Why is my Right Implant Riding So EXTREMELY High 4 Weeks Post Op for Revision? Hoping to Not Have to Do Another Revision (photo)

Original surgery was in 4/2012 with full lift and 550cc saline implant under the muscle.6 months in had to remove right implant completely for severe CC. Implant stayed out for 3 months and replaced 4 wks ago under muscle. Now its has not bugded at all and is hard to disguise to to deformation. PS says I may need a pocket rivision due to it closing back up on it's own or it may just be extreme swelling of the muscle. I do still have lots of tenderness in the lower parts not filled.

Doctor Answers 10

Implant remains high after revision

We don't have enough information to follow just where the problem is but the photo tells us clearly that things are not as they should be. The implant is high in the breast and the lower breast envelope is empty. It is nice to have confidence in your surgeon, however other opinions might be a good idea.

Chicago Plastic Surgeon
4.0 out of 5 stars 42 reviews

Breast Asymmetry after Revisionary Breast Surgery?

I'm sorry to hear about the problems you have experienced after breast surgery. Unfortunately, at this point there is not much to do except continue to exercise patience and continue  to follow-up with your plastic surgeon.

 Based on your photograph and experience, it is very likely that additional surgery will be necessary to lower the high riding breast implant.

 Best wishes.

Tom J. Pousti, MD, FACS
San Diego Plastic Surgeon
5.0 out of 5 stars 1,488 reviews

Why is my Right Implant Riding So EXTREMELY High 4 Weeks Post Op for Revision

Thank you for your question and for the posted photos. It would be helpful to know if this implant looked this way the day of surgery, or only later. If the breasts looked symmetric in the recovery room, I would have more optimism about improvement.

At any rate, it is too early to think about a revision--too hard to know what to do at this stage. You will need some patience and wait at least 3 months. If the scarring from the CC has made the muscle uncompliant, moving the implants above the muscle and under the fascia may be a consideration. 

Follow with your surgeon. All the best. 

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews

Implant riding high after revision, solutions?

Thank you for your question and photos. Although I would not intervene surgically right now, you will need another revision. The reasons for capsular contracture are many, but some are secondary to the technique and some are due to the way your body heals and forms scars. I believe the second reason is less likely, since I would expect that you would have this healing issue on both sides. If it is a malposition, the implant will need to be brought down surgically. With time the lower pole of the breast will tighten and tend to pull up against the implant. One option might be to Botox the muscle to help it relax and hopefully have your implant come down. Work with your plastic surgeon. Good luck.

George Marosan, MD
Bellevue Plastic Surgeon
4.8 out of 5 stars 38 reviews

Breast implant revision

I would have hoped you would be looking better at this point but all you can do for now is to trust your doctor and follow his/her advice and give things 6 months to settle.  At that point the result will be apparent.  Please also realize that scar tissue (CC), is the biggest problem we face in implant surgery and that it is your body doing it.  Sometimes there is just nothing the surgeon can do that your body won't foil with scar tissue.  I hope all the scar was removed when the implant was taken out.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Why is my Right Implant Riding So EXTREMELY High 4 Weeks Post Op for Revision? Hoping to Not Have to Do Another Revision

Hello! Thank you for your question! You are still early post-procedure. Your appearance looks typical at this stage and will continue to improve as the swelling subsides and the implants continue to settle into their desired position. This usually proceeds over the next several weeks as the lower pole skin/breast stretches to accommodate the implants. Follow-up closely with your surgeon for additional restrictions/instructions and the potential use of bras/garments or massage that may encourage the implant to settle appropriately.  However, given description and appearance, it is likely that a revision will be required along with consideration for dermal matrix after your revision/capaulectomy.  Hope that this helps! Best wishes!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 26 reviews

Implant High After Revision

   The implant could be high due to release issues, capsular contracture, or possible muscle spasm.  Kenneth Hughes, MD Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

Right implant issue

With the implants very high at 4 weeks, it may represent inadequate release of the muscle, or possible capsular contracture. Best to follow closely with your surgeon.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

Why is my Right Implant Riding So EXTREMELY High 4 Weeks Post Op for Revision? Hoping to Not Have to Do Another Revision

Something is missing in your story as seen in the posted photos. Best plan is to seek second opinions and YES you will need reconstruction of the right breast. Either with skin/muscle flap reconstruction, tissue expansion, use of BRAVA with fat grafts, or a combination. Sorry

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Implant high

Hi QueenB,

     Your right implant is high either because you are developing capsular contracture again or other causes are responsible for keeping it up.  These other causes could include inadequate muscle release, inadequate removal of previous capsule, residual scar tissue, hematoma, or seroma.  Undergoing examination  and knowing what your previous plastic surgeon did would help.  Regardless  of the cause, it is hard for me to imagine that your right implant will drop over time to such an extent that it would closely match your left breast.  It is not impossible, but highly unlikely.    In my opinion you will need a revision.  That revision should involve a complete capsulectomy with exchange of implants.  I would wait several months, three to six, preferably.

     If, after the above treatment, you still develop capsules, then the surgery should be repeated, this time using dermal matrix graft.

Good luck,

Ary Krau MD FACS

Ary Krau, MD, FACS
Miami Plastic Surgeon
4.8 out of 5 stars 319 reviews

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.