Should I just explant? (Photos)

Dear Energetic425057,

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

I would recommend switching the implant to a dual plane submuscular pocket; I would also recommend adding Galaflex for soft tissue support. You would likely need to upsize in size slightly to help fill out the soft tissue envelope. I would also recommend a drain to manage the dead-space from switching planes. You need to see an experienced plastic surgeon with extensive knowledge of revisionary breast surgery.

You have a failed breast augmentation as well as an anchor pattern. One thing to consider at this time would be explantation, fat transfers and scar revision. Fat transfers are usually good for 1 cup size change, which is about 150 cc. You appear quite thin but fat can be obtained from the abdomen, hips or thighs.

Best Wishes,

Gary Horndeski, M.D.

Thank you for your question. Unfortunately, you are not alone when implants are placed on top of the muscle. The skin will just stretch without anything between the implant and the skin envelope. I have a whole gallery of problems associated with implants on top of the muscle. The good news is that you can have attractive breast and keep your implants. You just need to have the implants placed under the muscle and then will need a revision of your lift to remove the excess skin. You should be able to have a beautiful result. Best wishes to you.

Regardless of whether you choose to stay in the same subglandular pocket or place in the subpectoral position, a better choice, you'll need resorbable mesh to secure your implants and avoid recurrent migration/malposition. Go to a better surgeon.

Thank you for your pictures and questions. Sorry to hear you are struggling with this. This can be fixed. You need a more stable implant position, tightening of the pocket to prevent implant migration, and implementation of soft tissue support (I prefer Galaflex for this). You have shown that over time your natural tissue is not going to support the implants, so you need reinforcements. Make sure you see a surgeon with experience with breast implant revision surgery, something we do more than anything else!
Hope this helps!
Dallas Buchanan, MD
VIVIFY plastic surgery
Tampa, FL

You would probably do best placing the implants behind the muscle and repairing the lateral pockets with mesh. The muscle would provide coverage and some support to the weight of the implants. the mesh will help provide support against more lateral displacement. Don't go larger, but you might go down a bit in size.