What is wrong with my breasts? What kind of revisions do I need? (Photo)

Question

I had my Textured implants replaced and lifted on 6/24/2021 with round 385 cc smooth silicone. The first few months they looked great . Around six months they were still sore and started to change . Eight months post op I’m now seeing capsular contracture in my left breast and heavy bottom weight in right. My right bothers me. I have an upcoming appt with my surgeon. From pictures he says I have CC on the higher up left implant. What do you see happening ? My right ? My left ? I feel deformed.

Dana Goldberg, MD · Answer

I’m sorry you’re having trouble with your breast surgery. Unfortunately this can happen. The left definitely has capsular contracture. To treat this, I remove the whole capsule, replace the implant, and use a graft to cover the bottom of the implant.

I suspect on the right that your implant has settled below the muscle, so that the muscle is tightly pushing down on the implant. This can sometimes be addressed by reporting the muscle and using a graft so the muscle doesn’t pull up too high again.

Your surgeon is probably the best person to address this, but if you don’t trust your current doctor, go to someone who does lots of revision surgery.

Luis A. Mejia, MD · Answer

Dear lsara22, thanks for sharing your pictures and questions, analizing your case you seem to need a revision, breast lift and maybe implants exchange but this must be determined after an in person evaluation. Make sure you go on consultation with a board-certified plastic surgeon. Hope this helps and best of lucks. Dr. Luis Mejia

Donald R. Revis Jr, MD · Answer

Good morning,
You do have some encapsulation of your left breast and bottoming out of your right breast. So the left needs a capsulectomy and exchange, and a sheet of Strattice mesh would be good to help prevent future encapsulation. On your right side you need the Original Internal Bra to correct your bottoming out, and a sheet of Strattice mesh on that side would also help prevent the bottoming out from happening again.

Gerald Minniti, MD, FACS · Answer

One side is contracted, the other has expanded too much. You'll need capsular tightening with mesh on the dropout side, and a total capsulectomy with mesh support on the contracted side. All surgery should be performed via an inframammary incision to avoid breast tissue in the wounds. Once that has been completed, you could get scar revision in the same surgery.

Gary M. Horndeski, MD · Answer

The technique I recommend is explantation with lift using The Bellesoma Method. The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage. Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained if not injured during your previous surgery. Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear lsara22,
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

Connie Hiers, MD, FACS · Answer

You have sagging from the weight and appear to have a capsule that has formed. I would suggest another capsulectomy, going with smaller implants, and another lift.

Darryl J. Blinski, MD · Answer

Yes appears as recurrent severe capsule formation is occurring. Best to seek only in person evaluations from boarded PSs. Multiple capsule formations indicated you might need implant removal and use of fat grafting only?

What is wrong with my breasts? What kind of revisions do I need? (Photo)

Answers (8)

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