Breast implant revision #4 - Can I upsize and will removing capsules be beneficial?

Question

Hello, I had two previous breast surgeries 1- 330 cc 3- 450 cc , I am unhappy with result I really want to go bigger and have fat graft will going bigger ( third time ) will leave me having capsular contracture? I don’t want to go extremely big 550-600 max with little fat has anyone had patients with three / four revisions for upsize and they kept their implants for long time? I really want to do it and will removing capsules beneficial in my case for third time

Daniel Barrett, MD · Answer

Dear munirah97x,
breast revision surgery is the most difficult plastic surgery procedure performed. Botched breast surgery alters normal tissue planes and laxity, the ability of breasts to heal properly, and leaves scar tissue that dramatically affects the level of difficulty of the corrective surgery.Many patients come in to correct poor outcomes from their initial surgeries. The most common problems are due to implant malposition, bottoming out of the implant, poor scarring, and incorrect implant size.While the type of revision required will depend on the result of the previous surgery and the desired result of the patient, some revisions involve extensive pocket repair that may or may not need specialized external bras.If you are considering breast surgery revision, you should speak with a board certified plastic surgeon and have yourself properly assessed. Only after a thorough examination you will get more information and recommendations. Also, you have to make sure that your surgeon understands your breast augmentation goals.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

John L. Burns Jr., MD · Answer

Unless you have a capsular constracture there is no reason to remove the capsules as this can weaken your soft tissue support.  If you go bigger I'd suggest an internal mesh bra to provide support and prevent bottoming out.

Connie Hiers, MD, FACS · Answer

Each time you chose to go larger, you are thinning and stretching your own tissue. Leaving the present capsules can provide some strength to your tissue.  Most women cannot support 550-600 cc implants long term. You did not mention your height or weight or how much initial breast tissue you had, so I cannot be specific.

Mats Hagstrom, MD (license on probation) · Answer

Breast documentation outcomes are usually based on three variables.
The first is the patient’s candidacy for breast augmentation.
The second variable is implant selection.
The third variable is the surgeons ability to put the implant in the correct anatomic location. 
Next, anytime we use excessively large implants the chance of undesirable side effects, complications and need for further surgery will go up.
I have no idea if you need a cap select me or if you need a third procedure.
Follow up with your plastic surgeon or schedule a few in person second opinion consultations.
 For second opinion consultations come prepared to bring with you the complete set of before and after pictures for your previous operations and operative reports for all your previous procedures.
This should be part of your medical record that you can request from your providers.
Best,
Mats Hagstrom MD

Breast implant revision #4 - Can I upsize and will removing capsules be beneficial?

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