Pec repair plus fat or pec repair + new implants - what should I do? (photos)

Question

Recurrent CC on left implant drove me to explant, which then required another capsulectomy, muscle repair + fat transfer just after explant, about 3.5 years ago. Of course, each surgery was peri-areolar and the area under my nipple has been shortened each time, making my right also appear different than left. I would love if muscle repair + fat transfer and mesh could return my breasts to a more natural and symmetrical state, but curious if you believe I can achieve this with fat or implants.

Donald R. Revis Jr, MD · Answer

Good morning,
Fat grafting is a waste of time and money- unpredictable and very little actually survives- beware of any surgeon heavily promoting this technique. Pec repair by itself is also doomed to failure, because it can't really be repaired, only camouflaged- again beware any surgeon who tells you differently. What you really need is a new set of implants and a piece of Strattice mesh on each side- this will result in the best shape, youthful fullness, and will camouflage the residual defects remaining from your previous endeavors.

Gary M. Horndeski, MD · Answer

The technique I recommend is The Bellesoma Method.  This will reshape your breast tissue creating upper pole fullness without implants, elevate them 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.

Kevin Tehrani, MD, FACS · Answer

Thank you for your question and posting appropriate pictures. You certainly have a complex situation which will require complex expertise to repair. I would consider implants with her without mesh as a better option than fat grafting. Of course it is best to be seen in person for an evaluation and to discuss options pertaining to your goals.

Gerald Minniti, MD, FACS · Answer

If you had a surgeon who used an inframammary incision you would have had less than a quarter the risk of either cc or recurrent cc; it's a real shame. Unless you have a heavy lower body, you don't have enough donor fat to transfer, and those tethered scars will not respond as well to fat grafting as they would with replacement of new implants.

Daniel Barrett, MD · Answer

Dear JupitaMoon06,
it is hard to tell for sure without an examination. If you are considering surgery, I would suggest you 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

Pec repair plus fat or pec repair + new implants - what should I do? (photos)

Answers (7)

Answer: Periareolar Incisions were the culprit

Answer: Periareolar Incisions were the culprit

Answer: Breast reconstruction

Answer: Breast reconstruction

Recommended reading

Everything you need to know about Breast Implants

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

Pec repair plus fat or pec repair + new implants - what should I do? (photos)

Answers (7)

Answer: Periareolar Incisions were the culprit

Answer: Periareolar Incisions were the culprit

Answer: Breast reconstruction

Answer: Breast reconstruction

Browse related questions

Recommended reading

Everything you need to know about Breast Implants

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