeks ago. Experiencing lateral displacement of right breast. How soon after initial breast augmentation can you have revision surgery to repair lateral displacement. Can it be done under local sedation?

Doctor Answers 11

Lateral Implant Displacement. When and Under Local/Sedation?

The answer is, it depends on what was done. Was there a change from under to over the muscle with a new implant pocket? If so then it would be best to wait for about 6 months for the capsule to mature because this is what will need to be repaired or sutured to correct the problem of lateral displacement. If the old capsule is still present and wasn't significantly disrupted during the downsize procedure, then potentially the revision could be done at any time.

If the revision is simply a matter of suture tightening of the capsule or capsulorraphy, then this potentially could be done under local with sedation, along with the caveat that only it your surgeon has experience and is comfortable with doing this.


BCS

How long do I wait before breast revision

Breast revision really depends on what type. It can be done under local anesthesia with IV sedation. 

Edward J. Domanskis, MD
Newport Beach Plastic Surgeon
4.4 out of 5 stars 27 reviews

Lateral displacement of breast

Lateral displacement or malposition of breast implants is very common. It is unusual so soon after surgery. I agree with the other opinions that you should wait about 6 months before performing a revision. When you go in too soon, the tissues still have swelling and inflammation and don't hold sutures as well, so the repair has less chance of being successful. I have performed hundreds of these types of surgeries - capsulorrhaphy, and when done in the right setting, they are very successful. This type of surgery is best to be performed under general anesthesia, but could also be performed under "twilight" sedation with an anesthesiologist.  Best of luck to you.

Paul E. Chasan, MD
Del Mar Plastic Surgeon
5.0 out of 5 stars 33 reviews

Lateral displacement of implant

You want to wait at least 6 months post surgery before considering a revision to help allow your tissues to to fully settle and heal.  In the meanwhile I would recommend really good bra support (like underwire) day and night so that as your body is healing from surgery it can hopefully improve.  At 6 months post surgery if you are still having this issue then you should seek opinions from Board Certified Plastic Surgeons in your area that specialize in revision breast surgery.  Best of luck to you.

Milind K. Ambe, MD
Orange County Plastic Surgeon
4.8 out of 5 stars 35 reviews

Lateral Displacement after Breast Augmentation

From your description, you would need to wait at least 3 months to have any intervention to tighten the pocket. Normally this is recommended to help address the smaller width of the implant at the time of the implant exchange. Operating too soon doesn't allow for the tissues to adequately heal and tolerate a second operation. 

Continue to follow up with your surgeon to ensure that you progress as planned.
Best of luck,
Vincent Marin, MD
San Diego Plastic Surgeon

Vincent P. Marin, MD
San Diego Plastic Surgeon
5.0 out of 5 stars 42 reviews

Complication after Revision Breast Augmentation

Hello,

It really depends on what was done in your last surgery.  If your surgeon did a simple removal and replacement without touching the capsule (which is a very likely possibility given your current problem), then you can go back to the operating room tomorrow.

It is unlikely that sedation or local anesthesia alone will keep you comfortable. 

Best of luck!

Gerald Minniti, MD, FACS
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 79 reviews

Lateral implant displacement. Can revision be done under local sedation?

Hi and sorry to hear about your problem. 3 weeks is much too early to consider revisionary surgery as it takes at least 3-4 months for the implants to settle into a stable position. Revisions of this sort can be done under local in certain circumstances but usually under a general anesthesia as the area may be difficult to anesthetize completely. See your surgeon to discuss your options and good luck.

Richard Chaffoo, MD, FACS, FICS
Triple Board Certified Plastic Surgeon

Richard Chaffoo, MD, FACS
San Diego Plastic Surgeon
4.7 out of 5 stars 16 reviews

Breast surgery

 Everything can be done under local with some sedation however with that being said I would never do a breast revision without using general anesthesia. The reasoning for that is that there is work being done under a muscle and I prefer using muscle relaxation to avoid complications and discomfort to the patient. I would highly recommend you to have the procedure done under general anesthesia. 

Lateral displacement

Thank you for the question and alot depends on what was done at the last operation when the timing of the second should be performed.  So see your surgeon and get his opinion as he knows what was done or get your records and get a second opinion from another expert in the area.

Dr. Corbin

Frederic H. Corbin, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 59 reviews

Lateral implant displacement.

I'm sorry to hear about the problem you are experiencing after revisionary breast surgery.  There are no "rules" when it comes to timing for revision breast surgery;  in my practice, I generally ask that patients allow for several (ideally 6 at least) months to pass  before evaluating the outcome of the procedure performed.  Doing so will allow for additional surgery to address any concerns you have on BOTH sides. Also, in my practice, I would not do additional revisionary surgery (that involves adjustment of the breast implant capsules and exposure of the breast implants) under local/sedation.

Generally, the lateral breast implant displacement can be corrected using an internal suture technique, decreasing the size of the pockets and moving the implants toward the midline. In my practice, I use a 2 layered suture technique to close off the space laterally (towards the axilla). The use of acellular dermal matrix is an option ( although not usually necessary) especially if significant implant rippling/palpability is present.

I hope this, and the attached link, (dedicated to revisionary breast surgery concerns) helps. 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.