How did my revision fail? (Photo)
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Doctor Answers 5
You may have thin capsular tissue
Thank you for the question. There are many reasons for recurrent bottoming out. In cases where direct suturing fails, often a acellular dermis (Alloderm, Flex HD) or a biologic mesh (Seri) are a little costly but needed to help the repair hold long-term.
Internal bra for recurrent bottoming out
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Revision Surgery Failure
I am so sorry that you still have this problem! There is a small minority of women that have the opposite problem to capsular contracture; they make too little scar capsule to support the implant. I would say that any revision surgery you have should be different than the one you just had, obviously.
Only your surgeon would know the details of what he did, like what type of suture, how many sutures, or any other surgical manipulations of the capsule. Based on those details, the surgeon could then decide on what additional measures should be taken. The most obvious would be to use a larger, braided, permanent suture, with multiple rows of stitches to encourage scar formation. Another change might be to include a product called 'acellular dermal matrix' or ADM like Alloderm or Strattice to reinforce that capsule walls. This product is very expensive, unfortunately. Finally, you may want to consider changing to a textured implant, preferably silicone gel or form-stable silicone gel to help with adhesion of the implant into the pocket.
I hope that the third time is the charm, and I'm very sorry that you've had to go through this experience.
Best of luck!
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.