Why Am I Getting Rippling W/ Silcone Gel Under Muscle and Allomax for Br Revision?

Cap contract 2x 1st w/475 silgel submusc,2nd x 425,3rd reused 425High co/gel w/allomax. 3wks post opp.Good but some rippling on top between breasts above cleav. Feel ripples when lean over under. What causes rippling? Didn't have previous. Also Have 1/8in between imp.Size 34.If I had gone to 450size would I had problems being too close or nip not being placed correctly?Dif in width of impl from 425 to 450 is about 1/8inch. Also dr.felt 450 would increase cont rate slightly. What do U think? Thx

Doctor Answers 1

Recurrent Capsular Contracture and Secondary Problems

Hello Mary,

I am sorry that you are having persistent issues after having capsular contracture twice.  Unfortunately, there is no standard of care based on scientific evidence on how to proceed with someone who has capsular contracture. Therefore, possible treatments number as great as the number of surgeons that perform them, which I know is no solice to you.

Having said that, your complaints include rippling medially and superiorly, as well as a narrow gap between the breasts.  Although you are only three weeks out and need more time to heal, I am unsure if these issues will improve significantly.  These are both expected problems, along with implant dropout/sagging, that occur after treatment of capsular contracture.  Both the problem, capsular contracure, and the treatment, usually capsulectomy, cause thinning and stretching of the tissues, as well as changes to the size and position of the implant pocket.

If you are still unhappy at three months you will probably need a revision surgery.  My recommendation would include placing the implants under the muscle if they aren't already, application of another layer of acellular dermal matrix, significantly decreasing the size of the implants, changing the projection of the implants to an intermediate profile, and possibly a breast lift if necessary.  This may sound drastic or excessive, but the intent is to obtain reasonably pretty breasts that feel good at the expense of compromising on your original aesthetic goals in terms of size or projection.

Best of luck.

Beverly Hills Plastic Surgeon
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