Over dissected breast implant pockets. Side effects/complications to closing them up on sides? (photo)

An in-person exam is critical in making these decisions - I would guess that a breast lift with small volume breast reduction would reduce the surface area of your breasts, remove the sagging breast tissue that you have and improve your overall breast cosmetic appearance.

Thank you for your question and photo. A number of patients come to my practice each year that unfortunately have this problem. Repairing the inside of the pocket with sutures to make it smaller (capsulorrhaphy) has been very successful. In some instances in addition to the suturing, I reinforce the repair with a "mesh" material to make the repair even stronger. Any surgery carries risk and damage to the sensory nerves is one of them, however relatively unlikely. Best of luck, Dr. Kludt

Implant pocket modification, particularly closing the pocket down, can be very tricky.  The surgeon who warned about nerve damage and recurrence of the problem after 6 months is being very honest about the difficulty of this procedure.  There are products such as SERI surgical scaffolding and acellular dermal matrix (several types) that can be used to support the implants and rely less on the stitches placed.  Again, this is tricky surgery.  One other issue with you is that your photos indicate that you would likely benefit a lot from a breast lift.  I think you have a pocket problem and a skin laxity problem.  I would recommend you find a surgeon who has a lot of experience with implant revision.  This is difficult surgery I would be a little put off by a surgeon who thinks this is an easy procedure.  But then again, I don't think anything is easy!

I do not think it is reasonable to label your problem as being related to over dissected breast implant pockets without at least seeing preoperative photographs of you.  Reviewing the one photograph that you posted suggests to me that you would be a good candidate for mastopexy possibly with some degree of internal capsulorrhaphy.  I have yet to see chronic pain develop as a result of the surgery but it is remotely possible though unlikely.  Reducing your skin, lifting your nipple areolar complexes and exchanging to similar or possibly smaller pair of implants would be my first consideration for you.  Keep in mind that this is based on a review of a single photo and my opinion might be different seeing a patient similar to yourself in person.  Best wishes and good luck to you in making your choice,Jon A Perlman M.D., FACSDiplomate, American Board of Plastic SurgeryMember, American Society for Aesthetic Plastic Surgery (ASAPS)ABC-TV Extreme Makeover SurgeonBeverly Hills, California

I have several patients a year come to the office to have this problem corrected and it's pretty straight forward for an experienced surgeon. I haven't seen the sutures pull out but they do have to be placed correctly to prevent that issue. All surgical procedures have risk and nerve damage is an infrequently seen risk of this type of surgery and all other cosmetic breast operations.