Implants never dropped. What can I do about this? (Photo)

Question

I had silicone implants replacing saline with a lift 5 years ago. They never settled into place. I recently lost weight and it’s now very visible.

Matthew S. Kilgo, MD · Answer

Hello, thank you for your question.Based on your photographs, you have a “waterfall“ deformity. This occurs when the breast is not centered over the most projected portion of the implant. Your weight loss likely made this condition worse. I would recommend a revision augmentation mastopexy. This would likely require repositioning (lowering) the breast implant by releasing portions of the muscle/capsule and revising your breast lift. You should choose a surgeon certified by the American Board of Plastic Surgery who has considerable experience with revision breast surgery. hope this helps. Good luck.

Daniel Barrett, MD · Answer

Dear Gigijojo,

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, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Edward Daniele, MD · Answer

Most likely there is some form of capsular contracture going on, especially since you underwent an implant replacement (assuming you had saline implants for some time before the silicone exchange). IT is also important to know the location of the implants (whether above or below the muscle). 
If this is from the capsule being hard or too tight, then it most likely needs to be either opened up or removed. The implant can then be replaced and can settle in a lower position. If this is a skin laxity issue (judging from the photos and in combination with weight loss I would say this is the more likely culprit) then you need a breast lift. After weight loss the tissues are stretched and even a lift may not put the soft tissue back to their original place. In addition each surgery around the nipple and areola decreases the blood supply and puts the risk of nipple necrosis (total or partial) higher.

Wayne I. Yamahata, MD · Answer

You have options for treatment at this point. The implants can be repositioned in a lower direction, or the breast can be lifted further, or both. To determine the best course of action would require an in-person examination of your breasts and implants. I would suggest beginning by returning to your surgeon for evaluation. Otherwise seek a consultation with a board-certified plastic surgeon

Gerald Minniti, MD, FACS · Answer

You will need to be examined by your surgeon to determine if a surgery to remove all the scar capsule or just some of it would be appropriate to allow a new set of implants to sit in the right location on your chest.

Connie Hiers, MD, FACS · Answer

I suggest going back to your surgeon or a new one to adjust you pocket so that the implants can settle. Your capsule is too tight.

Hilton Becker, MD · Answer

Your implants appear to be above the muscle, the muscle is holding them up.
You could either lower the  implants, place them above the muscle or revise the lift

Darryl J. Blinski, MD · Answer

Based on your posted photos, you have a few issues implants riding high, could be due to capsule contractor scar formation placement under muscle, too small of implant, and also not enough tightening or uplift of Lyft event. Best of virtual concert with expect to have a full revision either lowering the implants or exchange implant size or both again best of virtual concert with expected fees range from $5000-$10,000

Implants never dropped. What can I do about this? (Photo)

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