Rippling and position of implants. What are my options?

Question

Many years ago I had a double mast because of fibroids. I recently had the old implants replaced with Natrelle silicone implants. I have a tremendous amount of rippling and my new implants move position to my side when I lay down. I am so unhappy with the results. What are my options if I have any?

Lewis Albert Andres, MD · Answer

Hello!  Thank you for your question!  There are various options available to you and you should discuss your concerns, expectations and options with your plastic surgeon.  Given that rippling and malposition are your only complaints and not experiencing other issues with your reconstruction, incisions, or implants, several things may be available:1) Fat grafting may be an option to improve contour and shape to your breasts2) Revision of your reconstructed breasts with closure of your breast pocket laterally in order to improve shape and position of your reconstructed breasts3) Exchange of your implants/capsulectomy4) Use of acellular dermal matrix5) Aborting your implant reconstruction for a flap-based breast reconstruction6) Being content with your appearance7) Removal of your implantsDiscuss your concerns and complaints with your plastic surgeon who will assist you in deciding which option may be the right thing for you to meet your expectations.  Best wishes for a wonderful result!

Robert Whitfield, MD · Answer

Three
basic forms of breast reconstruction exist. You can use your own tissue,
implants or a combination of the previous two techniques. Your own tissue can
be used in the form of the DIEP flap, PAP flap, SGAP flap or fat grafting.
Implants can be done in one stage or two stage. Two stage reconstructions are
started by placing expanders at the time of mastectomy. Once they expanders are
placed they are able to be inflated as determined by wound healing. The final
time consists of combining any of the above techniques.

If
you are interested in being seen in Austin please give us a call.  I know
this is a difficult time for you.  The majority of my practice is devoted
to reconstruction for women with breast cancer or who are BRCA+

Samir Shureih, MD · Answer

Breast implants can ripple for many reasons, thin coverage, folds of the implant and saline implants will ripple.When implants fall to the side then there is malposition of the implant. Both can be corrected with surgery.Samir Shureih MD. FACSsshureih@msn.com

Karen Vaniver, MD (in memoriam) · Answer

The causes of wrippling after breast reconstruction include wrinkling of the implant, thinning of the overlying skin from mastectomy or capsulectomy in implant replacement, and stretching or disruption of the breast pocket.You have two options. The first is to work with your current situation. Techniques such as tightening of the loose pocket and covering wrinkling can be obtained by making sure the implant is under the muscle and reinforcing and camouflaging the pocket with Strattice. Fat grafting can also be very effective for filling wrippling areas and depressions. These are generally outpatient surgeries.The second option is to remove the implants and replace them with your own tissue. This can be accomplished by flaps from your abdomen (TRAM, DIEP), buttocks (GAP), and others. The surgery time and recovery downtime is much longer, but may result in permanent change. You may also be confronted with more scars and donor site issues.

Rippling and position of implants. What are my options?

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