My implants have dropped below the crease. Is a revision worthwhile? (Photos)

Question

I had an augmentation 6 months ago and my implants have dropped considerably. I have pectus excavatum predominantly on my right side. To combat this my doctor chose 345cc on the left and 275 on the right. My nipples were positioned on the higher side pre surgery and I had very little breast tissue. Now that they have dropped or bottomed out, my scars are very visible, my nipples sit very high making it challenging to wear low cut tops, and the implants appear uneven now that they sit below my chest deformity. I also see some noticeable Rippling and have concerns of left side capular contractor. Let me know your thoughts.

Tyler Frew, MD · Answer

Hi there,
Yes you are bottomed out and need a revision. The pockets should be opened up medial and superior while reinforcing the inferior and lateral pockets 
All the best

Paul E. Chasan, MD, FACS · Answer

Thank you for your question.  I have been in practice for over 30 years, and revisionary breast surgery is a large portion of my practice.  You have the classic bottoming out or inferior malposition of your breast implants.  Your surgeon placed your implants below the inframammary crease, and therefore there is no support there.  You will require an internal bra-capsulorrhaphy procedure.  I wrote the very first paper on this in 1999.  I have done thousands of the surgeries.  You should be able to have an excellent result.  Best wishes to you.

Waylon Zeng, MD · Answer

Hi there, thank you so much for your question, and thank you for taking the time to share you photos. What you are describing and showing is called a "double-bubble deformity". This happens when the structure layer of the bottom crease/fold of the breast was disrupted during surgery. I can appreciate that this causes concern for you, and this can be sometimes challenging to fix. A revision would involve tightening the pocket around the breast implant and then reinforcing the bottom part to the fold to prevent it from dropping. I will typically use an internal mesh in this case to reinforce the area as well. 
As far as capsular contracture is concerned, this is hard to tell from the photo. However, if you feel that one side is becoming a lot more firm than the other side, this could be an early sign of cap con.

My implants have dropped below the crease. Is a revision worthwhile? (Photos)

Answers (3)

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