Keeping Pockets Open After Breast Implants Revision?

Question

I recently had a bottomed out breast implant revision where my surgeon also cut a larger pocket superiorly. I have been trying to push the implant upwards in an attempt to keep the pocket open, however, it still does not go up as far as the other side (the good side). I am 3 1/2 weeks post-op. Any suggestions would be appreciated. Also, everytime after the displacement practice, my breast feels warmer. Is that normal?

Lavinia K. Chong, MD · Answer

The term "bottoming out" can be applied to a variety of conditions. Usually, this means an elongated distance between the nipple and the base of the breast, which makes the nipples point upwards. This condition could result from the accumulation of scar (capsule) around the implant, which effectively "closes" off the space, which was made. Alternatively, it could be a function of a mismatch between the size and weight of the implant and your breast skin's ability to "hold" the implant in place. Occasionally, changing the implant to either silicone and/or a textured surface or even changing the pocket position may be required. 
It sounds like your surgeon performed a capsulotomy (cut the scar capsule superiorly) to make more space for your implant. It would be hepful to know whether your implants are over or under the chest muscle as well as whether the surgery initially assisted in correcting the "bottoming out". Not to have a negative expectation,however these pices of information would be essential in planning any future surgeries. The warmth you experience, in the absence of redness of the breast skin and pain, is consistent with the recent surgery. By all means, call your doctor if the redness persists and is accompanied by increaing fever and tenderness. Good luck!

Steven Wallach, MD · Answer

WIthout being in the operating room, I do not know exactly what your surgeon did.  If he has you doing displacement exercises then continue as he recommends.

John P. Di Saia, MD · Answer

Hello,
You probably have some persistent capsule/scarring preventing your implant from moving as far on the one side. A revision cannot always make things as soft as the non-affected side. I would have your surgeon take a look to evaluate this. Keep the massage going as he directed as well.

Brian K. Brzowski, MD, FACS · Answer

Ima,
I'd see what you surgeon has to say. If you don't think the implant that was raised still looks too low, it might be a little worrisome.
I have a hard time believing that the portion of the implant pocket that was released has already scarred closed if you've been doing your exercises, so don't be too worried. Did your plastic surgeon do anything down low to support the bottomed out breast? One usually needs to do so.
Good question about the warmth. Shouldn't mean anything beyond you creating some warmth from the friction of the massaging. I assume that this feeling goes away afterward.

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question. I do understand your concern and you should see your surgeon to discuss this.

	I do have my patients do Breast Implant Displacement Exercises to try to keep their Breast Implant pocket open.

	It sounds as though you are doing this, be sure your surgeon approves.

	Displacement exercises are your best option.

	If the implant was "bottomed out" meaning that the implant was too low, and the position after your revision looks good, I would not be too worried about limitation of upward implant mobility.

	

	If the implant is tightening up after the revision, capsule formation is a concern and you should talk to your surgeon about treatment options.

Keeping Pockets Open After Breast Implants Revision?

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