Should I just explant? (Photos)

Question

Thank you to the HCP who answered my last question a few months ago. Now my case has declined. I’m majorly laterally displaced. My implants are only 280 LP+ and are bottoming out below my inframmory fold. Implants only 6 months old. My doctor put implants above muscle. He tells me I have thin skin, and I had a previous bad BA about 8 years ago and have been implant free until 6 months ago, only to have this happen. He said he may want to remove skin on my lower pole and put in mesh attached to my ribs but he said I need to manage my expectations. I detailed my PS on the previous problems and showed pictures yet not capsule was down. Just implanted above muscle and this happened. Should I just explant and try to find a better surgeon in a few years or give up altogether and assume I’ll never have implants?

Daniel Barrett, MD · Answer

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

Gianfranco Frojo, MD · Answer

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.

Gary M. Horndeski, MD · Answer

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.

Paul E. Chasan, MD, FACS · Answer

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.

Gerald Minniti, MD, FACS · Answer

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.

Should I just explant? (Photos)

Answers (7)

Answer: Breast implant revision

Answer: Breast implant revision

Answer: There is no need to explant

Answer: There is no need to explant

Recommended reading

Everything you need to know about Breast Implant Revision

Our mission is to create a world where every investment in modern beauty is Worth It.

Should I just explant? (Photos)

Answers (7)

Answer: Breast implant revision

Answer: Breast implant revision

Answer: There is no need to explant

Answer: There is no need to explant

Browse related questions

Recommended reading

Everything you need to know about Breast Implant Revision

Our mission is to create a world where every investment in modern beauty is Worth It.