Revision for recalled and misfigured implants? (photo)

Question

I've have naturelle silicone implants 339cc for 11 years now and I have issues with my left breast, there is a corner looking piece of the implant protruding and its causing a lot of pain. I've seen a primary physician and emergency room and they do not know why and ultrasound comes out clear, just benign cysts. My questions are is there a term for whats going on? Will i be able to get a regular replacement through my same scars? There are very wide due to stitch issues during healing

Daniel Barrett, MD · Answer

Dear reese15,

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

Wayne I. Yamahata, MD · Answer

There are many possible explanations for the issues you are having and to provide a definitive diagnosis would require a physical examination. The most likely cause is that you are feeling a small fold in the implant. You have very little tissue coverage in this area. There is a paucity of breast tissue as you get toward the edge of the breast, and you are thin so there is very little fat coverage. You didn't mention if the implant is above or below the muscle, but in this location, you are probably beyond the edge of the muscle. This condition can likely be improved by adjusting the pocket when you replace the implants. This can be done through the existing scars. As an added benefit the scars can be revised at the time.

Paul E. Chasan, MD, FACS · Answer

Thank you for your question. I have been in practice for over 30 years, and breast revision surgery is a large portion of my practice.  It is quite clear that your surgery was not performed adequately.  Additionally the bump is most likely a wrinkle.  You have moderate profile implants which tend to knuckle and wrinkled.  Is also quite possible that you have a ruptured implant.  Ultrasounds are not very accurate in determining rupture. The good news is that you should be able to have an excellent result with Reha augmentation, pocket modification with an internal bra-capsulorrhaphy, and revision mastopexy-lift.  Best wishes to you.

Gerald Minniti, MD, FACS · Answer

I'm sorry to hear that you went to your primary care doc and the ED, and got scanned for something your original surgeon could have diagnosed in 1 second. That lump is a 'knuckle', which is a fold in the implant shell that ends in a point. It appears your implants are over the muscle. If you are unable to see your original surgeon, then you should find a breast revision expert. Your breasts could use a makeover that would give you much better symmetry, finer scars and less noticeable implants.

Gianfranco Frojo, MD · Answer

I would recommend an ultrasound to evaluate the implant. If this is not possible, an MRI to evaluate the breast implants is also adequate but this is more time consuming/more expensive. I would then recommend a potential implant exchange and lift to revise the outcome including the scars.

Gary M. Horndeski, MD · Answer

If the ultrasound shows the implant is intact then it is most likely a benign cyst giving you the problem. You would benefit from a revision of the scars and through the same approach you can change out the implant and remove the benign cyst, if needed.

Best Wishes,

Gary Horndeski, M.D.

Best Wishes,

Gary Horndeski, M.D.

Connie Hiers, MD, FACS · Answer

Your implant is protruding because your breast tissue over that area is thin and has been stretched by the implant. When your implants are exchanged, mesh can be added for better support. Do not go larger or you may develop the same problem, but sooner. Yes, your same scars can be used and revised at the time of surgery. It would have been better to submit a photo with your arms both down by your sides.

Revision for recalled and misfigured implants? (photo)

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