I have THORACIC OUTLET SYNDROME. Do I need a PS with experience with patients with TOS?

Question

I have had 3 sets, saline in '79, then double lumen in '84, then Mentor Siltex in the 90's. I had neurological issues with my hands in 83, and after was diagnosed recently with TOS. The vascular surgeon thinks that explant might help before considering the more drastic TOS surgery. Do I need to seek out a PS who has experience with women with TOS? Will there be 3 capsules to remove? I want to have explant one time.

Kenneth Hughes, MD · Answer

Calcific capsules or capsules that are distorting anatomy should probably be removed during the implant removal procedure. Leaving a capsule behind is preferred if it is thin and pliable. Removing a capsule unnecessarily could result in bleeding and slight tissue loss. Your PS will require clearance from your vascular surgeon.

Gary M. Horndeski, MD · Answer

Unfortunately, you have not provided photographs or told us your bra size.  However, it is possible that removing the weight of the implants will help with thoracic outlet syndrome, as recommended by your vascular surgeon.  The technique I recommend is explantation and lift using The Bellesoma Method.  The implants are removed, your breast tissue is reshaped creating upper pole fullness, elevated higher on the chest wall and more medial to increase your cleavage.  Vertical scars are avoided, nipple sensation (in 95%) and the ability to breast feed are maintained, if not injured during your previous surgery.  Later, fat transfers can be performed if additional volume is desired.

Best Wishes,

Gary Horndeski, M.D.

Daniel Barrett, MD · Answer

Dear poodlex3,
it is hard to tell for sure without an examination. Generally speaking, if your capsules are thin, then there is no need for capsule removal. If you are considering a surgery, I would suggest you to consult a board-certified plastic surgeon. Only after a thorough examination you will get more information and recommendations.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

Your anesthesiologist needs to be made aware of your issue so your arms and shoulders can be positioned well in surgery. You only have one capsule in each breast. Anything you can do to decrease the weight of your breasts might improve your symptoms, but you still may come to a more involved surgery to correct the issue.  If you are overweight, please loose weight to decrease any additional fat causing pressure.

I have THORACIC OUTLET SYNDROME. Do I need a PS with experience with patients with TOS?

Answers (4)

Answer: Surgery

Answer: Surgery

Recommended reading

Everything you need to know about Breast Implant Removal

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

I have THORACIC OUTLET SYNDROME. Do I need a PS with experience with patients with TOS?

Answers (4)

Answer: Surgery

Answer: Surgery

Browse related questions

Recommended reading

Everything you need to know about Breast Implant Removal

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