Third surgery with same implants. Risk of capsular contracture? (Photo)

Smooth 304cc Natrelle implants submuscular. There was slight bottoming out noticeable within a few weeks of surgery. Ps performed revision to suture bottom of pocket & implants fell again in a few weeks. Im having surgery with a new ps who'll re-create my pocket and possibly use Seri. Is it ok to use implants again? He claims there is a high risk for CC but the revision is so expensive I'm not sure I can afford $1500 to replace with exact same implants. Would it be foolish not to replace?

Doctor Answers 4

Capsular Contracture

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If you are going in for your third revision, it would likely be best to also change out the implants.  You want to remove as many factors as possible to ensure an optimized outcome.  However, you should discuss all your options with your surgery.

Good luck

No ones knows for sure

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we do not know exactly why some pts get cap con and others don't. We do know, sub muscular placement, textured implant and ADM help prevent it. Not many surgeons using seri anymore, might want to ask about other mesh substitutes. 

Implants and capsule repair

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If it is solely to repair a bottoming out, then it is probably ok to use the same implants, but there is a risk of damage to the implants upon removal and replacement.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Bottomed out implants

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Hello and thank you for the question and the photos. Your photos show mild bottoming out. This is both a physics problem and a biologic problem. Gravity, exercise running etc.. all put downward pressure on the implants. Over time, this problem affects a small % of patients. The second factor is biologic. How your body heals, how strong your scar tissue and capsule form are factors that keep the implant where it was originally placed. Sometimes this is a genetic issue and sometimes it's environmental / dietary. A healthy high protein diet is a good idea both before and after surgery. 

My recommendation: 

1. I would suggest a switch to textured gel implants. Textured implants do not move as much as smooth. The risk of bottoming out is very low with textured. There are trade offs but in your case, it is the better option.

2. Capsulorraphy: tighten the excess capsule and make sure the upper capsule is loose enough to accommodate the implant in a higher position. 

3. Your pics show the implant to be ABOVE the muscle, not submuscular. If that is true, you will need to have them repositioned under the muscle. 

4. You appear thin and athletic. Commonly there isn't enough soft tissue under the breast to hold it up. Second, make sure you use an under breast wrap to prevent downward migration. 

5. NO exercise especially impact exercises ( running, jogging, crossfit, etc... ) for at least 2 months after surgery. 

As always, best to be healthy, no smoking, and make sure any health conditions you have are managed by your primary care md.

Best to you.

Bennett Yang, MD
Rockville Plastic Surgeon
4.8 out of 5 stars 21 reviews

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