Hello: I had a primary breast augmentation in July - 500cc smooth silicone under the muscle through the areola. Developed capsular contracture in my left breast and my right has dropped below the point where I liked it. I am also attaching a picture from before anything was done to me. I want both my breasts to look like my right did at 2 months after the surgery (refer to picture). Any way to achieve that without doing a lift? Why did the right drop so much if it wasn't droopy before? Thanks!
Do I Need a Lift 7 Months Post Implants? (photo)
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Doctor Answers 16
Revision after capsular contracture.
There are multiple issues that are apparent from your photographs. The left breast has an obvious capsular contracture. Release of this contracture and repositioning of the implant will certainly improve this area. The right breast is ptotic due to the heavy nature of a 500cc implant. Implants of this size are going to cause the breast to drop due to gravity. The use of a dermal matrix such as Strattice can help support the implant by providing an "internal" bra. In addition, the use of Strattice in the left breast should also lower the recurrence risk of capsular contracture.
Raise Breast Without Breast Lift?
Thank you for the question and pictures.
In order to raise the right breast implant It may be possible to support the lower pole of the right breast with internal sutures (capsulorapphy) plus/minus the use of a cellular dermal matrix. The left breast encapsulation should also be addressed to improve symmetry of the breasts.
You may find the attached link helpful.
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Breast lift after 7 months implants?
Actually, I would have tried to talk you out of having implants. Few women have the breast volume that you had for your frame. Then, if you insisted, I would have recommended much smaller implants. There is no muscle in a breast, and the pectoralis muscles do not cover the lower part of the implants. Think of sand in a sock. More sand causes more sagging. You will not get the shape of your breast like your photo at two months.
My suggestion is to reduce the size of the implants and correct the capsule contracture in the left breast. Additionally, when larger implants encapsulate, the deformity is much more obvious. I would recommend against an uplift. Your nipples are above the crease under the breast which is the usual benchmark for an uplift. Plus an uplift leaves scars that you may not like. Some day you may need an uplift, but not for several years, in my opinion. To me the right breast looks much better and natural than the left. Best of luck with your decision and result.
Do you need a lift
I think the implant on the right has moved out from under the muscle due to its size and that has allowed the right breast to sag. I do not think that a surgery on the left alone will get you symmetrical. Something will need to be done in order to place the implant on the right higher. You might possibly get away without a lift if both implants are removed and replaced in a new pocket in the subglandular plane, but it will not look exactly as your 2 month post op photo does.
The Challenge of Capsular Contracture
Despite all best surgical efforts capsular contracture can alter the early pleasing results of breast augmentation. Your photographs are consistent with left capsular contracure and it appears severe enough to warrant capsulectomy. The right breast has dropped due to the effect of breast implant weight and gravity. If it was not for the left capsular contracture your left breast would likely have dropped as well. The risk of this effect increases with larger breast implants. Potential options for the dropped effect could include smaller breast implants and/ or breast lift. Discuss your concerns with your plastic surgeon and consider a second opinion by one certified by The American Board of Plastic Surgery.
Do I Need a Lift 7 Months Post Implants? (photo)
Thanks for the series of posted photos. This demonstrates the progression of the left capsular fibrosis and the need for better follow up with the surgeon to try and to have avoided this. Now you could benefit from left calsular release and possible lifting. Better to be seen in person in a few additional consults. Follow up on your results and plan.
Uneven after BA
Your right breast reacted the way I would have predicted. it filled out in all areas nicely and dropped because of the weight of the implant. I would not have recommended that size, but, for that size, your right side came out nice. Your capsule contracture or incomplete dissection has prevented the implant from coming down. You will need a revision to release the implant from below and would be most successful from an approach at the infra mammary crease, even though it means adding another scar.
The picture of capsular contracture
Your photo series is an excellent example of how capsular contracture appears and progresses. Your breast started out well, and as contracture set in the implant rounded up and pushed upward distorting the breast. You will need the capsule corrected, but a lift is not necessary. Do you need implants? The befores might cause envy for some.
Best of luck, peterejohnsonmd.com
Breast Implant Asymmetry
I am sorry about your problems you are having with your breast augmentation. Unfortunately, you are experiencing two of the most common problems women have after breast augmentation: capsular contracture and implant malposition. I can tell you with absolute certainty that both complications could have been averted if a properly sized implant was chosen for you. Plain and simple, 500 cc is too big for you, and if you have a revision surgery keeping the same sized implant, you will probably have further complications subsequently.
Your right implant is completely subglandular now that it has dropped to this unpredictable position, causing significant tissue expansion in the lower pole of the breast which is difficult to correct. The internal capsule will need to be sewn together, possibly with a reinforcing material called acellular dermal matrix or ADM, which is more expensive than the breast implant. Your left implant is will need a removal of all the scar tissue to minimize recurrance of the capsular contracture. ADM might be useful there as well, as it has been shown to decrease the recurrance of cc.
Your problems are not easy to fix and even in the most experienced of hands, you may not get a perfect result. You should see a few surgeons with great reputations for revision surgery. These doctors will of course be certified by the ABPS and also be members of the ASAPS.
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.